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Purpose: With a historic lack of attention to synthesis methods such as systematic review and meta-analysis and a lack of randomised controlled trials, the evidence base for behavioural interventions for children and adults who are autistic or are diagnosed with developmental disabilities is patchy. The Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN), a network of like-minded researchers and practitioners across the UK, aims to address this. The purpose of this paper is to describe the network's work and provide the context for the remaining articles in the special issue that exemplify network projects. Design/methodology/approach: In this case study paper, the authors describe how the SF-DDARIN works and is resourced, detailing the process used to maximise research opportunities by facilitating network members working together. The authors outline the progressive research steps that the SF-DDARIN has identified are needed to develop and improve the evidence base for behavioural interventions systematically and, with examples, describe how the network delivers these steps. Findings: Since its establishment in 2016, the SF-DDARIN network members have collectively worked on more than 53 projects involving over 50 researchers, had over 120 special schools contribute to projects and have recruited over 500 participants. This has been achieved through funding from the Sharland Foundation, primarily to cover the staffing costs of a small support team and internship partnerships with external organisations. Some projects have attracted external funding. Originality/value: SF-DDARIN may provide an innovative, effective and resource-efficient model for other groups seeking to develop and extend their evidence base in developmental disability research. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to offer a commentary on Denne et al.'s (2024) article discussing the journey undertaken by the Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network to augment evidence surrounding the efficacy of the online Headsprout® Early Reading programme. Design/methodology/approach: Drawing from over 15 years of professional experience as a qualified teacher in special education settings, the author reflects on the network's approach and its alignment with their own expertise. Findings: While acknowledging the commendable focus of the network on amassing additional evidence, this commentary underscores the importance of identifying barriers and fostering adaptability within the educational landscape. Central to the discussion is the imperative to prioritise students' needs and tailor data collection methods to suit their unique contexts. Originality/value: This commentary is aimed at professionals working in special education settings striving to improve their practice and student outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Evidence-informed decision-making is considered best practice when choosing interventions in applied settings across health, social care and education. Developing that evidence base, however, is not straightforward. The pupose of this paper is to describe the process implemented by the Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN) that systematically develops an evidence base for behaviorally based interventions. Design/methodology/approach: In this case study, the progressive research steps undertaken by the SF-DDARIN to develop the evidence base for an online reading intervention, the Headsprout® Early Reading programme (HER®), which uses behavioural principles to promote learning to read, are described. Findings: A series of discrete projects targeting gaps in the evidence base for HER® led to funding two randomised controlled trials in England, one in education and one in health and social care. Originality/value: This case study illustrates an original, creative and effective way of collaborating across academic research departments and applied settings to extend the evidence base for a chosen intervention systematically. [ABSTRACT FROM AUTHOR]

Purpose: Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020).Design/methodology/approach: An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven interventions and eight sleep prevalence or sleep-associated factor papers were identified.Findings: Intervention research was very limited and the quality of the research design was generally poor. Interventions such as cognitive behavioural therapy for insomnia (CBT-I), yoga and mindfulness can be beneficial in a prison setting. This review identified a high prevalence of insomnia in prisons across the world, which was supported by recent evidence. Factors associated with insomnia include anxiety, depression, post-traumatic stress disorder, personality disorder and pain.Research Limitations/implications: There is a need for appropriately powered randomised control trials of CBT-I in prisons and a need to use objective measures of sleep quality.Originality/value: Due to a lack of an up-to-date review, this paper fulfils the need for a review of the evidence on interventions in prison settings with sleep as an outcome, rates of insomnia prevalence and associated factors in prisons. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to broaden the discussion on some of the barriers and solutions for co-production in positive behaviour support (PBS) planning as identified in the paper "Including people with intellectual disabilities in the development of their own Positive Behaviour Support Plans". Design/methodology/approach: Drawing on the literature associated with co-production in PBS planning, this commentary will reflect on the wider systems and culture needed to enable successful implementation of this way of working. Findings: Co-production in PBS planning is recommended as part of best practice guidelines. However, there is limited research in the area of co-production with regards to PBS and use of augmentative and alternative communication methods. Collaboration among speech and language therapy and PBS practitioners is an important factor for co-production to achieve the best outcomes for people with learning disabilities who display behaviours of concern. Along with identifying a range of communication tools/strategies needed for PBS assessment/planning, it also requires a whole systems approach and culture shift to ensure the necessary foundations are in place. Originality/value: Co-production in PBS planning remains an under practiced way of working. This commentary builds on the barriers and solutions identified for co-production and provides further insight into what might be needed to achieve this in health and social care settings. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population. Design/methodology/approach: In total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students' aggressive behaviors. Findings: Of the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group. Practical implications: In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. Originality/value: In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study's findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research. [ABSTRACT FROM AUTHOR]

Purpose: Intensive support teams (ISTs) are often poorly understood, despite reports of their effectiveness in managing behaviour that challenges for individuals with an intellectual disability. This paper aims to contribute to the understanding of ISTs through evaluating one IST's process and their use of positive behaviour support (PBS) as an intervention. Design/methodology/approach: Participants were obtained from the ISTs discharge database, and pre- and post-intervention data from these participants was used for analysis. Findings: Three-paired sample t-tests found that there were significant differences between pre- and post-scores on the behaviour problem inventory, Health of the Nation Outcomes Scale for people with Learning Disabilities and periodic service reviews, which measure quality of targeted, individualised support. This indicates that challenging behaviour frequency and severity were lower post-intervention, quality of life improved post-intervention and staff teams implemented recommended strategies more consistently by the end of the intervention. Originality/value: This service evaluation captured data over seven-year period, which helps to contribute to the understanding of the effectiveness of ISTs and the PBS framework. [ABSTRACT FROM AUTHOR]

