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Turkington, Douglas. "Cognitive-behavioural therapy (CBT) for schizophrenia". Thesis, University of Newcastle upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271209.
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Farrelly, Robert. "Clients experinces of cognitive behavioural therapy". Thesis, University of Oxford, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531832.
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Williams, Clare Anne. "Belief change in cognitive-behavioural therapy". Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326777.
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Jenkins, Hannah. "An exploration of cognitive behavioural therapy training". Thesis, Cardiff University, 2017. http://orca.cf.ac.uk/104375/.
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This thesis contains an exploration of Cognitive Behavioural Therapy (CBT) training. Paper one consists of a systematic review of 13 studies exploring the experience of CBT training. Findings were categorised into four themes; the exploration of Self-practice/Self-reflection, internal processes throughout CBT training, perceived effective components of CBT training, and general satisfaction with CBT training. Overall the findings concluded that CBT training is experienced in a relatively positive way, however, the journey can be difficult for students at times. The review revealed a clear gap in the literature regarding the general experience of CBT training, with no imposed focuses or pre-conceived themes. Implications for students, training course providers and commissioners are discussed. Paper two describes an empirical study conducted on eight students pre and post their postgraduate Diploma in CBT. Personal construct theory and the repertory grid technique were employed to capture students’ experience of training and their construal of their personal and professional development. Findings reported that whilst participants construed themselves as closer to ‘desirable’ elements post training, these differences were not statistically significant. A statistical difference was observed however, in participants’ perception of an ‘Ideal therapist’ post training. Implications for CBT training programmes are discussed and findings related to the political context both in Wales and the rest of the UK. Paper three presents a critical reflection and evaluation of the first two papers, including the authors’ personal reflections on the research process overall and her own experience of postgraduate, professional training in Clinical Psychology.
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Brown, Shona Lynsey. "Cognitive behavioural therapy for non-cardiac chest pain". Thesis, University of Edinburgh, 2013. http://hdl.handle.net/1842/9722.
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Objectives: This thesis aims to explore evidence for the effectiveness of cognitive behavioural therapy (CBT) for non-cardiac chest pain (NCCP). Design: The systematic review aimed to evaluate evidence for CBT as an effective intervention for anxiety in the NCCP population. Study one describes the chest pain characteristics, illness beliefs and prevalence of anxiety in a NCCP sample in a cross-sectional design. Study two explores the acceptability and clinical effectiveness of a CBT-based self-help intervention for NCCP patients, using a between subjects, repeated measures design. Methods: A systematic review was completed via a comprehensive literature search for comparative studies examining CBT-based interventions for NCCP including a measure of anxiety. In the empirical study, participants completed measures of anxiety, illness beliefs and indices of chest pain (self-reported frequency, severity and impact on activities) at baseline. Comparisons between illness beliefs and anxiety were undertaken using descriptive statistics and Pearson correlations. Participants were randomised to receive a CBT-based self-help intervention booklet or treatment as usual, with questionnaires re-administered at three-month follow-up. ANOVAs were used to evaluate whether the intervention led to improvements in anxiety levels, or increased belief in participants’ personal control of symptoms. Results: Ten studies met inclusion criteria for the systematic review, with four studies showing evidence regarding the effectiveness of CBT for anxiety. Approximately two thirds of the thesis research sample reported on-going pain following clinic attendance, for the majority this was ‘very mild’ or ‘mild’ pain. Almost half (47%) reported experiencing clinically significant anxiety. Stress was the most common causal attribution advocated by the sample to explain their chest pain. Anxiety scores were significantly associated with psychological attribution scores, but not with personal control or illness coherence beliefs. In study two, 87 participants completed the study and ITT analyses were completed on 119. There were no significant differences between the groups in terms of reduced anxiety or self-reported belief in personal control of symptoms. The intervention booklet was evaluated largely positively by those who reported reading it. Conclusions: CBT-based self-help appears an acceptable intervention for those diagnosed with NCCP. Further research is needed to identify those who are most likely to benefit from such self-help intervention.
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Linna, Sari J. "Therapist responsiveness in cognitive-behavioural therapy for depression". Thesis, University of Sheffield, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.680096.
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Stubbings, Daniel R. "The effectiveness of videoconference-based cognitive-behavioural therapy". Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/2111.
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The purpose of this research was to expand scientific understanding regarding the use of videoconferencing technology to administer psychological services. The primary study in this thesis is a randomised-controlled trial comparing in-person to videoconference-based Cognitive-Behavioural Therapy (CBT). This study is, to the author’s knowledge, the largest clinical trial investigating the effectiveness of CBT via videoconference that has been conducted on an adult population in Australia. Twenty-nine clients were recruited who had a primary DSM-IV diagnosis of anxiety and/or depression. Participants were randomly assigned to receive 12 sessions of either in-person or videoconference-based treatment. Participants in both conditions received treatment at a university clinic in Perth Western Australia.The intervention provided was based on CBT manualised treatments but individualised to suit the unique needs of each client. Primary symptomology and quality of life was measured pre, post and 6-weeks following treatment. Secondary outcome measures included working alliance, credibility of therapy and client satisfaction. Overall, retention in both treatment conditions was similar. Statistical analysis using multi-level linear modelling indicated a significant reduction in client symptoms across time but no significant differences between treatment conditions. There were also no significant differences between conditions on working alliance, credibility of therapy and client satisfaction ratings. The findings of study one suggest that CBT via videoconference can be effectively provided in a real-world clinical practice context.The second study in this thesis is an in-depth case study of a client with severe and complex obsessive-compulsive disorder who received forty sessions of psychotherapy administered through a mix of videoconference and text-chat. Session recordings, transcripts and therapists notes were analysed using thematic analysis to explore how the technology influenced client engagement. The results indicated that the mixture of videoconferencing and text-chat might have facilitated client engagement by helping to reduce interpersonal anxiety, thus allowing the client to continue disclosing and discussing issues that were espoused in shame, guilt and embarrassment. To the author’s knowledge, the methods of engaging the client via combined videoconference and text-chat reported in study two have not been reported in the literature before.
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Gower, Philip. "Therapist competence, case conceptualisation and therapy outcome in cognitive behavioural therapy". Thesis, University of Exeter, 2011. http://hdl.handle.net/10036/3275.
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Clients rarely present with prototypical presentations for which an “off the shelf” cognitive-behavioural therapy (CBT) approach can be used, and the most frequently cited rationale for case conceptualisation is matching clients’ unique presentations and therapy goals with available theory and research. In this, it is argued that case conceptualisation guides therapy by ensuring that individual cognitive and behavioural processes are targeted, thereby maximising therapy efficacy. Therefore, therapists who are competent in case conceptualisation should achieve better outcomes. However, little is known about the relationship between competency in case conceptualisation and general CBT competence, or how competency in case conceptualisation is linked to therapy outcome. Forty audiotapes selected from an ongoing study (CoBalT: Cognitive Behavioural Therapy as an adjunct to Pharmacotherapy for Treatment Resistant Depression in Primary Care: a randomised controlled trial) were rated for competency in case conceptualisation and competence in CBT using the Collaborative Case Conceptualisation – Rating Scale (CCC-RS) and Cognitive Therapy Scale – Revised (CTS-R) respectively. The assessment of competence was carried out by independent groups of researchers with expertise in these assessments, blind to treatment outcome. Therapy outcome was measured using The Beck Depression Inventory II (BDI-II). The results showed that 1) competence in case conceptualisation shared a strong and positive relationship with general CBT competence and, 2) that competence (in case conceptualisation and general CBT competence) was associated with better treatment outcome for depression. The results highlight competence in case conceptualisation as an important facet of therapist CBT competence, and indicate that investing in the training and selection of therapists competent in case conceptualisation as well as CBT competence has the potential to enhance treatment outcomes.
