Why some clinical psychologists are ignoring official best practice guidelines

By Christian Jarrett In England there’s an independent health advisory body that provides guidelines to clinicians working in the NHS, to make sure that wherever patients are in the country, they receive the best possible evidence-backed care. The National Institute for Health and Care Excellence (NICE) was set up in 1999 and many of its guidelines pertain to mental health, and they often promote psychological approaches – for example, the guidelines for depression state that talking therapies should be the first-line of treatment for all but the most severely affected patients. While clinical and counselling psychologists have been involved in producing these guidelines, many of their colleagues – especially those in practice – are highly critical of them. Why? A series of interviews with 11 clinical psychologists, published in Clinical Psychology and Psychotherapy, sheds new light on the scepticism and concern felt towards NICE guidelines, and why some psychologists are even deliberately ignoring them. Alex Court at the Salomons Centre for Applied Psychology interviewed 11 clinical psychologists “in routine practice in the NHS” for roughly an hour each. Court’s approach was open-ended and he began each interview by simply asking each psychologist to share their thoughts on the NICE guidelines. Court subsequently transcribed the interviews and together with his colleagues he set about looking for emerging th...
Source: BPS RESEARCH DIGEST - Category: Psychiatry & Psychology Authors: Tags: Mental health Qualitative Therapy Source Type: blogs

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Conclusion: This is the first implementation of SocialMind, which is the first mindfulness-based social cognition training. It is well tolerated by participants with schizophrenia spectrum disorders, and a further randomized controlled trial is proposed for people who have suffered their first episode of psychosis within the past 5 years.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03434405.IntroductionPeople suffering from psychosis frequently find it difficult to establish or maintain relationships with others or to engage in community activities (1, 2). These deficits are present even in high-risk ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Authors: Harrison P, Hardy GE, Barkham M Abstract The aim of the study was to investigate whether client-reported expected engagement with therapy predicted therapy outcome. It was hypothesised that higher expected engagement with cognitive behavioural therapy (CBT) or person-centred experiential therapy (PCET) would predict more symptomatic improvement following therapy and higher likelihood of therapy completion. The Sheffield Expected Engagement with Therapy Scale (ShEETS) was administered to 96 clients at pre-therapy assessment with all meeting a diagnosis of moderate or severe depression with 53 receiving CBT ...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research
Conclusions: CBT, psychosocial intervention, supportive counseling, psychodynamic psychotherapy, and other psychological interventions can be recommended for clinical practice. More studies are needed, especially for non-CBT interventions and for all psychotherapies on negative symptoms.IntroductionSchizophrenia affects approximately 1% of the population, usually starting in adolescence or young adulthood, frequently leading to persistent disability, with a high risk of suicide (8%). Despite the advance in antipsychotics treatment, approximately 30% of patients with schizophrenia show a poor response or no response to anti...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
In conclusion, treatment outcomes in different domains seem to be linked to the client’s motivation to attend treatment and the feeling of being coerced into therapy, regardless of mandate (2). It has been argued that there is, potentially, an element of coercion in every clinical encounter (80) and the perception of coercion has a variety of determinants, many of which are dependent on the quality of relationship with the service provider (45). Therefore, reducing feelings of coercion might improve treatment outcomes, prevent disengagement from services, and ameliorate therapeutic relationships (5). Facilitating the...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: The findings from this exploratory study are consistent with the possibility that dialogue therapy may lead to improvements in symptoms and functioning compared to standard treatment in psychosis. Introduction Standard treatment (ST) for psychosis consists primarily of antipsychotics, hospitalization, social rehabilitation, and different types of supportive therapy (1–3). Antipsychotic drugs have only moderate effects on positive symptoms and no demonstrable effects on negative symptoms (4–6). Side effects are often prominent and might include a reduction in emotional expression, menstrual ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: Compared with waiting list, guided iCBT is effective and likely results in symptom improvement in mild to moderate major depression and social phobia. Guided iCBT may improve the symptoms of generalized anxiety disorder and panic disorder compared with waiting list. However, we are uncertain about the effectiveness of iCBT compared with individual or group face-to-face CBT. Guided iCBT represents good value for money and could be offered for the short-term treatment of adults with mild to moderate major depression or anxiety disorders. Most people with mild to moderate depression or anxiety disorders with whom...
Source: Ontario Health Technology Assessment Series - Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research
DiscussionThe expected results will be a major step forward in establishing empirically supported psychological treatments for survivors of CA suffering from Complex PTSD.Trial registrationGerman Clinical Trials Register: registration numberDRKS00005578, date of registration 19 December 2013.
Source: Borderline Personality Disorder and Emotion Dysregulation - Category: Psychiatry Source Type: research
This study supports existing research showing promise for the application of rt-fMRI neurofeedback in the treatment of problems like PTSD, addiction and depression that are associated with heightened amygdala activation. The clinical potential of this technique, bridging the worlds of neurobiology and psychotherapy, is clear. That said, fMRI scanning is an expensive business, so it may be a while before a new world of personalised mental health interventions reveals itself. —Training emotion regulation through real-time fMRI neurofeedback of amygdala activity Post written by Eleanor Morgan (@eleanormorgan) for B...
Source: BPS RESEARCH DIGEST - Category: Psychiatry & Psychology Authors: Tags: Brain guest blogger Mental health Source Type: blogs
CONCLUSIONS: Evidence from RCTs of moderate quality suggest that psychotherapy is useful for treating depressive states in advanced cancer patients. However, no evidence supports the effectiveness of psychotherapy for patients with clinically diagnosed depression. PMID: 30480780 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
OBJECTIVE:: Identify the core 'interaction structures' between therapists and depressed adolescents within and across two common forms of psychotherapy. METHOD:: A total of 70 audio-recorded psychotherapy sessions representing short-term psychoanal...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
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