Purpose: Although the concept of transformative gamification is mentioned in previous research, no research has provided a theoretically based explanation of how gamification can lead to transformative change. This paper aims to provide the explanation for the first time by combining storytelling elements with cognitive behavioural therapy logic and incorporating these into a framework to show the process of transformative behaviour change through gamification. The proposed framework not only furthers the theoretical understanding of transformative gamification services but also provides practical insight into design and implication of such services. Design/methodology/approach: This paper is based on critical analysis and synthesis of literature from different fields of research such as transformative service research (TSR), gamification, game studies, social marketing, storytelling and journalism. Ergo, several propositions based on the extensive literature review are proposed and aggregated in a conceptual framework. Findings: This paper argues that apart from game mechanics that are often considered as an inseparable aspect of gamification services, immersive storytelling and a mechanism to encourage reflection are the pivotal components of transformative gamification services. In addition, this paper suggests that although reflection and immersive storytelling are often considered as opposite sides of the spectrum, they can have a synergistic effect once they work in tandem in gamification services. Originality/value: This paper proposes a novel framework and an operational definition for transformative gamification services. It contributes to TSR, gamification and health promotion research through differentiating this concept from similar concepts, such as mHealth, propelling gamification to a more meaningful and user-centric version and providing service researchers with a practical guide to make use of gamification as a tool to serve TSR. [ABSTRACT FROM AUTHOR]

Purpose The term catastrophizing was coined by Ellis (1962) and commented on by Beck (1979). Since that time, much research has been done on the topic and a recent review article postulated that catastrophizing served as a transdiagnostic mechanism across the psychiatric disorders (Gellatly and Beck, 2016). In rational emotive behavior therapy (REBT), there is a greater emphasis placed on the underlying irrational beliefs than the surface-level automatic thoughts; therefore, REBT therapists tend to focus on Awfulizing as opposed to catastrophizing. While these terms sound similar, it is unclear what theoretical overlap and distinction exists between the concepts. The paper aims to discuss these issues.Design/methodology/approach This paper is a review and synthesis of the extant literature, drawing from both theorists and empirical studies, to map out the similar and unique aspects of each cognition.Findings Awfulizing and catastrophizing are distinct concepts with differing effects on cognitive, affective and behavioral responses; these findings extend beyond theoretical models and are supported by empirical literature.Originality/value This review has direct implications for practitioners of the cognitive and behavioral therapies, including REBT, and those seeking an integration of the cognitive therapies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a commentary to Hayward, Poed and McKay-Brown's article by expanding upon some of the reasons for the apparent dominance of Positive Behaviour Support (PBS). Design/methodology/approach: The commentary notes the rise and dominance of Cognitive behaviour therapy (CBT) over a similar time frame, and uses both this and ideas from the literature to examine the reasons for, advantages and consequences of PBS's dominance. Findings: The paper identifies three overlapping reasons for the comparable rise of PBS and CBT, and examines the impact that their dominance has had on attempts to manage quality, improve outcomes and train staff. Originality/value: Establishing the reasons for the success of a theoretical approach can assist with the development of other effective interventions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe and discuss the variables which have contributed to the adoption of positive behaviour support (PBS) and applied behaviour analysis (ABA). Differences and similarities are highlighted, applications to contemporary issues in the UK and Australia are emphasised, and considerations posed for their improved adoption. Design/methodology/approach: A conceptual framework for diffusion of innovations theory is used to guide the analysis of three sets of articles, and application of the framework is guided by narrative analysis. Findings: Eight variables from the conceptual framework were identified, and the communication networks for PBS and ABA are argued to be distinct. There has been a positive change in the perception of PBS by the ABA field, but PBS has leveraged diffusion more successfully. ABA appears to have been separated from PBS in the UK while Australia is yet to fully benefit from the contributions of ABA. Those working in the fields of PBS and ABA should further collaborate for their mutual benefit. Practical implications: Greater attention to the factors which promote diffusion can assist PBS and ABA to improve their adoption. Originality/value: This is the first paper to use diffusion of innovations theory to analyse the adoption of PBS and ABA. [ABSTRACT FROM AUTHOR]