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Marino, Alfonso. "Treating chronic insomnia, a cognitive-behavioural group therapy approach". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ63577.pdf.
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Searson, Ruth. "Cognitive-behavioural therapy for bipolar disorder : a case series". Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.505523.
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Frzina, Jasmina. "Clients' experiences of relational depth within Cognitive Behavioural Therapy". Thesis, University of Manchester, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.632306.
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Background: Relational depth (RD) is gaining empirical attention as a well-articulated phenomenon within therapeutic relationship literature. Despite this, with the exception of a small number of client-focused studies, research of this issue is relatively sparse and predominantly reflects upon therapeutic work from a person-centred orientation. Aims and Methods: The aim of this research was to explore clients’ experiences of RD within individual Cognitive Behavioural Therapy. Eight clients, who had self-identified at least one helpful relational moment with their therapist, were interviewed about their experience. The interviews were transcribed and analysed employing Grounded Theory methods. Findings and Discussion: Four core categories emerged from the analysis. These were: (1) the experience of the therapist, (2) the experience of self, (3) the experience of the therapy relationship, and (4) the perceived impact/effects of the moment of RD. Each core category and the corresponding subordinate codes are described by illustrative quotes from the participants. Following this, each finding is discussed in relation to RD research and beyond. Conclusions: This research project ultimately demonstrates that clients who have worked with a cognitive behavioural therapist can and do experience RD during their individual therapy. The like-by-like comparison of the findings with previous RD research indicated a high degree of convergence. Nevertheless, when differences are present, clients’ RD experience is influenced and to some extent contained by dissimilarity in experience between therapist and non-therapist clients. This is also manifested through theoretical differences of the given therapeutic approach. No negative impact or effect was described by the clients as a result of their experience of a moment of RD. The implications of the findings are highlighted and future research is suggested.
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Burchardt, Francis. "Client experience of the formulation within cognitive behavioural therapy". Thesis, University of Sheffield, 2004. http://etheses.whiterose.ac.uk/14860/.
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Section I: Literature Review A literature review examining the relationship between the formulation and the therapeutic alliance in cognitive behavioural therapy. Various 'definitions' of the formulation are reported, and the relative roles and merits of 'nomothetic' and 'idiosyncratic' formulations considered. The function of the formulation is considered in relation to its development in conjunction with the therapeutic relationship and alliance. Research and clinical case reviews are critiqued. Section II: Research Report An Interpretative Phenomenological Analysis of clients' experience of the formulation within cognitive-behavioural therapy. A sample of(N=8) of clients with depression and/or anxiety were interviewed following the 'acute phase' ofCBT during 'follow-up'. Interviews provided five master themes: Somebody that listened and understood - trust in therapist; Understanding what happens; A Foundation and Direction - Something to start from, something to work on; Working to a plan; and Effectiveness and Self -efficacy. These master themes and associated sub-themes represent clients' experience of progress through therapy and the experience and process of formulation. Section III: Critical Appraisal A critical appraisal describing the origin, planning and process of the research, personal reflection and experience gained.
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Steyn, Katharine Mary. "Posttraumatic stress disorder, its sequelae and cognitive behavioural therapy as an appropriate therapy". Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50062.
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Thesis (MA)--University of Stellenbosch, 2004.ENGLISH ABSTRACT: Posttraumatic stress Disorder (PTSD) has been researched and written about since its recognition as a disorder in the DSM-III in 1980. This study reviews the literature on PTSD and cognitive behavioural therapies, designed for its treatment. It covers the historical aspects of how the syndrome came to be identified, defined and recognized as a discrete disorder. The neurobiological features of the disorder, its cognitive processes, particularly those of dissociation and traumatic memory are dealt with. Cognitive behavioural therapies are reviewed, these include: relaxation; hypnosis; exposure; eye movement desensitization reprocessing; anxiety management training; cognitive therapy and combination therapies. Further areas for research are suggested based on the lacunae that have yet to be explored with regard to cognitive behavioral therapy treatments.
AFRIKAANSE OPSOMMING: Posttraumatiesestressversteuring is nagevors en bespreek vandat dit in 1980 in die DSM-III as 'n versteuring herken is. Hierdie studie gee 'n oorsig van die literatuur oor PTSVen kognitiewe gedragsterapeutiese, ontwerp om dit te behandel. Dit gee 'n historiese oorsig van hoe dit geïdentifiseer, beskryf en gedefinieër is as 'n spesifieke gedragsversteuring. Die neurobiologiese implikasies van die versteuring, die kognitiewe kenmerke, veral die van dissosiasie en traumatiese geheue word ondersoek. Kognitiewe gedragsterapieword beskryf en sluit die volgende in: ontspanning; blootstelling, oogbewegingdesensiteringherprosering; angsbeheeropleiding; kognitiewe terapie en kombinasie terapie. Verdere areas vir navorsing word voorgestel en is gebasseer op die gebrekke wat bestaan in kognitiewebedragsterapie.
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Aspland, Helen C. "Resolving ruptures in the therapeutic alliance in cognitive behavioural therapy". Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275191.
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Hansen, L. K. "The influence of cognitive-behavioural therapy on suicidality in schizophrenia". Thesis, University of Southampton, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.416492.
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Levi, Nina. "The power of the therapeutic relationship in Cognitive Behavioural Therapy". Thesis, City University London, 2010. http://openaccess.city.ac.uk/8703/.
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As the Cognitive Behavioural Therapy (CBT) model has developed in recent years, so has the role of the therapeutic relationship within that model. This portfolio aims to uncover aspects of the therapeutic relationship in CBT as it is practiced nowadays. The first section presents an overview in which the different parts included in this portfolio are briefly described, and the way in which they are linked together is outlined. The second section, the research component, explores qualitatively Counselling Psychologists' experience of the therapeutic relationship while practicing CBT. This section aims to provide the reader with insights from the therapists' perspective, which has been a largely neglected variable in the literature. The third section represents the clinical component and gives a vivid account of CBT with a client with anger issues. Finally, the fourth section, the critical literature review, presents the role of empathy in the cognitive behavioural treatment of depression. As a whole, the portfolio provides a broad view of different perspectives of the therapeutic relationship in CBT, and aims to increase awareness among researchers and therapists of how the research findings can be of use for clinical practice.
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Bergman, Nordgren Lise. "Individually tailored internet-based cognitive behavioural therapy for anxiety disorders". Doctoral thesis, Linköpings universitet, Psykologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-100969.
