Psychotherapy Journals

Miscellaneous

Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp f1-f2

Abstract

Miscellaneous

Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp b1-b3

Abstract

Rapid Communication
Shanaya Rathod, David Kingdon, Peter Phiri, Mary Gobbi,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 511-533

Abstract
Background: Studies of cognitive behaviour therapy (CBT) for schizophrenia demonstrate that African-Caribbean and Black African patients have higher dropout rates and poor outcomes from treatment. Aim: The main aim of the study was to produce a culturally sensitive adaption of an existing CBT manual for therapists working with patients with psychosis from specified ethinic minority communities (African-Caribbean, Black-African/Black British, and South Asian Muslims). This will be based on gaining meaningful understanding of the way members (lay and service users) of these minority communities typically view psychosis, its origin and management including their cultural influences, values and attitudes. Method: This two-centre (Hampshire and West London) qualitative study consisted of individual semi-structured interviews with patients with schizophrenia (n = 15); focus groups with lay members from selected ethnic communities (n = 52); focus groups or semi-structured interviews with CBT therapists (n = 22); and mental health practitioners who work with patients from the ethnic communities (n = 25). Data were analyzed thematically using evolving themes and content analysis. NVivo 8 was used to manage and explore data. Results: There was consensus from the respondent groups that CBT would be an acceptable treatment if culturally adapted. This would incorporate culturally-based patient health beliefs, attributions concerning psychosis, attention to help seeking pathways, and technical adjustments. Conclusion: While individualization of therapy is generally accepted as a principle, in practice therapists require an understanding of patient-related factors that are culturally bound and influence the way the patient perceives or responds to therapy. The findings of this study have practical implications for therapists and mental health practitioners using CBT with people with psychosis from BME communities.

Research Articles
Jakob Smári, Ástdís Þorsteinsdóttir, Lilja Magnúsdóttir, Unnur J. Smári, Daníel Þ. Ólason,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 535-544

Abstract
Introduction: Inflated responsibility has been hypothesized as an important influence on OCD symptoms. According to Salkovskis and colleagues (1999) there are in turn five developmental pathways that lead to inflated responsibility. Coles and Schofield (2008) proposed the Pathways to Responsibility Beliefs Scale (PIRBS) as a measure of these pathways. Method: In the present study the psychometric properties of an Icelandic translation of the PIRBS were evaluated and its factor structure was studied in a confirmatory factor analysis. Further it was tested whether responsibility mediated between pathways to responsibility beliefs and OCD symptoms. Results: While neither a four nor a five-factor structure of the PIRBS was found to be wholly satisfactory; support for the latter was slightly better. Correlations of the PIRBS scales with measures of responsibility and obsessive-compulsive disorder symptoms were moderate as expected. Support was found for a mediating role of responsibility attitudes between pathways measured by the PIRBS and OCD symptoms in support of Salkovskis and colleagues' theory (1999). Conclusion: The PIRBS is a promising approach to study the developmental precursors of inflated responsibility and OCD symptoms but its factor structure may need a revision

Research Articles
Paul Stallard, Thomas Richardson, Sophie Velleman,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 545-560

Abstract
Background: Research has begun to examine the effectiveness of computerized cognitive behaviour therapy (cCBT) with children and adolescents. Although cCBT appears promising, the attitudes of clinicians towards this type of intervention with children and young people have not been assessed, yet these are important in determining when and if cCBT will be offered. Aims: To survey clinicians concerns about the effectiveness of cCBT for more substantial problems and the level of therapeutic support required.

