Background The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp. One response to this problem has been the development of CBTp in brief formats that are targeted at a single symptom and the mechanisms that maintain distress. We have developed a brief form of CBTp for distressing voices and reported preliminary evidence for its effectiveness when delivered by highly trained therapists (Clinical Psychologists). This study will investigate the delivery of this intervention by a cost-effective workforce of Assistant Psychologists following a brief training and evaluate the acceptability and feasibility of conducting a future, definitive, randomised control trial (RCT). Methods This is a feasibility study for a pragmatic three-arm parallel group superiority 1:1:1 RCT comparing a Guided self-help CBT intervention for voices and treatment as usual (GiVE) to Supportive Counselling and treatment as usual (SC) to Treatment as usual alone (TAU), recruiting across two sites, with blinded post-treatment and follow-up assessments. A process evaluation will quantitatively and qualitatively explore stakeholder experience. Discussion Expected outcomes will include an assessment of the feasibility of conducting a definitive RCT and data to inform the calculation of its sample size. If evidence from a subsequent fully powered RCT suggests that GiVE is clinically and cost effective when delivered by briefly trained Assistant Psychologists, CBTp offered in these less resource-intensive forms has the potential to generate benefits for individual patients (reduced distress, enhanced recovery and enhanced quality of life), service-level patient benefit (increased access to evidence-based psychological therapies) and economic benefits to the NHS (in terms of the reduced use of mental health inpatient services). Administrative Information Increasing access to CBT for psychosis patients: a feasibility, randomized co 4 Title {1} evaluating brief, targeted CBT for distressing voices delivered by Assistant (GiVE2) Trial registration {2a and 2b}. Current Controlled Trials ISRCTN registration number: 16166070.
Objectives To compare the effectiveness of cognitive behaviour therapy delivered by telephone with the same therapy given face to face in the treatment of obsessive compulsive disorder. Design Randomised controlled non-inferiority trial. Setting Two psychology outpatient departments in the United Kingdom. Participants 72 patients with obsessive compulsive disorder. Intervention 10 weekly sessions of exposure therapy and response prevention delivered by telephone or face to face. Main outcome measures Yale Brown obsessive compulsive disorder scale, Beck depression inventory, and client satisfaction questionnaire. Results Difference in the Yale Brown obsessive compulsive disorder checklist score between the two treatments at six months was − 0.55 (95% confidence interval − 4.26 to 3.15). Patient satisfaction was high for both forms of treatment. Conclusion The clinical outcome of cognitive behaviour therapy delivered by telephone was equivalent to treatment delivered face to face and similar levels of satisfaction were reported. Trial registration Current Controlled Trials ISRCTN500103984.
This study provides the first meta-analysis of the purported differences in sleep time and sleep quality between people with and without intellectual disabilities. Twenty-one papers were identified that compared sleep time and/or sleep quality in people with and without intellectual disabilities. The meta-analysis of sleep time revealed that people with an intellectual disability slept for 18 min less, on average, than people without an intellectual disability. This significant difference was limited to those studies that tested groups of people with an identified genetic syndrome or developmental disorder. The analysis of sleep quality also concluded that people with intellectual disabilities experienced poorer sleep: In 93% of comparisons between groups, sleep was found to be of poorer quality in the group of people with intellectual disabilities. There were no differences found between studies that measured sleep objectively and those that used diary or questionnaire measures. Notably, most samples were drawn from populations of people with specified genetic syndromes or developmental disorders, rather than intellectual disability of heterogeneous origin. Similarly, most studies investigated sleep in children, although there was no evidence that the differences between the groups reduced during adulthood. Most studies used highly-regarded objective measures of sleep, such as polysomnography or actigraphy, although methodological flaws were evident in the identification of samples and the measurement of intellectual disability.
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