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Fear is an innate emotion and an adaptive response to provide protection from potential harm. When fear is excessive and out of proportion in relation to the confronted situation, it can lead to the development of an anxiety disorder. Many individuals feel anxious at some point, but not all experience clinical anxiety or meet the diagnostic criteria of an anxiety disorder. Still, anxiety disorders are the most prevalent form of psychiatric disorder in the general population. More often than not people suffering from one anxiety disorder also present other psychiatric conditions. As of today, cognitive and behavioural treatments have been tested and found to positively affect anxiety disorders, making them the treatment of choice. Nevertheless, many patients do not seek or receive adequate treatment. One common critique of the research trials from which the recommendations for treatments stem is the use of a single protocol targeting only one diagnosis. This is because many people suffer from comorbidities. Another problem connected to the recommendation that cognitive behavioural therapy (CBT) should be the treatment of choice for anxiety disorders is the lack of therapists with adequate training. One possible way of dealing both with the shortcoming of therapists and making CBT more accessible is the use of the Internet. Internet-based CBT (ICBT) has been tested in numerous trials during the last 15 years, showing positive outcomes for a large variety of disorders. Many ICBT trials also make use of a single protocol. Another way of dealing with comorbidities might be to tailor the treatment to let characteristics and preferences of the patient guide the design of the protocol. Little is known about possible effects of tailoring the ICBT, the effects of therapeutic relationships in ICBT, and the effectiveness and cost-effectiveness of these treatments. This thesis is based on three studies on two separate randomized controlled trials (RCTs) using the same set of modules accessible for the tailored protocol. Study I was an RCT investigating treatment effects up to two-year after completion, showing favourable outcomes of the treatment in a self-recruited sample at all measure points. Study II was a secondary analysis exploring possible relations between working alliance and treatment outcome for participants in the treatment group recruited for Study I indicating that working alliance predict outcome in this tailored treatment. The second RCT was an effectiveness trial (Study III) analysing treatment effects and cost-effectiveness of the treatment up to one year post treatment in a primary-care population. This study showed positive treatment effects both regarding symptom reduction and cost-effectiveness, and that effects were sustained at one year post treatment. Conclusions drawn from these studies are that individually tailored ICBT seems to be a feasible approach for patients with anxiety disorders regardless of comorbidities, and a responsible choice in terms of societal costs.Rädsla är en medfödd känsla och en adaptiv respons för att skydda organismen från potentiell skada. När rädslan blir överdriven och oproportionerlig i relation till den konfronterade situationen, kan det leda till utvecklandet av ångestsyndrom. Många personer upplever någon gång ångest, men inte alla upplever klinisk ångest eller uppfyller de diagnostiska kriterierna för något ångestsyndrom. Trots detta är ångest det vanligaste psykiatriska tillståndet i befolkningen i stort och oftast uppfyller personer som lider av ett ångestsyndrom även andra psykiatriska tillstånd. Till dags dato har både kognitiva och beteendeinriktade behandlingar testats och visat sig verksamma vid ångestproblem, vilket gjort dem till de behandlingar som rekommenderas för dessa tillstånd. Trots god effekt av behandling söker många patienter ändå inte hjälp, alternativt erhåller inte adekvat behandling. En vanlig kritik mot den forskning från vilka behandlingsrekommendationerna för ångestsyndrom stammar är att många använt en manual eller ett protokoll som riktar sig mot bara en diagnos. Detta på grund av den stora komorbiditeten. Ett annat problem kopplat till rekommendationerna att kognitiv beteendeterapi (KBT) ska vara förstahandsval vid behandling av ångest är bristen på behandlare med adekvat utbildning. Ett möjligt sätt att göra KBT mer tillgängligt är att använda Internet. Internet- förmedlad KBT (IKBT) har prövats i ett stort antal studier de senaste 15 åren dessa har visat positiva resultat vid ett stort antal psykiatriska tillstånd. Flertalet av dessa studier har dock använt ett enda behandlingsprotokoll. En annan möjlighet att hantera komorbiditet kan vara att skräddarsy behandlingen för att låta patientens egenskaper och preferenser vara med och styra utformningen av behandlingsprotokollet. Möjliga effekter av att skräddarsy IKBT är relativt lite undersökt, likaså effekterna av terapeutiska relationer i IKBT samt klinisk effektivitet och kostnadseffektiviteten för dessa behandlingar. Denna avhandling bygger på tre studier från två randomiserade kontrollerade studier med samma uppsättning av moduler tillgängliga för att skräddarsy behandlingsprotokollen. I Studie I undersöktes behandlingseffekter upp till två år efter avslutad behandling i en självrekryterad grupp patienter. Studie II var en sekundäranalys av behandlingsgruppen från Studie I där eventuella samband mellan arbetsallians och behandlingsresultat undersöktes. Den andra randomiserade kontrollerade studien var en prövning av huruvida denna behandling var effektiv för en klinisk population (Studie III) rekryterad via primärvården. Förutom behandlingseffekter undersöktes även kostnadseffektiviteten upp till ett år efter behandlingsavslut. De slutsatser som dras utifrån dessa studier är att skräddarsydd IKBT verkar vara en framkomlig väg för patienter med ångest oavsett komorbiditet, att arbetsalliansen kan vara en faktor som påverkar utfallet, samt att det är ett ansvarsfullt val vad gäller samhälleliga kostnader.
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Morgan, Louise. "Exploring homework in second and third wave cognitive behavioural therapy". Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7723/.
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Volume one Volume one of the thesis comprises of three research chapters examining the use of therapeutic homework in second and third wave cognitive behavioural therapy. The first chapter is a correlational meta-analysis examining the relationship between mindfulness homework and improvement over a mindfulness course. The second chapter is an empirical study exploring the phenomenological experience of cognitive behavioural psychotherapists in using therapeutic homework. The final chapter is a public dissemination document providing an accessible summary of the meta-analysis and empirical paper. Volume two Volume two of the thesis consists of five clinical practice reports. The first report presents a cognitive behavioural and psychodynamic formulation of low self-esteem in an 18 year-old man. The second report evaluates the care package received by cluster eight clients in an adult mental health service. The third report describes a cognitive behavioural and systemic narrative intervention with a 72 year-old woman experiencing health anxiety. The fourth report presents a single-case experimental design to investigate the effectiveness of a behavioural intervention for challenging behaviour in a 32 year-old man with Rubinstein-Taybi Syndrome. The final report is an abstract of an oral presentation of clinical work completed in an early intervention service.
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Clark, Gavin. "A transdiagnostic approach to cognitive-behavioural therapy for anxiety disorders". Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.510417.
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Hall, Josephine. "Cognitive behavioural therapy for older adults with generalised anxiety disorder". Thesis, University of Sheffield, 2016. http://etheses.whiterose.ac.uk/13859/.
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Cognitive behavioural therapy (CBT) and applied relaxation are the recommended talking treatments for generalised anxiety disorder (GAD) in adults. No specific recommendations are currently available for older adults with GAD due to paucity of evidence. In order to contribute to the GAD older adult evidence base (1) a meta-analysis of clinical trials has been performed and (2) a case series of providing group CBT has been conducted. The first part of the thesis reports a meta-analytic review of 14 randomized controlled trials of CBT for GAD in older adults. Results showed CBT to be an effective treatment, but did not provide conclusive evidence of superiority of CBT against other evidenced-based psychotherapies. Avenues for the continued methodological development of field are discussed. The second part of the thesis presents a case series study evaluating group delivery of an existing GAD treatment protocol with older adults. The focus of the study was on feasibility, acceptability and effectiveness. Mixed methods were used across the three main study phases (baseline, intervention and follow-up) with N=23 eligible participants. Participant dropout was low, homework compliance high, and large treatment effects on the primary outcome measure of worry were found. Merged findings suggested the group intervention was an acceptable, feasible, effective, and durable treatment option. The potential of group interventions for late life GAD are discussed. Taken together, the two studies suggest that group format does not reduce the acceptability and effectiveness of treatment, and provide an opportunity for delivery of cost-effective treatment for older adults with GAD.
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Perry, Cassandra. "Implementing positive clinical change : cognitive behavioural group therapy for loners". Thesis, Swansea University, 2008. https://cronfa.swan.ac.uk/Record/cronfa43196.
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Introspection and self-reflection has been used throughout this study in order to examine my effectiveness as a psychotherapist. I have explored the dynamics of engaging more effectively with pre-adolescent loners in group therapy by assessing the personal determinants and therapeutic conditions necessary to create positive social behavioural change. Did I make a difference? If not, why not? My specific method, reality therapy, is a highly confrontational cognitive-behavioural therapeutic approach. Its difference to mainstream cognitive behaviour therapy is that, as well as treating the symptoms of a problem, reality therapy deals directly with the cause - unmet needs. As a reflexive practitioner, I have used action research to assist in the implementation of clinical change and allow me to amalgamate research with practice and vice versa. The action-evaluation-understanding design, combined with a reality therapy pedagogical tool, will take you through a personal journey of hope and despair: the advantages, conflicts and tensions of my role as a practitioner-researcher and the experiential learning along the way which improved my practice as a therapist. Significantly, the differences between the successful and unsuccessful outcomes of the three group programmes undertaken will be dissected and learned from. I am confident that these needs-based interventions for children can be equally as effective with an adolescent or adult loner population. They are multi-functional and can also be used for one-to-one interaction. All are adaptable for wider use such as youth/adult offender programmes, substance misuse rehabilitation and the specific treatment of anticipatory anxiety and post-event processing in social phobia therapy. Undoubtedly, there is new learning to take into the workplace from my successes. However, there is even more new learning to be assimilated from my many mistakes.