Purpose: Without effective support and intervention, young people with learning disabilities and severe challenging behaviour are at risk of placement in out-of-area residential settings or highly specialist child and adolescent mental health service (CAMHS) units. Such placements may be inappropriate and result in significant reductions to the quality of life of young people and their families. This paper aims to evaluate the effectiveness of the Bradford positive behaviour support (PBS) service model in terms of its aims to improve quality of life, develop skills and maintain children living with their families in their own homes. Design/methodology/approach: A service evaluation using quantitative and qualitative data from a range of sources to review the effectiveness of the PBS model being applied in Bradford and Calderdale was the methodology used. Findings: When consistently implemented, the Bradford positive behaviour support–in reach service may improve quality of life, facilitate skill development in young people and their carers and reduce placements in residential and CAMHS inpatient units. Avoidance of such placements is likely to reduce the overall costs of service commissioning in Bradford. Originality/value: This paper evaluates a novel approach being applied by a third sector agency to implement effective PBS with a small group of children, their families and networks. There is scope for this model to be successfully implemented in other areas. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide a commentary on some of the issues raised in the paper “Developing a logic model to guide evaluation of impact for learning disability projects: the case of the Positive Behavioural Support (PBS) Academy”.Design/methodology/approach Drawing on the PBS literature and with reference to the Scott et al. paper, the use of a logic model as a framework for implementing PBS within social care organisations is described.Findings A logic model may be a useful framework for the implementation of PBS within social care organisations and could be used to help organisations develop a strategic approach to whole-system implementation of PBS.Originality/value This commentary adds to the discussion by considering the use of a logic model as a framework for implementing PBS within social care organisations. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC intervention.Design/methodology/approach This paper is based on in-depth, semi-structured interviews with participants (n=40) who have received an IBHC intervention for one year. These qualitative data are supplemented by descriptive quantitative data from those same participants.Findings This research suggested that IBHC increased awareness and access to behavioral health services, and that IBHC may be especially amenable to treating complex health conditions. The research also found that IBHC provided a point of regular contact for patients who had limited time with their primary care providers, which helped to enhance access to and engagement with health care.Practical implications IBHC has the potential to meet the complex needs of Karen resettled refugees living in an urban setting in the USA.Originality/value IBHC is a promising approach to help meet the mental health needs of refugees in the USA. There are, however, gaps in knowledge about the “active ingredients” of IBHC. This paper helps fill these gaps by studying how IBHC works from the perspective of a group of Karen refugees; these are critical perspectives, missing in the literature, which must be heard in order to better address the complex conditions and needs of resettled refugees. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to assess the quality of systematic reviews on the effectiveness of psychological therapy for adults with intellectual disabilities (ID) and mental health difficulties. Design/methodology/approach: Four electronic databases were used: Cochrane, PsycINFO, PubMed and Scopus. Studies were included if they were a systematic review focused primarily on psychological therapy for adults with ID and mental health difficulties. Systematic reviews focused on anger were also considered for inclusion. These reviews were rated for quality on the Amstar-2, a quality rating tool designed to evaluate systematic reviews. Findings: Twelve relevant systematic reviews were identified, which included seven reviews focused primarily on cognitive behavioural therapy, two on psychodynamic therapy and three on third-wave therapies. The AMSTAR-2 indicated that all 12 reviews were of "critically low" quality. Thus, there are significant problems with the evidence base. Originality/value: To the best of the authors' knowledge, this is the first systematic review of systematic reviews of the effectiveness of psychological therapies for people who have ID. It provides an overview of the quality of the evidence base into one place. [ABSTRACT FROM AUTHOR]

Purpose: Women with deafness are one of the vulnerable groups who experience sexual harassment. As a result, they experience psychological disorders such as stress, anxiety, fear and trauma. This problem is made worse because women with deafness have language and speech disorders. This paper aims to explore sexual harassment of women with deafness and develop Bisindo-based rational emotive behaviour therapy (REBT) to deal with sexual harassment against women with deafness. Design/methodology/approach: Using the Analysis, Design, Development, Implementation and Evaluation model of the R&D approach, this preliminary research study was carried out in four stages. The research respondents for the need assessment were 166 people with ten professional backgrounds spread throughout Indonesia. Respondents for model validation tests are ten people: REBT experts, psychologists, Bisindo experts, teachers, lecturers, Head of Women's Organization (WCC) and Head of the Deaf Community (Gerkatin) in West Sumatra. Data were collected by questionnaire. Findings: The results showed that many women with deafness experienced sexual harassment. The handling model using REBT mediated by Bisindo is needed in further research to test its effectiveness. The validity test results show that the Bisindo-based REBT model has been declared feasible, helpful, accurate and practical to be used as a response model for sexual harassment in women with deafness. Originality/value: The results of this study imply the need for the application of therapies that follow the characteristics of victims, such as Bisindo-based REBT for female sexual victims. [ABSTRACT FROM AUTHOR]

Purpose: Research highlights that antipsychotic medications are prescribed more in people with Intellectual Disability (ID) without a diagnosis of severe mental illness. Despite non-pharmacological interventions recommended as alternatives, their application can be challenging due to heterogeneity of the patient group. The purpose of this paper is to discuss application of quality improvement (QI) methodology in adapting interventions, aiming to reduce challenging behaviour of people with ID, thereby reducing use of antipsychotic medication. Design/methodology/approach: Two interventions were introduced as "tests of change"; an "Attention-Deficit Hyperactivity Disorder (ADHD) clinic" and "Positive Behaviour Support (PBS) clinic". Process (Clinical Global Impression (CGI) and Modified Overt Aggression Scale (MOAS)) and outcome measures (total antipsychotic use) were used to assess the interventions, with each being reviewed as per QI methodology guidelines. Findings: There was an improvement in CGI scores for both interventions. MOAS scores reduced for those attending the ADHD clinic, resulting in reductions of antipsychotic medication. MOAS scores did not reduce for the PBS clinic, so there was no reduction in medication for this group. Originality/value: Based on the introduction of pilot clinics, this paper provides a commentary on how QI interventions can be used to evaluate and adapt evidence-based interventions, in managing the needs of patients with ID. It further highlights the importance of the diagnosis of ADHD in patients with ID and challenging behaviour. Although PBS is recommended to manage challenging behaviour, this paper demonstrates the importance of continuous evaluation of behavioural interventions. There is currently no existing literature investigating use of QI methodology to reduce challenging behaviour in ID populations, emphasising scope for future research and service evaluation. [ABSTRACT FROM AUTHOR]