Research Articles
Kate L. Mathew, Hayley S. Whitford, Maura A. Kenny, Linley A. Denson,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 561-576

Abstract
Background: Mindfulness-based Cognitive Therapy (MBCT) is a relapse prevention treatment for major depressive disorder. Method: An observational clinical audit of 39 participants explored the long-term effects of MBCT using standardized measures of depression (BDI-II), rumination (RSS), and mindfulness (MAAS). Results: MBCT was associated with statistically significant reductions in depression from pre to post treatment. Gains were maintained over time (Group 1, 1 24 months, p = .001; Group 3, 25 booster sessions and ongoing mindfulness practice correlated with better depression outcomes (p = .003 and p = .03 respectively). There was a strong negative correlation between rumination and mindful attention (p .001), consistent with a proposed mechanism of metacognition in the efficacy of MBCT. Conclusion: It is suggested that ongoing MBCT skills and practice may be important for relapse prevention over the longer term. Larger randomized studies of the mechanisms of MBCT with longer follow-up periods are recommended.

Research Articles
Alyson Bessell, Alex Clarke, Diana Harcourt, Tim P. Moss, Nichola Rumsey,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 577-596

Abstract
Background: Individuals with visible differences can experience social anxiety in relation to their appearance. Social skills-based psychosocial interventions have to date shown only limited effectiveness at addressing their concerns. Aims: To incorporate user perspectives in the development of an online psychosocial intervention, known as Face IT. Method and Results: Study one consisted of a needs assessment with 12 individuals with a visible difference and six health professionals in order to identify the difficulties experienced by those with visible difference and obtain feedback on the proposed content of Face IT. The findings demonstrated support for the social skills model and the use of an online intervention. Study two consisted of an empirical usability evaluation of Face IT with 14 potential users and 14 health professionals. Based on feedback from the participants, changes were made to the graphics and navigation of the programme. The clinical content has been made more acceptable. Conclusions: The findings indicate support for the importance of social skills-based psychosocial interventions for addressing the needs of those with a visible difference, and have allowed modifications to be made to Face IT ahead of a randomized controlled trial of effectiveness.

Research Articles
Stephanos P. Vassilopoulos, Robin Banerjee,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 597-609

Abstract
Background: Recent research has indicated that individuals with social interaction anxiety make biased interpretations of positive social interactions, with greater general apprehension in response to such events and more negative predictions about the future. There has also been some preliminary evidence for a second facet of interpretation bias, namely a failure to accept others discounting dimension and utilized a nonclinical sample of undergraduate students to provide an initial analysis of the scale. Results: Results provide early support for the psychometric properties of our scale, and indicate that discounting mediates the relationship between social interaction anxiety and low positive affect, over and above the previously studied aspect of positive event interpretation bias. Conclusions: The implications for treatment interventions and further research are discussed.

Research Articles
Bryan Hartzler, Blair Beadnell, David B. Rosengren, Chris Dunn, John S. Baer,
Behavioural and Cognitive Psychotherapy, Volume 38 Issue 05 , pp 611-628

Abstract
Background: Proficient delivery of motivational interviewing (MI) is often determined by global rating of relational elements or cumulative tallies of technical elements. Yet limited empirical evidence exists to clarify how relational and technical elements are associated, or if rates of skill indices and their constituent technical elements vary within a clinical encounter. Aims: This study sought to document temporal variance in rates of MI skill indices and their constituent technical elements during brief clinical encounters with a standardized patient wherein delivery was , and to distinguish those temporal patterns from those observed in encounters with delivery. Method: Data were accessed from a large MI training trial wherein relational and technical elements of MI delivery were scored for 503 recordings of a simulated 20-minute clinical encounter. Notably, independent raters tallied technical elements in 5-minute segments, allowing evaluation of potential variance among the encounter's quartile intervals. Global ratings of MI spirit identified subsets of recordings with MI-proficient (n = 49) and MI-inconsistent (n = 43) delivery for stratified analyses. Results: Analyses contrast temporal trajectories of technical aspects of MI-proficient and MI-inconsistent delivery, with the former characterized by: 1) elicitation and reflective listening as primary opening strategies; 2) increased depth of reflective listening as a predominant strategy in subsequent, focused therapeutic discussion; and 3) increased use of elicitation and information provision in change planning as the encounter approached conclusion. Conclusions: Findings are generally consistent with seminal descriptions of MI (Miller and Rollnick, 1991, 2002), and document temporal aspects of skilful MI delivery in brief encounters.