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Burgess, Moser Melissa. "The Cognitive-affective and Behavioural Impact of Emotionally Focused Couple Therapy". Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23175.
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Emotionally Focused Couple Therapy (EFT; Johnson, 2004) addresses relationship distress by facilitating the development of new patterns of interaction between partners. These new patterns of interaction are based on partners' vulnerable acknowledgement and expression of attachment needs. Partners' engagement in these new patterns of interaction is thought to improve their relationship-specific attachment bond. Although previous studies have shown EFT to result in excellent relationship satisfaction outcomes (Johnson, Hunsley, Greenberg & Schindler, 1999), research had yet clearly to demonstrate if and how EFT facilitates increases in partners' relationship-specific models attachment security over the course of therapy. To address this research gap, the current study employed Hierarchical Linear Modelling (HLM; Singer & Willet, 2003) to investigate the pattern of change in couples' (n=32) self-reported relationship satisfaction and relationship-specific attachment over the course of EFT. Couples reported significant linear increases in their relationship satisfaction and significant linear decreases in their relationship-specific attachment avoidance over the course of therapy. Couples who completed the blamer-softening therapeutic change event (n=16) demonstrated significant linear decreases in their relationship-specific attachment anxiety after completing this event. Decreases in relationship-specific attachment anxiety predicted increases in couples' relationship satisfaction over the course of therapy. Couples also demonstrated significant increases in the security of their pre-post-therapy relationship-specific attachment behaviour, as coded Secure Base Scoring System (Crowell, Treboux, Gao, Fyffe, Pan & Waters, 2002). The current study also used HLM (Singer & Willet, 2003) to examine how the completion of blamer-softening impacted softened couples' relationship-specific attachment anxiety, and whether the completion of blamer-softening had a similar impact on softened couples' relationship-specific attachment avoidance and relationship satisfaction. Softened couples reported an immediate increase in relationship satisfaction and immediate decrease relationship-specific attachment avoidance at the softening session. Further, softened couples' post-softening decreases in relationship-specific attachment anxiety were initially preceded by an increase at the softening session. These results provided an understanding of how EFT leads to increases in couples' relationship-specific attachment security. These results provide support for the use of attachment theory in the treatment of relationship distress, and also provide an illustration of how attachment can shift over the course of a therapeutic intervention.
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Deary, Vincent Aaron Vernon Adrian Hugo. "Cognitive behavioural therapy for functional dysphonia : development of a complex intervention". Thesis, University of Newcastle Upon Tyne, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.576979.
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Functional dysphonia, loss or alteration of voice in the absence of physical pathology, is the commonest presentation to speech and language therapists (SLTs) and accounts for up to 40,000 new cases every year in the UK. Besides its impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aim of this research project was therefore to develop an improved intervention. Method A broad cognitive behavioural model of medically unexplained symptoms (MUS) was researched and identified as a suitable theoretical basis for the intervention development process. This was then applied as an assessment format in a series of patient interviews. Data from this stage were used to design a cognitive behavioural therapy (CBT) intervention for a SLT to deliver in a small consecutive cohort study. Data and clinical insights from this study were used to further develop the CBT intervention, which was then trialled in an external pilot patient randomised trial. Following up findings from the consecutive cohort phase, particular attention was paid in the randomised trial to the process issues involved in the professional behaviour change of the SLT, and a questionnaire study to investigate fatigue and perfectionism in functional dysphonia patients was conducted. Results and conclusion It was acceptable and feasible for a SLT to deliver CBT and there was some evidence of clinical effectiveness. This data is used to discuss the power and design of a future definitive study. The focus on process illuminated the work that needed to be done to embed a complex intervention in clinical practice. Functional dysphonia was shown to resemble other MUS in ways that could significantly contribute to our understanding and treatment of this condition.
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Tucker, Eliza M. "Tinnitus in cochlear implantees : cognitive behavioural therapy for cochlear implant users". Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/359783/.
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Background to the study: Cochlear implants (CI) can help to suppress tinnitus and often make existing tinnitus more bearable. However, a number of patients still suffer from tinnitus afterwards. In some cases the implantation makes existing tinnitus worse, or tinnitus may occur as a result of cochlear implantation. Because of the inconclusive aetiology of tinnitus it is difficult to treat its effects. So far, one of the most popular treatments for tinnitus is the widely used Cognitive Behavioural Therapy (CBT), which aims to influence dysfunctional emotions, behaviours and cognitions though a goal-orientated, systematic procedure. CBT aims to minimize the side-effects of tinnitus and help to manage it in a more efficient way. CBT has been investigated in several studies and shows promising results in reducing the debilitating effect of tinnitus. CBT has not yet been used specifically for, or investigated in, relation to treating CI users suffering from tinnitus. Aims and outline of the study: Our research aimed to investigate CBT’s effectiveness for cochlear implant users. Using a randomized control trial, we investigated whether two-hour Tinnitus Workshops for the control group were as equally as effective as CBT for the research group. We also explored if either type of treatment for cochlear implant users needed any modifications to make them more suitable for this group of tinnitus sufferers. Using Open Questions, we investigated tinnitus in cochlear implant users. We analysed the Open Questions from both groups, creating a profile of a typical cochlear implant user who suffers from tinnitus, and we also explored whether both interventions (Tinnitus Workshop or CBT) were suitable for this kind of patient. Data was gathered, pre- and post-interventions, by questionnaires; these were Tinnitus Questionnaires (TQ), Visual Analogue Scale (VAS), Quality of Life Short Form 36 Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS). Results: In the control group, we found no significant differences between the TQ scores pre- and post-intervention. VAS scores post-intervention were lower than pre-intervention, indicating some improvement in individual tinnitus perception; however, the difference was not significant. In the research group, we found small, but not significant, differences in both TQ pre- and post-intervention (z =1.83, p>.05) and in VAS (z=0.14, p>.05). No significant differences were found between the control and the research group pre- and post-intervention. Conclusions: The questionnaires used in this study, such as TQ or VAS, showed a decrease in general tinnitus distress, but a larger-sized sample group may be needed for greater statistical certainty. The results from the Open Questions showed that cochlear implant users were affected by tinnitus in a similar way to non-cochlear implant users. Overall, both interventions need further, small modifications and adjustments to their protocols in order to be more effective for this type of tinnitus sufferer.
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Kaldo, Viktor. "Cognitive Behavioural Therapy as Guided Self-help to Reduce Tinnitus Distress". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis Acta Universitatis Upsaliensis, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8927.
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Barber, Louise. "Pragmatic evaluation of group cognitive behavioural therapy for chronic fatigue syndrome". Thesis, Bangor University, 2007. https://research.bangor.ac.uk/portal/en/theses/pragmatic-evaluation-of-group-cognitive-behavioural-therapy-for-chronic-fatigue-syndrome(a81828ae-ccdb-4eed-a504-a54979c0795f).html.
