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Low-intensity CBT Skills and Interventions
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Страница 1
Страница 2
Low-Intensity CBT Skills & Interventions
Страница 4
About the Editor
About the Contributors
Foreword
Acknowledgements
Страница 9
Страница 10
1 Low-Intensity Cognitive Behavioural Therapy: Revolution Not Evolution
Learning Objectives
Background
The IAPT Programme
Key Point
Stepped Care
Key Point
What is Low-Intensity CBT?
Key Point
Evidence Base
Interventions
Delivery and Support
Acceptability
Key Point
Differences between HICBT and LICBT
Clinical Method
Therapeutic Dose
Here and Now v. Longitudinal Cognitive Behavioural Formulation
Specific Factor Skills Employed When Questioning
Single-Strand v. Multi-Strand Interventions
Workforce
Responsibilities
Training and Supervision
Challenges Encountered
Clinical Heterogeneity
Lack of Consensus Regarding Single-Strand Interventions
Therapeutic Drift during Support Sessions
Therapeutic Drift within CBT Self-Help Interventions
Reflection Point
Retention of the LICBT Psychological Therapy Practitioner Workforce
Increased Demands Placed on LICBT Psychological Therapy Practitioners
Key Point
Summary
Assessing Your Understanding Declarative Essay Questions
Extended Matching Questions
Procedural Case Vignette-Based Question
Further Reading and Resources
Страница 48
2 Low-Intensity CBT Assessment: Unlocking the Key to Successful Intervention
Learning Objectives
Background
Key Point
Questioning Skills
Funnelling
Top of the Funnel
Key Point
Moving down the Funnel
Bottom of the Funnel
Problem Formulation Assessment Structure
Introduction to Assessment Session
Introductions
Clinical Example Introduction
Brief Clear Explanation of LICBT Practitioner Role
Clinical Example Introducing Role
Overview and Agree Session Agenda
Clinical Example Overviewing Session
Confidentiality and Informed Consent
Clinical Practice Confidentiality
Clinical Example Breaking Confidentiality
Information-Gathering: General Presentation
Key Point
Triggers
Onset and Progress
Medication
Clinical Example Questions Exploring Medication Use
Impact
Modifying and Maintaining Factors
Employment Status
Previous Treatments
Other Current Treatments
Alcohol Consumption and Drug Use
Administration of Routine Outcome Measures
Clinical Example Introducing Routine Outcome Measures
Risk Assessment
Reflection Point
Clinical Example Introducing Risk Assessment
Information-Gathering: Problem Formulation
Clinical Example Questions to Elicit Symptoms of the Presenting Problem
Information Giving and Shared Decision-Making
Problem Statement
Goal-Setting
Key Point
Barriers to Goals
Psychoeducation
Treatment Options
Ending the Session
Clinical Practice Areas Addressed
Summary
Assessing Your Understanding Declarative Multiple Choice Questions
Procedural Self-Practice/Self-Reflection
Further Reading and Resources
3 Diagnoses and Problem Descriptors: Labelling Problems, Not People
Learning Objectives
Background
Key Point
Reflection Point
Problem Descriptors
Key Point
Presenting Characteristics of Common Mental Health Disorders (CMDs)
Depression
Key Point
Anxiety Disorders
Key Point
Generalised Anxiety Disorder
Key Point
Panic Disorder
Key Point
Agoraphobia
Key Point
Obsessive Compulsive Disorder (OCD)
Key Point
Specific Phobias
Key Point
Diagnosis of CMDs Not Treated with LICBT
Social Anxiety Disorder
Key Point
Key Point
Health anxiety
Key Point
Post-Traumatic Stress Disorder (PTSD)
Key Point
Mixed Anxiety and Depressive Disorder
Key Point
Validity of Diagnostic Systems
Probable Diagnosis Determining a Problem Statement
Clinical Example Case Example: Sallyanne
Improving Diagnosis Rates
Summary
Assessing Your Understanding Declarative Extended Matching Questions
Procedural Reaching a Probable Diagnosis
Further Reading and Resources
4 Clinical Decision-Making in Low-Intensity Cognitive Behavioural Therapy: Integrating Patient Choice, the Practitioner and Evidence Base
Learning Objectives
Background
Key Point Characteristics of Shared-Decision Making (Elwyn et al., 2010)
Key Point Factors Potentially Causing Drift from the Evidence Base in Decision-Making
Clinical Decision-Making within Stepped Care
Clinical Practice Principles of the Stepped Care Model Informing Key Decision-Making Stages (Bower & Gilbody, 2005; Richards et al. 2010)
Decision-Making Protocols within Low-Intensity CBT
Clinical Practice Common Clinical Decisions within the IAPT Programme and Factors to Consider
Decision 1: Is Step 2 or 3 Treatment Suitable for the Patient?
Clinical Practice IAPT Inclusion and Exclusion Criteria
Clinical Practice To Determine the Suitability of Step 2 and 3 Treatments consider:
Provisional Diagnosis
Severity
Clinical Practice Wider Information to Consider Alongside ROM Severity (NICE, 2011b, para. 1.4.1)
Risk
Alcohol and Drug Use
Clinical Practice Indicators of Unsuitability of Step 2/3 Treatment for Patients Using Alcohol or Drugs
Decision 2: Which LICBT Intervention Do I Offer?
Clinical Practice NICE (2011b) Recommended LICBT Interventions
Co-morbidity
Signposting
Decision 3: How Should the Intervention Be Delivered?
Decision 4: Should I Discharge or Step up?
Clinical Practice Clinical Decision-Making Informed by Number of Treatment Sessions
Summary
Assessing Your Understanding
Declarative Multiple Choice Questions
Procedural
Reflection Point
Further Reading and Resources
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