Clinicians' concerns about delivering cognitive-behavioural therapy for eating disorders

Mountford

2015

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Section: Resultsmentioning

confidence: 99%

Weighing patients within cognitive-behavioural therapy for eating disorders: How, when and why

Mountford

2015

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“…Potentially underpinning the role of anxiety is the construct of intolerance of uncertainty, which Turner, Tatham, Lant, Mountford & Waller (2014) have shown to be associated with clinicians' concerns about delivering a range of elements of CBT. CBT is founded on neither clinician or patient knowing for certain what will happen when one implements change, but on both being willing to tolerate the uncertainty until the result is clear.…”

Section: Our Emotionsmentioning

confidence: 99%

“…In recent years, there has been more evidence to support the proposal that more anxious clinicians implement behavioral change less and are wary of implementing other central therapeutic techniques (e.g., Meyer et al, 2014;Turner et al, 2014;Waller et al, 2012). Such clinicians tend to focus on the role of the therapeutic alliance as an agent of change, and to prioritise its role over that of the therapeutic techniques that are supported by the evidence, even when doing so is associated with poorer outcomes (e.g., Brown et al, 2014).…”

Section: Our Safety Behaviorsmentioning

confidence: 99%

Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track

Turner

2016

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195

147

Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. AbstractTherapist drift occurs when clinicians fail to deliver the optimum evidence-based treatment despite having the necessary tools, and is an important factor in why those therapies are commonly less effective than they should be in routine clinical practice. The research into this phenomenon has increased substantially over the past five years. This review considers the growing evidence of therapist drift. The reasons that we fail to implement evidence-based psychotherapies are considered, including our personalities, knowledge, emotions, beliefs, behaviors and social milieus. Finally, ideas are offered regarding how therapist drift might be halted, including a cognitive-behavioral approach for therapists that addresses the cognitions, emotions and behaviors that drive and maintain our avoidance of evidence-based treatments.Keywords: therapist drift; psychotherapies; evidence-based practice; training; cognitivebehavioral therapy Therapist drift redux 3 Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track There are different reasons why evidence-based therapies might be delivered poorly, such as clinicians being inadequately trained in the therapy in question (e.g., Royal College of Psychiatrists, 2013) or working in a setting that does not permit the implementation of the necessary methods (e.g., not being permitted to provide the necessary number of sessions).Among those reasons is one that is centred in our own practice -therapist drift (Waller, 2009). Therapist drift can be conceptualised as our failure to deliver treatments that we have been trained to deliver, or failure to deliver them adequately, even where resources exist to allow us to do so. Such failure can be a consciously or an unconsciously-driven course of action. Regardless, it has the same consequence -the patient receives treatment that deviates significantly from the evidence-base, reducing their chances of improvement or recovery. This paper will review the substantial recent evidence fo...

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“…However, despite its theoretical and empirical support, exposure-based therapy is used relatively infrequently with eating disorders (Turner, Tatham, Lant, Mountford & Waller, 2014;Waller, Stringer & Meyer, 2012). This low level of usage is similar to that in other diagnostic groups (e.g., Becker, Zayfert & Anderson, 2004), and is explained at least in part by similar intra-clinician characteristics (Deacon, Lickel, Farrell, Kemp & Hipol, 2013;.…”

Section: Impact Of Education On Clinicians' Attitudes To Exposure Thementioning

confidence: 99%

Impact of education on clinicians' attitudes to exposure therapy for eating disorders

Walsh

Wright

2016

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