Purpose: Direct care staff may be resistant to the use of behavioural interventions. Whilst some research suggests that resistance to the cost of behavioural interventions is one factor of influence, there is lack of research exploring why staff are influenced by the cost. The purpose of this paper is to explore this issue. Design/methodology/approach: In this paper, the phenomenon of resistance is analysed with the help of behavioural economics and of the behavioural perspective model (BPM). Findings: The resistance to the cost of behavioural interventions is correlated with the low quality of the working environment and ways in which staff might attend to factors which protect their own well-being. Practical implications: Services might need to focus on the ways in which behavioural interventions protect staff's well-being. Originality/value: This paper explores the use of the BPM and of behavioural economics as conceptual tools for the analysis of the factors leading to non-adoption of behavioural interventions. [ABSTRACT FROM AUTHOR]

Purpose The last two decades have seen an increase in service user involvement (SUI) in the training of Mental Health Professionals (MHP). There is developing empirical support for SUI in MHP training, however, there is no published research into SUI in the training of Cognitive Behavioural Therapists. The purpose of this paper is to explore cognitive behavioural therapy (CBT) trainees' experience of SUI in their training. The study focuses on how an individual service user (SU) led training session is experienced and how this differs to routine CBT training.Design/methodology/approach Semi-structured interviews were conducted with six participants. Transcripts of the interviews were analysed using interpretative phenomenological analysis.Findings Data revealed three superordinate themes: first, predisposing influences on learning; second, factors associated with emotional processing of experience; and third, impact upon learning outcomes. The results suggest that participants' appraisal of their learning from SUI maybe influenced by how they accommodate the emotional impact of the experience.Originality/value The paper makes recommendations for educators on courses involving service users (SUs), acknowledges the study's methodological limitations and suggests areas for future research. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a commentary on "A logic model for the implementation of a regional workforce strategy in Positive Behavioural Support". Design/methodology/approach: This commentary provides a discussion of the importance of evaluating positive behaviour support (PBS) training and key issues relating to this. This provides a springboard from which researchers/practitioners may consider these issues when designing and evaluating PBS training courses. Findings: Three main issues are explored: the necessary diversity and breadth of PBS training approaches, the outcome domains to be evaluated and wider systemic issues that may influence PBS training and evaluation of its effectiveness. Originality/value: Effective PBS implementation requires robust training. To achieve this, it will be important for the field to overcome issues relating to the evaluation of training approaches. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is mainly to present a general review of third generation cognitive-behavioural therapies (CBTs), and to debate whether these approaches are applicable to persons with neurodevelopmental disorders (NDD). Design/methodology/approach – Despite the lack of consistent literature focused on this population, the authors have considered the available general literature on the third generation of CBTs and analysed core issues of the processes within the context of intellectual disabilities and Autism spectrum disorder. Findings – The evidence from typical developing population studies and the emerging literature specific to people with NDD is convincing, but there is a need for studies exploring how and when these therapeutic approaches can be applicable. Two behavioural approaches of third generation therapies – acceptance and commitment therapy and mindfulness-based CBT – appear to have the most potential to be adapted for robust intervention for the broad spectrum of persons with NDD. Research limitations/implications – The number of studies and methodologies applied are a clear limitation and the present paper is only exploratory. Originality/value – The paper supports clinicians to use the emerging protocols, and to replicate and implement procedures and techniques. [ABSTRACT FROM AUTHOR]