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Although cognitive behaviour therapy is recommended by the National Institute for Clinical Excellence as one of the treatments of choice for people suffering with chronic fatigue syndrome (CFS) there is relatively little evidence of the effectiveness of this treatment in group format. Group interventions are often preferred as resources are scarce within the National Health Service and are considered to be more cost effective. There is no cure for CFS and the treatment options that are currently available are reviewed, with particular emphasis on the limited group cognitive behaviour therapy (GCBT) studies. The methodological limitations and generalisability of the findings are questioned followed by implications for clinical pýactice. Finally the direction of future research is discussed and the need for further f group CBT in routine clinical settings. The research paper investigates the effectiveness of a GCBT for people with CFS. In this pragmatic,n on-randomisedc, ontrolled design2 8 people acted as their own waiting list control by completing a range of measures 8 weeks prior to taking part in GCBT. The intervention consisted of 8 consecutive weeks of 2.5-hour sessions. Significant improvements were found compared to the waiting list in physical and mental fatigue and depressive symptoms. Improvements in quality of life, hope and optimism were also found but no improvements were reported for anxiety levels, pain or physical functioning. Global outcomem easurersr evealedt hat the majority of the patients found the treatment beneficial and were satisfied with the results. It is concluded that GCBT is a beneficial treatment that patients find amenable in routine clinical practice for CFS. However further research is indicated to improve subgroup identification and refine intervention programmes. Contributions to theory and researcha re presentedin the final section research,along with the strengths and limitations of the research and future researchs uggestionsT. he contribution to clinical practice is also discussed. Finally the research experience is explored to include personal motivations and the research experience.
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Brown, Amy. "The role of therapeutic alliance and early behavioural change during cognitive behavioural therapy for anorexia nervosa". Thesis, University of London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.583368.
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Cognitive behavioural therapy (CBT) is often the treatment of choice for the outpatient treatment of anorexia nervosa. However, little is known about which elements of the therapy bring about change. This study explored two potential change processes: early therapeutic alliance and early behavioural change. In Study 1, the temporal relationship between therapeutic alliance and weight gain during CBT for anorexia nervosa was examined in a cohort of 65 adults with a diagnosis of anorexia nervosa (or atypical anorexia nervosa). Patients completed a measure of alliance at session 6 (early therapeutic alliance) and at the end of treatment. Early behavioural change was defined as weight gain over the first six sessions. Early therapeutic alliance was associated with neither the likelihood of completing treatment norwith subsequent weight gain. Thus, no evidence was found that therapeutic alliance is a process that brings about change during CBT for this client group. The data indicated that it was vice versa: behavioural change (measured by weight gain) was predictive of subsequent alliance strength. Treatment completers had made more early behavioural changes (measured by weight gain) compared to those who prematurely discontinued treatment, but early weight gain was negatively associated with later weight gain. In Study 2, 100 clinicians who deliver CBT for anorexia nervosa completed a survey that explored beliefs and clinical practice related to therapeutic alliance and early behavioural change. Responses indicated that clinicians consider both processes to be important change processes, with particular emphasis placed on early therapeutic alliance. The gap between the clinicians' perspective and the empirical findings of Study 1 are discussed, with reference to the potential influences of the existing evidence base and information processing errors.
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Grist, Rebecca Mary. "Actualising therapy 2.0 : enhancing engagement with computerised cognitive behavioural therapy for common mental health disorders". Thesis, University of Sussex, 2014. http://sro.sussex.ac.uk/id/eprint/51609/.
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Computerised cognitive behavioural therapy (CCBT) is a clinically effective method of delivering CBT which may help address the under – treatment of common mental health disorders (CMHDs) in the population. However, concerns regarding acceptability, attrition rates and the therapeutic alliance are obstacles to widespread population dissemination. This thesis aimed to address these implementation issues by applying concepts from human – computer interaction (HCI) and attachment theory to the field of CCBT. Chapter 1 presents a meta – analysis investigating the effectiveness of CCBT for CMHDs and moderators of this effect. Chapter 2 presents a systematic review and analysis conducted to examine predictors of CCBT engagement. A process – based model of engagement with CCBT developed from the findings of this review is also presented. Adult attachment is known to influence engagement and alliance in face to face therapies, but research has not explored whether these relationships are mirrored in CCBT. Four empirical studies intended to address this question. Study 1 used a student population based survey to explore the acceptability of CCBT in a student population and the associations with adult attachment. Results demonstrated adult attachment was not associated with acceptability of CCBT. Study 2a utilised an open trial of a supported CCBT program to investigate whether adult attachment would predict engagement and alliance in vivo. Results showed attachment did not predict these outcomes. Study 2b utilised an open trial with a non – supported online CCBT program. Results indicated attachment security was positively associated with program engagement and alliance. It is proposed a combination of attachment system activation and perceiving computers as social actors account for these findings. Study 3 used a randomised, experimental paradigm to test the benefits of security priming in CCBT. Security priming produced higher levels of program engagement and better working alliance compared to neutral primes. Furthermore these effects were not moderated by dispositional attachment styles. These results demonstrate something so uniquely human, dispositional attachment orientations, founded on the intimate bonds we form in infancy and in adulthood , extend their influence into the experience of unguided CCBT, a solely human – computer interaction. Unguided – CCBT, a highly cost effective intervention with the potential for considerable public health impact, may benefit from incorporating security priming techniques in program designs to maximise engagement and alliance. Engagement and alliance is attainable in CCBT and paying attention to the attachment styles of program users may present a distinctive opportunity to overcome these implementation barriers.
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O'Carroll, Pierce. "Dual emotional processing in posttraumatic stress disorder : three single case studies". Thesis, University of East Anglia, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246964.
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Newey, Ian. "Evaluating cognitive therapy for young men with Asperger's syndrome : targeting secondary anxiety through the teaching of theory of mind". Thesis, University of East Anglia, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246965.
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Andersson, Peter. "Implementation of website for cognitive behavioural therapy using the development framework Symfony". Thesis, Linköping University, Department of Computer and Information Science, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-54722.
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This report follows the process of developing a website for cognitive behavioural therapy using the web development framework Symfony. The purpose was to find out if it is appropriate to use Symfony to ease development and maintenance of a website for therapy. For this to be true the framework had to be able to help create a website that was secure, user-friendly and easy to maintain.
The website was developed using several features of the framework including database abstraction, automatic code generation and URL-rewriting. A plugin was used to enhance the security by adding a complete solution for user authentication. The website was tested by using built-in test functionality of the framework that could run test on functions or emulating a browser visiting the website.
During the development the framework was tested and evaluated. The worst drawback turned out to be Symfonys steep learning curve, its security solution that only worked if the website was installed correctly and its slow loading time. Except those faults the framework performed well and was easy to use ones the initial learning time was over.
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McDougall, Dana L. "The group treatment of social phobia with cognitive-behavioural therapy and imagery". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0015/NQ47904.pdf.
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Robertson, A. "Anger in women with developmental disabilities : cognitive behavioural therapy : a case series". Thesis, University of Edinburgh, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.661223.
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There is very little literature on the nature of anger in clinical populations of women, and little by way of individual anger treatment in people with a developmental disability. There has been considerable criticism of the assumptions made within forensic services that women can be treated in the same ways as men. The purpose of this study was twofold: firstly, it explored the nature of women’s anger in a small sample (n=27) with a developmental disability in a hospital forensic service, and compared them with men in a study based in the same setting; secondly, it evaluated treatment outcome for those meeting inclusion criteria for an eighteen session individual treatment programme. The design of the outcome study (n=9) was a multiple baseline study with participants acting as their own controls. Some qualitative material is presented in relation to three case studies in order to illustrate process and because this has been a consistent recommendation regarding research into women in forensic services. Results showed that there were virtually no differences in self reported or staff reported anger, but more women had assaulted than men during their admission. Results also showed that the majority of women improved post treatment and through follow up. It was concluded that women in this service experienced similar anger to the men and could benefit from the same cognitive behavioural treatment programme.
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Facer, April L. "Service users' experience of computerised cognitive behavioural therapy : an interpretative phenomenological study". Thesis, University of East London, 2011. http://roar.uel.ac.uk/3718/.
