Designing a CBT service for an acute inpatient setting: A pilot evaluation study

Durrant, Caroline; Clarke, Isabel; Tolland, Abigail; Wilson, Hannah

doi:10.1002/cpp.516

Cited by 42 publications

(28 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The findings of our study suggest that a large minority of psychotic inpatients may be expressly interested in therapy, which provides support for the introduction of CBT during a hospital admission (Durrant, Clarke, Tolland, & Wilson, 2007;National Institute for Clinical Excellence, 2009). Further, we were able to uncover a number of reasons why patients in hospital might be interested in receiving therapy.…”

Section: Discussionmentioning

confidence: 91%

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Mitchison

Jakes

Kelly

et al. 2013

Clin Psychology and Psychoth

View full text Add to dashboard Cite

The reasons why some patients with psychosis are not interested in receiving psychological therapy may relate to past negative experiences with psychologists, negative perceptions of psychologists as a group and low perceived efficacy of therapy. These barriers may be addressed through interactions with psychotic patients during an admission to a hospital that disconfirms these perceptions and provides a positive alternative experience with a psychologist. Patients who are hospitalized with psychosis may be interested in receiving psychological therapy; however, the reason for this likely will not be to address psychotic symptoms. Rather, the therapist should be willing to work with the patient on a range of other presenting problems. If a patient has a lack of insight into their psychotic symptoms, this does not always negate them from perceiving other psychological problems for which they may desire support in addressing. Thus, therapists should be encouraged to approach all psychotic patients on a ward, even when there is an apparent lack of awareness of their psychotic symptoms. The themes related to patients' perspectives were generated from psychologists' summaries of interviews with patients and not directly from verbatim transcripts. Although this meant that the reasons given for participants being interested or not interested in therapy were interpreted by the psychologist, efforts were made to relate the exact reasons provided by the participants. Eighteen (29%) of the potential participants were not interviewed, usually as a result of their being discharged or transferred prior to arrangement of an interview. This meant we were unable to capture the views of these patients. Discharge prior to being seen by a psychologist is a barrier to engaging a patient in therapy and preventing them falling through the gaps of service provision.

show abstract

Section: Discussionmentioning

confidence: 91%

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Mitchison

Jakes

Kelly

et al. 2013

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…We have shown that individual therapy sessions can be delivered with relative ease in the acute environment, whereas, in contrast to previous work (Araci & Clarke, ; Durrant et al ., ), delivery of group interventions was challenging. This disparity may be due to reliance on ward staff nurses or less resource from the psychological team to deliver groups.…”

Section: Discussionmentioning

confidence: 99%

A feasibility study of a cross‐diagnostic, CBT‐based psychological intervention for acute mental health inpatients: Results, challenges, and methodological implications

Paterson

Karatzias

Harper

et al. 2018

British J Clinic Psychol

View full text Add to dashboard Cite

Objectives Acute psychiatric inpatient wards are characterized by minimal provision of therapeutic activities and high readmission rates. Implementation of a comprehensive inpatient psychological intervention service has been recommended to overcome these problems; however, whether this is feasible or effective remains unclear. Methods This non‐randomized parallel cluster feasibility trial examined the feasibility of delivering and evaluating cross‐diagnostic psychologically informed acute psychiatric care the Edinburgh‐Acute Psychological Inpatient Therapy Service (EDAPTS) and gathered preliminary clinical outcome data. Patients able to consent and complete questionnaires were recruited from two adult acute wards (i.e., clusters) and received either EDAPTS plus TAU or TAU. Results Between October 2015 and October 2016, 96 inpatients were recruited. Findings suggested that there were good data completion rates for several clinical outcomes, that several EDAPTS components were successfully delivered, and that some initial effects appeared to favour the intervention, depending on outcome. However, difficulties relating to the recruitment process were also identified, as well as problems relating to adequate delivery of group therapies, participant engagement in some intervention components, and data completion at follow‐up. Conclusion These issues, and the feasibility of randomization and rater‐blinding, have important implications for the design of future trials. Overall, this study provides an important insight into the challenges and complexities of developing and evaluating a comprehensive psychological intervention service in an acute psychiatric setting. Practitioner points Individual therapy sessions can be delivered in the acute environment. The EDAPTS intervention showed some promise on outcomes of distress and self‐efficacy. Delivery of nurse‐led groups was challenging and may need to be embedded into routine clinical practice to increase intervention and outcome reach. More parameters, for example, randomization at cluster level, should be tested before progressing to an adequately powered, single‐blind, definitive cluster RCT.

show abstract

“…In vocational rehabilitation studies of persons who are chronically ill and homeless, the PES can assess the lack of resources and unmet needs (2). The MHCS will fit well in studies aimed at the effect of treatment in interventions, such as peer support groups (15), dual-focus self-help groups (16), and cognitive-behavioral therapy (17), but it does not measure societal empowerment.…”

Section: Discussionmentioning

confidence: 99%

Measuring Empowerment Among People With Psychotic Disorders: A Comparison of Three Instruments

Castelein¹,

Gaag²,

Bruggeman³

et al. 2008

View full text Add to dashboard Cite

Objective: This study compared three instruments that are used to measure empowerment of people with psychotic disorders. The study evaluated internal consistency, discriminant and convergent validity, sensitivity to symptom levels, and clinical usefulness. Methods: Fifty patients in the Netherlands were administered the Empowerment Scale (ES), the Personal Empowerment Scale (PES), and the Mental Health Confidence Scale (MHCS). E mpowerment is an outcome pursued by advocacy groups, consumer organizations, mental health professionals, and health care providers. It originates from the political arena, although a consensus has not yet been reached on its definition. ResultsThe many definitions of empowerment suggest that the concept is still evolving (1), and the number of empirical studies on empowerment is limited. Most definitions of empowerment include participation in society in terms of access to employment, education, and other valued resources (2,3). However, there is a distinction between definitions focusing on interpersonal characteristicscontrol over one's life and the recovery process or the efforts to achieve more control and self-efficacy (1)-and those that also highlight influencing the organizational and societal structure in which one lives (4).In instruments developed to measure empowerment, these differences can be seen. In this study, we assessed the impact of these differences and examined whether these instruments measure the same concept. Also, we aimed to gain some insight into how to choose the right instrument for measuring empowerment in a population of patients with psychotic disorders.The instruments studied are the Empowerment Scale (ES) (1), the Personal Empowerment Scale (PES) (2), and the Mental Health Confidence Scale (MHCS) (5). They are the most frequently cited instruments to measure empowerment in the literature, and their reliability and validity have already been established for people with severe mental illness (1,2,6). Here we reappraised their internal consistency, convergent and discriminant validity, and applicability for patients with psychotic disorders (7,8). As for their convergent and discriminant validity, we hypothesized that the total scores of the instruments will have correlations of at least .70 and that between subscales with common content the correlations will be even stronger. Furthermore, we assessed the association between empowerment and the level of symptoms. Methods

show abstract

Designing a CBT service for an acute inpatient setting: A pilot evaluation study

Cited by 42 publications

References 25 publications

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

A feasibility study of a cross‐diagnostic, CBT‐based psychological intervention for acute mental health inpatients: Results, challenges, and methodological implications

Measuring Empowerment Among People With Psychotic Disorders: A Comparison of Three Instruments

Contact Info

Product

Resources

About