Purpose: The over-reliance on psychotropic medication for the management of patients with learning disabilities with behaviour that challenges is well documented.This paper aims to discuss the application of the methodology of clinical audit within community learning disability mental health services to adapt interventions including optimising prescribing practice and behavioural interventions aiming to reduce behaviour that challenges in people with learning disabilities. Design/methodology/approach: Questionnaire-based review of documentation in electronic patient records, covering relevant audit standards in line with NICE and Royal College of Psychiatrists, was carried out in the North Essex Community Learning Disability Service, Hertfordshire Partnership NHS Foundation Trust. The audit included patients on the caseload of consultant psychiatrists. Findings: The audit demonstrated that the prescribing of psychotropic medication was within BNF maximum limits for all patients, evidence of "consent" procedures was being followed in the majority, and there was some evidence of deprescribing attempts.Improvement was required in several areas e.g. undocumented off label prescribing in a significant proportion of patients. Objective measures to record the severity of behaviours and the effects of the medication were being used by clinicians in only a small proportion of patients. A significant proportion of patients have prescribed medication in the absence of appropriate psychological or environmental interventions. Originality/value: As a result of the audit findings, the action plan made recommendations such as the development of a database for tracking the prescribing of psychotropic medicines and routine use of standardised measures. This action has been supported by the pharmacy team. Positive developments include a clinical psychologist taking on the role of leading the development of behavioural intervention strategies. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to draw upon a range of material to improve the understanding of disengagement with everyday life, by some individuals who have learning disabilities and mental health difficulties. Illustrative incidents from historical clinical cases are utilised, to consider whether this reframing may enhance the interpretation of presenting behaviours. Design/methodology/approach – Key recurring themes within transpersonal literature were reviewed, relevant to adults with behaviour indicating a degree of disengagement from everyday life. These were grouped into Physical Realm, Psychosocial Realm and Realm of Being. Illustrative examples of behaviour are reviewed and re-interpreted within this framework. Findings – These examples generated plausible interpretations for the presenting behaviours within this framework of the Three Realms. These interpretations support a fresh understanding of the quality of the individual's inner experience. This paper suggests a potential framework to consider the way in which some individuals may experience a different quality of consciousness than the usual. Practical implications – Use of the Three Realms for behaviour interpretation should result into a more empathetic and client-centred approach that could reduce the need for aversive approaches, lessening risk for the client and any employing organisation. The identification of behaviours that signal participation in the Realm of Being could be defined and evaluated with the potential to be used to inform the nature and content of the support provided. Originality/value – This paper, rooted in clinical examples, offers an original synthesis with reasons to include the immaterial realm in the perspective of the human condition. This could benefit people with substantial episodes of disconnection from the Physical Realm and everyday culture and those who support them. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the impact of inclusion of victim empathy-based content in offender treatment. Design/methodology/approach: This study first presents a systematic review of 20 papers before proceeding to consider qualitative interviews with therapists (n = 7) and forensic patients (n = 5), who had completed a long-term violence therapy (Life Minus Violence – Enhanced, LMV-E©). The research explored perceptions of forensic patients and treatment facilitators when completing victim empathy work and explored any negative effects this may have. Findings: Findings from the systematic review indicated five themes: interventions incorporating victim empathy can be effective; there are positive risk-understanding consequences from completing victim empathy work; offenders perceive victim empathy positively; the emotional impact of victim empathy work on offenders' is poorly explored; and completing victim empathy in treatment groups receives mixed evaluations from offenders. The systematic review was used to inform the interview themes for the resulting qualitative study with facilitators and forensic patients. This study indicated six themes: victim empathy content facilitates change; victim empathy content can be difficult for patients; victim empathy content can lead to an emotional response; victim empathy content can be beneficial, with the process important; victim empathy content can help understand risk, and patients' experience of treatment begins before attending sessions. Practical implications: The potential impact of victim empathy content needs to be evaluated before sessions are completed, accounting for client expectations and treatment readiness. This should include ensuring that appropriate support is in place. Any support provided to patients should be regularly reviewed. Originality/value: The study represents the first to apply detailed analysis to this topic area and with a complex group. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present the process of reviewing, adapting and evaluating, the second edition of the I Can Feel Good programme (Ashworth et al., 2018) and adapted DBT programme facilitated at a low-security psychiatric hospital for men with intellectual disability. Through the presentation of programme development, evaluation and revision, a more thorough and transparent understanding of the process involved can be disseminated. Design/methodology/approach: The programme lasted approximately 14 months and covered all four modules. N = 5, all-male, ages ranged between 23 and 57 years old. All detained under the MHA (1983) with a primary diagnosis of Mild ID with comorbid psychiatric diagnoses including mental illness, autism spectrum disorders and personality disorder. To evaluate routine effectiveness a pre-post comparison within groups design was used. A standardised GAS approach provided a template to score the degree to which identified goals were achieved over the intervention for participants. Findings: Wilcoxon signed-rank tests were used due to data not meeting parametric assumptions regarding normal distribution. Except for the mindfulness module, all modules saw pre to post programme psychometric results in the desired direction, evidencing skills acquisition. Coping in crisis and managing feelings modules outcomes neared statistical significance, with the module of people skills demonstrating statistical significance (p < 0.05). Originality/value: Upon examination of the results, it appears as though the second edition pilot programme, displayed initially promising results. The clinical and statistical aspects of the programme are explored, in the hope that clinicians may consider the programme's application and utility within various clinical contexts, in addition to gaining insight into the process of programme development and refinement. [ABSTRACT FROM AUTHOR]

Purpose There are a lack of recourses for substance abuse (SA) treatment for forensic clients with intellectual disabilities (ID). Many complexities arise when treating this population, calling for the creation of comprehensive resources which not only address the SA, but also account for the risk and offending issues. The purpose of this paper is to detail a pilot programme which aims to provide treatment for forensic ID clients with substance abuse issues as well as a significant risk of reoffending.Design/methodology/approach Six participants completed a 27-week SA treatment programme (the Alcohol and Substance Abuse Programme-Intellectual Disability) which incorporated the use of dialectical behavioural therapy (DBT) and the Good Lives Model concepts. Pre- and post-measures aimed to assess readiness for change and confidence in ability to stay clean and sober.Findings Preliminary findings showed a marked improvement in confidence of the participants’ ability to stay clean and sober in risk-related situations as well as an increase in overall readiness for change.Originality/value This research paper addresses a gap in the current forensic ID research and clinical treatment options pertaining to SA, by focussing on supporting forensic ID clients in their recovery journey from SA. Being at the forefront of SA treatment for forensic ID, further research in this domain should attempt to consolidate the findings of this programme. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to develop a model of bank advisor/customer relationships and customer saving behavior. Design/methodology/approach – The research is a theoretical review and model development of savings behavior and bank advisor/customer relationships. The review is used for the development of a model of bank advisor/customer relationships, and their effect on savings behavior. Findings – Findings are a model that distinguishes three kinds of exchange (relational, interimistic, and transaction) in between bank advisor and customer. The three kinds of exchange then influence customer savings behavior. Research limitations/implications – The implications of this research is that it points to that relationship marketing theory can be used in the analysis of how bank advisors influence customer savings behavior. Practical implications – For regulators and financial services firms, these findings point to how the role of bank advisors for consumer savings behavior can be analyzed. This is important, as much policy work presumes that advisors influence customer savings behavior, but the knowledge base for that presumption needs to be better understood. Social implications – The paper contributes toward a better understanding of the social exchange between bank employees and customers as regards savings products. Originality/value – This paper is original because it includes many theoretical research fields, and because it connects the bank advisor and customer relationship with the customer's savings behavior. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the place of medication in the management of challenging behaviour in people with intellectual disability by considering it in the context of the whole system around the person and by considering the challenges of implementing best practice guidance. Design/methodology/approach – The paper identify factors that are barriers to implementing appropriate best clinical practice guidelines (such as "Challenging behaviour: a unified approach") in relation to medication intervention. The paper explores current policy and recommendations on how to improve services for people with intellectual disability and challenging behaviour and make suggestions about how to ensure better compliance with existing guidelines and improve service delivery. Findings – Better integration of services, access to specialist interventions including applied behavioural analysis and understanding communication are all essential to reducing the use of medication, as is the need for reactive, personalised and skilled social care provision. Originality/value – The paper will help professionals and those involved in the provision of service to people with challenging behaviour to focus on areas of improvement and ensure that available resources are maximised to deliver the best outcome for them. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to determine the effectiveness of an adapted dialectical behaviour therapy (DBT) treatment programme for individuals with an intellectual disability, via completion of a service evaluation. Design/methodology/approach: Outcome measurements were competed at pre-, post- and 12 months follow-up, and the effectiveness of the intervention was assessed using a Friedman analysis. Findings: Findings demonstrated that the treatment group showed significant differences in their "psychological distress" scores, but no significant differences were found in their "psychological well-being", "anxiety" or "quality of life" (WHO-QOL) scores over time. Originality/value: Overall, the current study adds to the small but growing literature that supports using the skills training group part of DBT as a stand-alone psychological intervention when working with people with an intellectual disability. [ABSTRACT FROM AUTHOR]