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Background: Computerised Cognitive Behavioural Therapy (CCBT) is used within the NHS to treat anxiety and mild to moderate depression. Research has quantitatively demonstrated the efficacy of CCBT but has neglected to examine its use from patients' perspectives or the processes which contribute to success in practice. Therefore this study aimed to qualitatively explore users' subjective experience of CCBT. This was contrasted with Therapist-led CBT (TCBT) to gain understanding through evaluation of similarities and differences. Method: Semi-structured interviews were conducted with eight participants who had received CCBT and eight TCBT, within a Primary Care Psychological Therapy Service. These were analysed using Interpretative Phenomenological Analysis (IPA). Results: Findings demonstrate participants perceive CCBT as insufficient in delivering CBT techniques without therapeutic interaction and interpersonal elements. The lack of these had a severely disabling effect upon 'Engagement' and 'Deep-Processing', which emerged as superordinate themes. Areas described as lacking in CCBT and in contrast enhanced engagement in TCBT included characteristics of a therapeutic relationship, e.g. being heard, therapist qualities, acceptance and empathic genuine feedback which promoted expectations and motivation. Deep-Processing was reliant upon engagement and encompassed utilisation of specific CBT techniques, through emotional exposure, personalisation and agency. This led to deeper understanding, meaningful processing, significant cognitive change and development of self-efficacy for the future. Conclusions: The limitations of CCBT highlights a disparity between current CCBT research and users views, whilst confirming the role of non-specific factors in therapeutic interventions. This suggests the necessity for critical appraisal of the evidence-base. Future research recommendations include incorporating and integrating qualitative and mixed-method research with empiricallysupported research paradigms, to ensure patient's experience, views and expectations are considered and practice-based process research also informs clinical practice.
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Bothelius, Kristoffer. "Cognitive Behavioural Therapy for Insomnia : How, for Whom and What about Acceptance?" Doctoral thesis, Uppsala universitet, Institutionen för psykologi, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-259605.
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Sleep is essential for survival but a significant minority of the adult population are dissatisfied with their sleep, and 6-10% meet the criteria for insomnia disorder, characterised by difficulties falling asleep at bedtime, waking up in the middle of the night or too early in the morning, and daytime symptoms. Cognitive behavioural therapy for insomnia (CBT-I), an evidence-based sleep-focused intervention, has been suggested as the treatment of choice for chronic insomnia. However, access to specialised sleep therapists is sparse, and a service delivery model based on the principles of ‘stepped care’ has been proposed. Even though CBT-I is shown to be effective, there is a need to continue the development of cognitive behavioural treatments for insomnia. As a complement to traditional interventions, the potential value of acceptance, that is, to make an active choice of openness towards psychological experiences, has been recognized. However, it has not yet been systematically investigated, and specific instruments for studying acceptance in insomnia are lacking. The present thesis is based on three studies: Study I showed that manual-guided CBT for insomnia delivered by ordinary primary care personnel has a significant effect on perceived insomnia severity, sleep onset latency and wake time after sleep onset. Study II demonstrated that non-responders in Study I reported shorter sleep time at baseline than did responders, a notion that may help select patients for this type of low-end intervention in a stepped care treatment approach. Study III aimed to develop a new assessment instrument for studying acceptance of insomnia, the Sleep Problem Acceptance Questionnaire (SPAQ), resulting in an eight-item questionnaire with two factors; the first being Activity Engagement, persisting with normal activities even when sleep is unsatisfactory, and the second involving Willingness, avoiding fighting and trying to control sleep problems. In conclusion, the present thesis demonstrates that it is feasible to treat patients with insomnia using CBT-I administrated by ordinary primary care personnel in general practice, and that those with relatively longer initial sleep duration benefit most from treatment, enabling allocation to relevant treatment intensity. In addition, acceptance of sleep difficulties may be quantified using the SPAQ.
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Wahid, Rasha M. "Cognitive behavioural therapy for psychosis developing family intervention for schizophrenia in Egypt". Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517721.
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Cook, S. E. "Predicting attrition in guided parent-delivered cognitive behavioural therapy for anxious children". Thesis, University College London (University of London), 2014. http://discovery.ucl.ac.uk/1448568/.
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Volume one of this thesis consists of three parts. Part one is a literature review that examines pre-treatment demographic, clinical, parent, child and therapist characteristics as predictors of outcome in the treatment of child anxiety disorders. Methodological weaknesses associated with existing prediction studies are considered and recommendations made for future research. Part two is an empirical paper which investigates predictors of treatment attrition in a guided manualised self-help CBT intervention for anxious children, delivered solely via parents. The results are discussed in relation to clinical implications and recommendations are made for increasing retention in low-intensity, parent-led treatments for childhood anxiety disorders. Part three is a critical appraisal which discusses the limitations of using observational measures to assess parent-child interactions and the challenges associated with outcome measurement in child anxiety research. The background context to the research is also outlined and the advantages and disadvantages of conducting research using pre-collected data are considered.
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Handley, Alicia Katherine. "A randomised controlled trial of group cognitive behavioural therapy for clinical perfectionism". Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/802.
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This thesis consisted of two linked studies. The first study examined the relationship between perfectionism and generalised anxiety disorder symptoms in a clinical sample. Perfectionism demonstrated significant associations with pathological worry and a principal diagnosis of generalised anxiety disorder. The second study examined the efficacy of group cognitive behavioural therapy for clinical perfectionism in a clinical sample. This treatment produced significant reductions in perfectionism and psychopathology and significant increases in self-esteem and quality of life.
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Todd, Sue, i n/a. "Narrative therapy : with a single case study". University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20061109.150410.
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A single case study using a narrative approach to therapy
was undertaken to examine the process and outcomes of
therapy with a case of a 12 year old boy who presented with
what could be described as an "anxiety disorder".
The results were contrasted with the possible process and
outcomes should a cognitive-behavioural approach have been
used. This aspect of the Study was necessarily a
speculative endeavour.
Specific behaviours of the client and significant others
were measured pre, post and followup. Positive changes
occurred in the following behaviours: absence from school,
reports of victimization, positive and negative self
statements and statements by significant others.
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Stott, Joshua Charles Hugh. "Pre-therapy skills required to be ready for cognitive behavioural therapy in people living with dementia". Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10061784/.
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Background: People living with dementia (PLWD) commonly experience depression and anxiety. For the general adult population, cognitive behavioural therapy (CBT) is a recommended treatment. Adapted forms of CBT have been used with PLWD. However, method of adaptation and outcomes are inconsistent across studies. Examining pre-therapy skills required to take part in a core aspect of CBT (cognitive restructuring) in PLWD could inform future adaptation. Given the limited previous work in PLWD, the intellectual disability literature was systematically reviewed and integrated with the dementia literature to inform aims. Main aims: 1) to develop measures of pre-therapy skills (behaviour-thought-feeling discrimination and cognitive mediation) validated for use with PLWD; 2) to compare performance of PLWD and older (OA) and younger (YA) adults without a recognised neurocognitive impairment on these validated pre-therapy skill measures; 3) to examine whether neurocognition mediates observed differences between PLWD and OA in pre-therapy skill performance; 4) to examine neurocognitive correlates of pre-therapy skill measures in PLWD with a focus on memory, language and executive function. Main methods: 102 PLWD, 77 OA and 56 YA were recruited. Measures of pre-therapy skills used in an intellectual disability context were adapted for PLWD using a published framework and subjected to factor analysis and validity checks. Performance on pre-therapy skills measures was compared across groups, mediation of between group differences was assessed (using structural equation modelling) and correlations between pre-therapy skills and neurocognitive functions were examined. Main findings: Tools were developed. PLWD scored lower than OA who scored lower than YA on pre-therapy skills measures. Differences between OA and PLWD but not between OA and YA were mediated by neurocognition. Pre-therapy skill performance was associated with scores on measures of language and, to a lesser extent, executive function. Use of tools within, and implications of findings for, CBT practice and research are discussed.
