In a controlled trial, 20 patients at high risk of repeated suicide attempts were randomly allocated to either cognitive-behavioural problem solving or a 'treatment-as-usual' control condition. The group practising problem solving improved significantly more than controls on ratings of depression, hopelessness, suicidal ideation and target problems at the end of treatment and at follow-up of up to one year, and there was evidence of an effect on the rates of repetition over the six months after treatment.
In order to evaluate how many patients presenting at accident and emergency (A&E) departments show signs of psychiatric disturbance, 140 consecutive medical presentations to an A&E department were evaluated using a range of simple self-report and rater measures, then followed up a month later. High levels of reported psychological problems were detected at screening, and these persisted at follow-up. Correlates of psychological disturbance and repeated attendance at A&E were investigated, indicating the relevance and feasibility of psychiatric intervention related to simple predictors.
This study was a controlled clinical trial in which patients were offered a brief low cost, low intensity self-help intervention while waiting for psychological therapy. A CBT based self-help pack was given to patients with significant anxiety problems and no attempt was made to exclude patients on the basis of severity or co-morbidity. The treatment group received the intervention immediately following assessment and the control group after a delay of 8 weeks so comparisons between the two groups were made over 8 weeks. Although there was some support for the effectiveness of the self help intervention, with a significant time x group interaction for CORE-OM scores, this was not significant with the intention to treat analysis, nor for HADS anxiety and depression scores and the effect size was low. A follow up evaluation suggested some patients attributed significant goal attainment to the intervention. The findings suggest the routine use of self-help interventions in psychological therapies services should be considered although further more adequately powered research is required to identify the type of patients and problems that most benefit, possible adverse effects and the effect on subsequent uptake of and engagement in therapy.
The National Institute of Standards and Technology (NIST) conducted a black-box study in conjunction with a scientific foundation review documented in NISTIR 8354 -Digital Investigation Techniques: A NIST Scientific Foundation Review (initially released as a draft report for public comments [1]). The purpose of the study was to evaluate the outcomes of mobile and hard-drive forensic results achieved on mock examinations based on the demographic characteristics of the participants. The demographic data related to an individual's workplace environment, education, and work experience. This study was open to anyone in the public or private sectors who work in the field of digital forensics. This document describes the methodology used in the study and a summary of the results.
Objective
We describe the development of an instrument aiming to offer interaction‐level feedback based on “patient activation”: client confidence and perceived ability to manage their health.
Method
Twenty‐two session‐transcripts from cognitive behavioral therapy with high‐users of healthcare were analyzed thematically, producing themes describing in‐session interactions. Themes were subcategorized using patient activation theory into high and low activation presentations. Two coders new to the process were trained to use this consultation interactions coding scheme (CICS). Inter‐rater reliability (IRR), convergent validity, and clinical utility were assessed and illustrated with extreme cases.
Results
Good‐to‐excellent IRR was achieved. The CICS, therapeutic alliance, and therapist competence were correlated. Client engagement in session‐structuring interactions correlated with outcome. The highest CICS scorer showed multiple outcome‐improvements, the lowest scorer reported deteriorations.
Conclusions
This study presents the CICS's psychometric properties and indicates the value of client engagement in session‐structuring.
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