Purpose Dialectical behaviour therapy (DBT) has been widely used in a number of different settings with published outcomes and literature supporting its validity and efficacy. What is less understood is DBT’s application to forensic populations. The purpose of this paper is to qualitatively explore the experiences of high risk and adult male forensic clients (diagnosed with borderline personality disorder (BPD) and antisocial personality disorder (ASPD)) in a forensic adapted version of DBT.Design/methodology/approach Six clients who had completed four modules of DBT and individual therapy engaged in semi-structured interviews which were transcribed and analysed using thematic analysis.Findings The findings identified emerging themes relating to group processes and treatment outcomes. Specifically, the importance of motivation, shared learning, professionalism, reinforcement and reflection in creating a positive experience of DBT were identified. In addition clients identified feeling supported, a sense of belonging, personal achievement, increased knowledge and skills application as being part of their experience of DBT.Research limitations/implications Whilst efforts were made to manage limitations, potential confounders include the impact of the researcher’s direct involvement in the facilitation of DBT and the small sample size.Practical implications This study provides support for the use of DBT with forensic males diagnosed with ASPD and BPD and the importance of the group component to the treatment modality. It emphasises the importance of group cohesion and the development of interpersonal factors including feeling supported, sense of belonging and a sense of achievement.Originality/value This paper provides a unique contribution to the understanding of the application of DBT with forensic male clients with personality disorder. It is the first known study to use qualitative methods to explore forensic male clients’ experiences of group and individual DBT. This paper provides insight into the key themes of clients’ experiences of DBT. These identified themes lend support to the importance of motivation of clients and the experience of shared learning, reinforcement and reflection. Furthermore, feeling supported, having a sense of belonging and a sense of personal achievement were identified as key to the positive experience of clients. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to review the current literature on working with young people with intellectual disabilities who commit arson. Design/methodology/approach – A review of assessment methods and interventions involving young people with intellectual disabilities who start fires was completed. It explores the trends across the population of firesetters as a whole and also compares how treatment implications may differ for young people with and without an intellectual disability. Findings – The paper outlines the core risk factors to be investigated within an assessment of a young firesetter with intellectual disabilities. In terms of treatment, the best current approach appears to be a combination of education and cognitive behavioural approaches including social skills training. Other treatment modalities, e.g. joint interventions provided by fire services and mental health services, are also discussed. Originality/value – Given the lack of available literature on young firesetters with intellectual disabilities it is hoped that this paper will be useful in guiding clinicians working in this area and also prompt future research regarding treatment with this client group. [ABSTRACT FROM AUTHOR]

