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Low-intensity CBT Skills and Interventions

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Страница 1Страница 2 Low-Intensity CBT Skills & Interventions Страница 4 About the Editor About the Contributors Foreword Acknowledgements Страница 9Страница 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 {buyButton}

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