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McKenna, Ian. "Cognitive behavioural therapies for social anxiety disorder (SAnD) review". Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/13623.
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Background: Social anxiety disorder (SAnD) is a highly prevalent condition, characterised by an intense fear of social or performance situations where individuals worry about being negatively evaluated by others. An up to date systematic review of the effectiveness of cognitive behavioural therapies for SAnD is required to guide practice. Objectives: To assess the efficacy and acceptability of cognitive behavioural therapy (CBT) compared with treatment as usual/waiting list (TAU/WL) for individuals with SAnD. Search methods: We searched the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Controlled Trials Register and conducted supplementary searches of MEDLINE, PsycInfo, EMBASE, and international trial registers (ICTRP; ClinicalTrials.gov) in October 2011 and CINAHL in October 2012. We also searched reference lists of retrieved articles, and contacted trial authors for information on ongoing/completed trials. Selection criteria: Randomised and quasi-randomised controlled trials undertaken in out-patient settings, involving adults aged 18-75 years with a primary diagnosis of SAnD, assigned either to CBT or TAU/WL. Data collection and analysis Data on patients, interventions and outcomes were extracted by two review authors independently, and the Risk of bias in each study was assessed. The primary outcomes were social anxiety reduction (based on relative risk (RR) of clinical response and mean difference in symptom reduction), and treatment acceptability (based on RR of attrition). Results: Thirteen studies (715 participants) were included in the review, of which 11 studies (599 participants) contributed data to meta-analyses. Based on four studies, CBT was more effective than TAU/WL in achieving clinical response at post-treatment (RR 3.60, 95% CI 1.35 to 9.57), and on eleven studies (599 participants) it was more effective than TAU/WL in reducing symptoms of social anxiety. No significant difference was found between CBT and TAU/WL for attrition. No significant difference was demonstrated for social anxiety at follow-up and no studies examined follow-up data for clinical response or attrition. Authors' conclusions: The available evidence suggests that cognitive behavioural therapy might be effective in reducing anxiety symptoms for the short-term treatment of SAnD. However, the body of evidence comparing CBT with TAU/WL is small and heterogeneous.
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Evans-Jones, Catherine. "The therapeutic relationship in cognitive-behavioural therapy for psychosis : the role of client, therapist and therapy factors". Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1446628/.
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The study investigated which client, therapist, and therapy characteristics were associated with the quality of the therapeutic relationship in Cognitive-Behavioural therapy (CBT) for psychosis. The development of a good therapeutic relationship is essential to the work of CBT for psychosis but is often more difficult to achieve due to the nature of psychotic symptoms. Despite this, there has been little research investigating what affects the development of the therapeutic relationship within CBT for psychosis. The study had a cross-sectional, correlational design with measures taken at around the sixth session of therapy. Clients and therapists completed questionnaires measuring client, therapist, and therapy factors, and their perceptions of the therapeutic relationship. On average, both clients and therapists rated the therapeutic relationship as good. Although there was a trend towards agreement on the quality of the therapeutic relationship, on average clients rated it higher than therapists. There were few significant effects of client or therapist factors on the therapeutic relationship, including some unexpected negative results, e.g. no effect for psychotic symptoms. There were some significant effects for therapy factors and clients reports of the therapeutic relationship, e.g. the presentation of a case formulation.
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Le, Huray Corin. "An investigation into the role of non-specific factors in Cognitive Behavioural Therapy". Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.636531.
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There is limited research into the impact of non-specific factors on the outcome of Cognitive Behaviour Therapy (CBT). This current study aimed to investigate the relationship between client and therapist attachment styles and client interpersonal problems to the therapeutic relationship and symptom reduction over eight sessions of CBT. Seventeen therapist-client dyads were asked to complete measures of interpersonal problems, attachment style and report on the therapeutic relationship. Results showed that in this small sample there was a relationship between core alliance, as rated by clients, to reduction in symptoms of depression over the course of eight sessions of CBT (TB=0.423, p<0.05) but not anxiety. Client level of confidence in relationships was negatively correlated with the reduction in anxiety symptoms over time (TB =-.320; p<0.05). The level of difference in scores on a measure of ‘confidence in relationships’ between therapists and clients was found to be positively correlated to the level of reduction in anxiety scores over eight sessions (TB = .0428; p<0.05) and negatively correlated to the therapist rated core alliance (TB=-.428, p<0.05). These results indicate that the role of attachment styles in CBT warrants further investigation and both clinical and theoretical implications of these findings are discussed. Key words: Cognitive Behaviour Therapy, therapeutic relationship, treatment outcomes, attachment, interpersonal problems Service Improvement Project Title: What is helpful about attending an Alzheimer’s café: does it do what it says on the tin? Abstract: Alzheimer’s Cafes were developed in 1997 in the Netherlands and have since been set up all over the world. They are a post-diagnostic support group for people with dementia and their families with an aim to reduce stigma around having dementia. As yet there have been very few evaluations of these cafes. This project aimed to find out what family carers of people with dementia found helpful about attending one of two Alzheimer’s cafes. Seven carers took part in a focus group and two were interviewed individually about what they found helpful about attending an Alzheimer’s Café and what they thought could be improved on in the future. Results showed that people found the opportunities to socialise with others ‘in the same boat’ the most helpful aspect as well as meeting professionals outside of the clinic. The results of this study will enable the development of a questionnaire that can be used to continue to evaluate the café and the feedback provided used to guide future service development. Key words: Alzheimer’s Café, social support, dementia, service evaluation Critical Literature Review Title: Risk and protective factors for psychological adjustment of children born with a cleft lip and/or palate and their families: A review of the literature Abstract: Research suggests that around 30-40% of children born with a cleft lip and /or palate will develop psychological difficulties. Services supporting these individuals need to be able to identify those that might be vulnerable as early as possible so that preventative support can be offered. This review summarises findings from research studies looking at within-group differences in samples of children with a cleft and their families. Risk factors found included being male, experiencing bullying or having additional difficulties. Protective factors included satisfaction with appearance and social support. The methodological strengths and weaknesses of these studies are discussed along with implications of the findings for theory and clinical practice.
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Ingham, Jessica. "Cognitive behavioural therapy skills in children who have sustained an acquired brain injury". Thesis, University of East Anglia, 2014. https://ueaeprints.uea.ac.uk/51159/.
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Background: Childhood brain injury can result in cognitive, behavioural, and psychological difficulties. It is reported that many children who have suffered a brain injury experience the same level of emotional distress as children seen in mental health services. Cognitive behaviour therapy (CBT) has been shown to be an effective intervention for a range of psychological disorders that arise during childhood, yet to date there is little evidence to suggest whether this is a beneficial therapy for children with acquired brain injury (ABI). The current study explored whether children who have sustained an ABI have the necessary skills to engage in CBT, by assessing their ability to distinguish between and link thoughts, feelings and behaviours. Furthermore, performance on these tasks was investigated in relation to a number of cognitive functions thought to enhance an individual‘s ability to engage in CBT. Methods: The study employed a between-subjects design comparing typically developing children (n = 20) and children who have sustained a brain injury (n = 18). Children were aged 8-12 years. Children completed two measures of CBT skill, a theory of mind (ToM) task, a brief measure of intelligence, and questionnaires relating to mood and metacognition. Parents also completed questionnaires relating to empathy, executive functioning, and their child‘s overall strengths and difficulties. Results: Children with ABI demonstrated significantly poorer performance on the CBT skills tasks than typically developing children. Significant relationships were also found between empathy, ToM and performance on the tasks. However, contrary to the hypotheses, mental health/behavioural difficulties, executive functioning, and metacognition did not significantly impact on task performance. Conclusions: This highlights that children with ABI may find engaging with CBT challenging. Continued research investigating the application of CBT for children with ABI would be valuable, as well as further exploration of how different cognitive functions impact on CBT participation.