Purpose – The field of cognitive-behavioural therapy contains many different theoretical models of psychopathology, with each discipline ascribing greater emphasis to a particular cognitive process or organisation of beliefs. This paper seeks to propose a method of integrating the two most widely practiced and researched schools of CBT; Beck's cognitive therapy (CT) and Ellis's rational emotive behaviour therapy (REBT). Design/methodology/approach – Although there exist a large degree of similarity between the two therapeutic approaches, the two models do differ in relation to their respective hypothesises regarding the core psychological variable in psychopathology. Cognitive theory hypothesises that negative representational beliefs are of central importance whereas rational emotive behaviour theory hypothesises that negative evaluative demands lie at the core of psychological disturbance. This paper evaluates these competing predictions on the basis of the available empirical literature. Results – The empirical literature provides greater support for the organisation and interrelations of the irrational beliefs proposed by REBT theory over CT theory, however the research data clearly indicate the importance of the cognitive variables stressed by CT theory in the pathogenesis of psychological distress. Based on the available evidence an integrated CBT model which incorporates elements of both CT and REBT theory is presented. It is proposed that this integrated model can serve as the stepping-stone toward a larger, single, coherent CBT model of psychopathology. Research limitations/implications – Few empirical studies have directly compared the competing predictions of CT and REBT theory. If future research supports the findings presented in this paper, the proposed model can serve as a template for the development of a unified, general-CBT theory of psychopathology. Practical implications – The integrated model presented in this paper can serve as a guiding theoretical model for therapeutic practice which takes into account therapeutic methods from both CT and REBT. Originality/value – This paper proposes the first theoretical model which incorporates the competing theoretical conceptualizations of psychological distress from the two main schools of CBT. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate the social validity of the Aberrant Behavior Checklist - Communit y (ABC-C). Design/methodology/approach: Thirty-six participants completed a questionnaire in which they identified and commented on items of the ABC-C they saw as problematic. Thematic analysis was conducted on the comments made. Findings: All participants identified at least one item of the ABC-C as problematic with six items being so identified by over half the participants. A number of themes were identified in participant comments including ambiguity, judgemental language, child-focussed language, lack of attention to behavioural function and repetition. Research limitations/implications: More research is required using empirically based methodologies on measures used to assess people with learning disabilities. This should involve ascertaining the social validity of such measures by soliciting the views of both those being assessed and those assessing. Originality/value: This study is the first of its kind to evaluate the social validity of one of the most widely used measures of challenging behaviour for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose - This paper sets out to present the concept of the value of information, review the descriptive, rational, social and behavioral approaches for assessing the value of information, and explain why user-centered rather than information-centered evaluations are the most relevant. Design/methodology/approach - The paper starts by highlighting the main facets and market characteristics which influence the value of information. Next, four approaches to assessing the value of information are explained, including a discussion of advantages and limitations of each approach. The approaches reviewed include descriptive, rational, social and behavioral research. Finally, an information value assessment recommendation is given and a theoretical framework is offered. Findings - The descriptive approach is useful in raising new angles for theory development. The rational approach assumes that the value is inherent in information and offers models that describe how information should be valued. The social perspective suggests that markets are enhanced by social activity. The behavioral aspect teaches that value perception changes by person and circumstance and is a key influence on information markets. Originality/value - This paper offers a concentrated multi-dimensional theoretical basis on a topic of central importance to anyone interested in Internet research, information consumption and production. Theory offered here constitutes a basis for a large number of potential empirical research endeavors. [ABSTRACT FROM AUTHOR]

Purpose — Recent research and media attention has highlighted soaring levels of stress among young people. As part of a programme of research based across a number of universities in London and the South-West of the UK (called WestFocus) a team of psychologists, social scientists and complementary practitioners have started to investigate this issue with the aim of introducing stress management interventions into the school environment. This paper aims to examine their findings. Design/methodology/approach — This paper summarises the set up, progress, results and implications of a six-week stress management intervention piloted and evaluated with teenagers at school. The intervention aimed to provide a holistic approach to stress management teaching students both psychological techniques (such as cognitive behavioural therapy) and complementary therapy approaches (such as Indian head massage and aromatherapy). Findings — Structured assessments and qualitative feedback taken at the beginning and end of the programme revealed that emotional well-being and self-esteem improved and perceived stress decreased for students. Initial stress levels were found to be high and to have a negative impact on school performance and social activity. Practical implications — The nature and high levels of stress symptoms experienced by this group of young people have significant implications for the general well-being of young people and the design of products or services to help. Originality/value — Relatively little is know about how stress levels affect the well-being and behaviour of young people including avenues for stress relief, methods of coping and the implications this may have for services, interventions or marketing. This paper aims to explore these issues. [ABSTRACT FROM AUTHOR]

The article discusses various papers published within the issue including an article by Dave Dagnan which described the structure of psychosocial interventions and another by Paul Willner which reviews the evidence for the effectiveness of anger management.

Purpose: Positive behaviour support (PBS) is currently considered best practice for managing challenging behaviour in young people with intellectual and developmental disabilities. A key principle of PBS is that all members of the person's support network participate in the assessment and intervention. It is, therefore, important to understand what factors act as facilitators or barriers to family engagement; however, research in this area is limited. The purpose of this paper is to conduct a novel piece of qualitative research analysis into experiences of family members of young people who have received family-based PBS. Design/methodology/approach: Eight parents of a young person with an intellectual or developmental disability who had received PBS were interviewed about their experiences and factors they found helpful and hindering in terms of their engagement. Thematic analysis allowed a detailed and robust interpretation of the qualitative data. Findings: Five superordinate themes were identified, namely, PBS is more than just strategies, considering the family context, the therapist/family relationship, acknowledging challenges and the ongoing nature of the problem and supporting family member change. Research limitations/implications: Although research was rigorously conducted, the small sample size mean findings should be considered preliminary. Originality/value: The literature related to family engagement in PBS is limited and largely based on the opinions of professionals. This study identified factors that parents themselves felt were helpful and hindering in terms of their engagement and offers practical suggestions for services and future research. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate if positive behavioural support (PBS) can be an effective alternative to medication, and can aid medication reduction in people with a learning disability, autism or both who are prescribed psychotropic medication for behaviour thought to be challenging. STOMP is an initiative supported by NHS England which aims to reduce inappropriate prescribing of psychotropic medication, i.e. antipsychotics used for challenging behaviour in the absence of a documented mental health diagnosis. PBS has been described as the first line of intervention for behaviours which challenge, (NICE, 2015) and has been highlighted as a non-pharmacological alternative to, medication. Design/methodology/approach: A two-group, experimental design was utilised. Both groups were considered for medication reduction. The experimental group of 25 people received input from a specialist PBS team, while the control group of 29 people underwent unsupported medication challenge. Findings: There was a significantly higher success rate for medication reduction and discontinuation when PBS assessment and intervention was provided as an alternative to medication. Practical implications: This study indicates that providing PBS is associated with decreased medication and if replicated should be become standard practice for specialist teams. Originality/value: This is the first study to investigate the effect of PBS on medication reduction in patients prescribed psychotropic medication for behaviour thought to be challenging. [ABSTRACT FROM AUTHOR]

