A frequent complaint by service-users of psychiatric inpatient units is the unavailability of talking therapy at precisely the time when they need to make sense of their situation. However, conventional models of cognitive-behavioural therapy (CBT) delivery, with set numbers of sessions and diagnostic specificity, are not well suited to the conditions of the acute ward, with variable and unpredictable lengths of stay and multiple and indistinct presentations. This pilot study describes a modification of CBT designed to deliver an effective, brief therapy in these conditions. The approach is grounded on the cognitive science-based model, interacting cognitive subsystems, and draws on dialectical behaviour therapy and other recent, mindfulness-based CBT approaches to provide a combination of simple formulation and skills-based treatment. Evaluation in the inpatient setting also presents challenges, and these have been met by choosing measures that tap into self-efficacy and confidence in the management of emotions rather than symptomatic change. The evaluation data on a small number of cases suggest the effectiveness of the approach and the need for wider testing of the model. Copyright

Comprehend, Cope, and Connect (CCC) is a third‐wave cognitive behavioural approach developed for acute mental health services. The aim of this study was to assess feasibility and acceptability of a newly developed, manualized single‐session CCC intervention delivered face‐to‐face with service users in acute and crisis psychology services in South London. The study adopted a within‐subjects pre‐post‐test design. Participants (N = 23) were recruited from five acute psychiatric wards and a crisis resolution home treatment team. Service users had a range of diagnoses of complex and severe mental health conditions, in particular mood, personality, and psychotic disorders. Feasibility data were gathered for number of times the CCC formulation was accepted, duration of CCC intervention, clinician adherence to manualised protocol, and frequency of goal‐based activity completion. Acceptability data on pre‐ and post‐CCC mood and post‐CCC helpfulness were self‐reported by participants. Findings indicated a significant increase in positive mood (large effect) and moderate–high helpfulness rating postintervention. Most participants reported goal‐based activity completion. There was high fidelity to the protocol, high percentage of acceptance of the formulation and formulation components completed, and frequent single‐session completion. Single‐session CCC appears feasible and acceptable in acute and crisis psychology services and yields formulation‐driven goal‐based activities intended to stabilize mental health crisis. High fidelity to formulation protocol suggests broader applications for single‐session CCC, for example, to support clinical staff to manage crisis situations in their work environment or to train nonpsychologist clinicians to deliver the intervention for service users. A randomized controlled trial of single‐session CCC would increase validity and generalisability of findings.

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This paper reports on the development and running of an anger management service that has been provided in Southampton for the past decade. It discusses some of the challenges that the service has had to face, (including over-popularity with referrers and high attrition rates) and describes the model that is used. The paper also examines the outcome of one particular therapeutic group. The results of this evaluation show that those who drop out of the group have higher initial depression and poorer self-esteem compared to those who remain in the group. In addition, those who complete the anger management group show improvements in anger control and have improved self-esteem. The paper concludes with practice recommendations.

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