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McPhee, Ingrid. "Investigating the need for and utility of cognitive behavioural therapy for vestibular migraine". Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/16761.
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Vestibular migraine (VM), a disorder characterised by true vertigo, disequilibrium or imbalance that is causally related to migraine phenomena, is currently poorly understood. High rates of psychiatric comorbidity have been reported by patients with VM, yet there has been little investigation into their psychological functioning and no trials of psychological intervention. Cognitive behavioural therapy (CBT) has been shown to be effective in treating dizziness and vestibular symptoms. Hence, there is good reason to believe that CBT would confer benefits for people with VM. This thesis comprised four studies. The first study evaluated rates of psychiatric diagnosis, along with physical and psychological outcomes in VM. The second study investigated attentional biases in patients with VM. The third study was a randomised controlled trial that compared CBT as an adjunct to routine medical management to routine medical management only, for patients with VM. The fourth study was a case series. The main findings were as follows. Firstly, patients with VM demonstrated significantly higher rates of anxiety, but not depression, compared to control groups, suggesting that VM and anxiety may be specifically related. Comorbid psychopathology was also found to be associated with poorer physical symptom and disability outcomes. Secondly, anxiety disorders in the context of VM were not associated with attentional bias towards dizziness-related information. Thirdly, CBT did not have any significant impact on physical outcomes over and above the passage of time. However, high rates of remittance of psychiatric disorders were seen for those who completed the CBT intervention, with gains generally maintained over six months. VM appears to be a disorder which improves without psychological intervention, although psychopathology in the context of VM does not. Therefore, CBT adapted to the context of VM does appear to be effective in treating anxiety disorders in patients with VM.
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Wong, Chi-keung Max. "The impact of group cognitive behavioural therapy programmes on breast cancer patients : a meta-analysis /". View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36887195.
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Ross, Victoria. "Evaluating effectiveness of antenatal cognitive behavioural based treatment for anxiety and stress". Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/25680.
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Psychological distress is common during pregnancy. The objective of this thesis was to evaluate the effectiveness of antenatal cognitive behavioural based treatments in reducing psychological distress in pregnant women. A systematic review was undertaken of randomised controlled studies utilizing antenatal cognitive behavioural based treatment in reducing anxiety and stress compared to treatment as usual. Eleven papers were identified through a systematic search of databases using predefined criteria comparing intervention groups to treatment as usual in pregnant women with anxiety or stress. The systematic review revealed preliminary evidence for the effectiveness of cognitive behavioural based treatment with several studies noting changes over time in anxiety and stress; however, only a few studies reported intervention effects when compared to control. While the systematic review results suggest that a small number of cognitive behavioural based interventions may be effective in reducing anxiety and stress during pregnancy compared to treatment as usual, confidence in these findings is limited due to methodological limitations such as lack of follow-up, high attrition rates and difficulties with generalisability. The evidence base is currently insufficient and further research which utilises a robust methodology is needed before any reliable conclusions can be drawn. An empirical study was conducted to examine the effectiveness of a brief, single-session stress reduction programme introducing cognitive behavioural techniques aimed at reducing general anxiety, other pregnancy related distress and improving general well-being and pregnancy outcomes. Twenty-nine participants with clinically significant levels of anxiety were recruited to the empirical study from the local maternity hospital. Participants completed measures of general anxiety, pregnancy related anxiety, general well-being and childbirth experience. The control was derived from a historical dataset where 37 participants were matched for baseline anxiety levels. The empirical study demonstrated significant reductions in general anxiety; however, similar findings were also observed in the control group. Significant reductions were observed with pregnancy related anxiety and women also reported their childbirth experience similarly regardless of delivery type. Although our findings were not significant when compared to control, our recruitment design resulted in good return rates following birth. Further studies using sophisticated study design with use of robust control group are required.
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Wong, Chit Yu. "How can a music therapy student facilitate contributions by adolescent clients who have psychiatric disorders in group music therapy? : a thesis presented in partial fulfillment of the requirements for the degree of Master of Music Therapy at New Zealand School of Music, Wellington, New Zealand". Massey University, 2009. http://hdl.handle.net/10179/1093.
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This study explored ways in which a music therapy student could modify and improve her own clinical practice in order to facilitate client contribution in group music therapy in an acute adolescent inpatient unit. Through cycles of observation, evaluation, planning, and action, the music therapy student was able to examine her facilitation techniques in detail and modified them accordingly. There were six fortnightly cycles and in each cycle, the research journal, research notes, and video-recording were systematically reviewed by the music therapy student herself, and themes were drawn out to contribute to the planning of the next cycle. The results suggested that while direct questions predominated at the start of study, the music therapy student was able to adopt a variety of other techniques by the end of the research period, including self-disclosure, appropriate eye contact, and the shifting of responsibility. The music therapy student also found that her own anxiety level, which was often caused by periods of silence in music groups, also had an important impact on her ability to facilitate. The discussion addressed other factors that are believed to have contributed to the student?s ability to facilitate in group music therapy.
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McGowan, John F. "Cognitive-behavioural therapy for psychosis : individual accounts of the therapeutic process in successful and less successful outcomes". n.p, 2000. http://ethos.bl.uk/.
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Gibbard, Isabel Mary. "Clients' experiences of change in cognitive behavioural therapy and person-centred therapy in primary care : a qualitative analysis". Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/clients-experiences-of-change-in-cognitive-behavioural-therapy-and-personcentred-therapy-in-primary-care-a-qualitative-analysis(f8d68779-0119-45da-8e89-50a48a61fccc).html.
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The aim of this qualitative research project was to investigate the experiences of clients who had received Cognitive Behavioural Therapy (CBT) and Person Centred Therapy (PCT) in primary care. The rationale for the investigation was to inform the assessment and referral process whereby prospective clients are assigned to the two different therapies. A total of 16 clients responded to an invitation to attend an unstructured interview (PCT = 9; CBT = 7) to talk about their experiences of therapy. The resulting transcripts were analysed using Grounded Theory methodology. Transcripts were broken down into meaning units and conceptualised as categories, using the constant comparison method. The categories were integrated, a core category conceptualised and a theory generated. A comparison of the accounts revealed similar and contrasting experiences. The main categories (eg Accessing therapy, Engaging with the therapy) could be organised in the chronological order of the client`s journey through therapy. All participants entered therapy with a particular view of reality. In successful therapy this view changed and they went on to manage their lives in a more constructive way. Participants attributed this change to different elements of the therapy (categorised as It did the trick) which brought about a new understanding (categorised as The key). Where therapy was unsuccessful this did not occur. The mechanism of change was personal to the individual and did not appear to be specific to either therapy. Some of the mechanisms appeared to be consistent with the therapy received (eg. Carrying out tasks, in the CBT group). Others appeared counterintuitive (eg. Putting me straight, in the PCT group). The differences and similarities in the participant`s experiences appeared to be due to the therapist and client`s capacity to respond to each other in order to make the therapy “work.” The Core Category, Reciprocal Responsiveness, was chosen to explain this. The findings also suggest that the ability of the therapist and client to respond to each other will affect the outcome of therapy. The theory was constructed that the outcome of therapy is determined by the occurrence of a sufficient degree of Reciprocal Responsiveness. This study has implications for the assessment process as the findings suggests that, when making a referral, it may be helpful, to take into account the potential client`s activity and responsiveness rather than relying solely on diagnosis. It also contributes to the growing body of literature emphasising the importance of therapist responsiveness to the individual needs of the client, rather than strict adherence to one therapeutic approach. The study is limited to two therapies within primary care. Future studies may consider clients experiences within other settings and with other therapeutic approaches.