Purpose: Fidelity data in clinical trials are not only necessary for appraising the internal and external validity, but also could provide useful insights how to improve the application of an intervention in everyday settings. The purpose of this paper is to understand the current literature of fidelity measurements in complex interventions for people with intellectual disabilities (ID) and behaviours that challenge. Design/methodology/approach: The electronic databases MEDLINE, Embase, PsycINFO, Web of Science and CINAHL Plus were searched for studies published between 1990 to 2017 that have mentioned fidelity in randomised controlled trials of complex interventions for people with ID and behaviours that challenge based on positive behaviour support or applied behaviour analysis principles. The authors also searched the grey literature and reference lists. Findings: Five randomised controlled trials were included in the review. The authors found variable and inconsistent fidelity measurements reported in the studies. The most frequently provided fidelity elements found in four out of five studies were adherence of implementation, dose and some aspects of quality of delivery. Research limitations/implications: Research recommendations for a standardised approach of measuring fidelity in such studies are suggested. Originality/value: The first review of such type that confirms the paucity of research measuring fidelity in complex interventions in this population. [ABSTRACT FROM AUTHOR]

Purpose: Mood and anxiety disorders affect 20–30 percent of school-age children, contributing to academic failure, substance abuse, and adult psychopathology, with immense social and economic impact. These disorders are treatable, but only a fraction of students in need have access to evidence-based treatment practices (EBPs). Access could be substantially increased if school professionals were trained to identify students at risk and deliver EBPs in the context of school-based support services. However, current training for school professionals is largely ineffective because it lacks follow-up supported practice, an essential element for producing lasting behavioral change. The paper aims to discuss these issues. Design/methodology/approach: In this pilot feasibility study, the authors explored whether a coaching-based implementation strategy could be used to integrate common elements of evidence-based cognitive behavioral therapy (CBT) into schools. The strategy incorporated didactic training in CBT for school professionals followed by coaching from an expert during co-facilitation of CBT groups offered to students. Findings: In total, 17 school professionals in nine high schools with significant cultural and socioe-conomic diversity participated, serving 105 students. School professionals were assessed for changes in confidence in CBT delivery, frequency of generalized use of CBT skills and attitudes about the utility of CBT for the school setting. Students were assessed for symptom improvement. The school professionals showed increased confidence in, utilization of, and attitudes toward CBT. Student participants showed significant reductions in depression and anxiety symptoms pre- to post-group. Originality/value: These findings support the feasibility and potential impact of a coaching-based implementation strategy for school settings, as well as student symptom improvement associated with receipt of school-delivered CBT. [ABSTRACT FROM AUTHOR]

Purpose – The IAPT programme has been rolled out across England in the last ten years. Although undoubtedly many people have benefited from having greater access to psychological therapy there are several issues with the practicalities of Improving Access to Psychological Therapies (IAPT) and also with its ideology. The paper aims to discuss these issues. Design/methodology/approach – This is a personal reflection of working within the IAPT system for several years. Significant statements heard or interpretations of what has been said are presented alongside an analysis of the implications. Findings – A number of important concerns are presented. The overarching concept of the “McDonaldization” process is discussed as a way of encapsulating the IAPT experience; with its theoretical reliance on the medical model and the real world impact of tendering for services in the modern NHS. The impact of IAPT on cognitive behavioural psychotherapy is also highlighted. Originality/value – A lot has been written in the press and online about IAPT. Many of the criticisms seem to derive from people outside of the IAPT system, many of whom have their own personal or professional agenda for attacking IAPT and Cognitive Behavioural Therapy (CBT); often the criticisms are uninformed. This paper is a reflection of working within the IAPT system and not just an uninformed critique of CBT. Several concerns are raised that without remedy may seriously hold back the progress that psychological therapy has made in recent years. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide a routine evaluation of clinical effectiveness of an adapted DBT informed skills programme (“I Can Feel Good”; Ingamells and Morrissey, 2014), run on both male and female intellectual disability wards of a medium security psychiatric hospital.Design/methodology/approach A pre–post evaluation study of routine clinical practice was undertaken utilising staff report scales collected as the primary source of evaluation.Findings Findings show a positive shift regarding each module for both gender groups. Due to observed baseline differences between gender groups, data were separated and analysed separately. Non-parametric statistical analysis demonstrates statistically significant improvement across three modules for the male sample (managing feelings, coping in crisis and people skills) and two modules for the female sample (managing feelings and people skills).Originality/value There appears to be subtle outcome differences regarding this programme for both gender groups across modules. Potential reasons for this are discussed, along with clinical reflections regarding gender differences and adaptations. Reflections upon future revisions including the integration of the new DBT skills (Linehan, 2014) are made in light of these findings. [ABSTRACT FROM AUTHOR]

Purpose – Positive Behaviour Support (PBS) is thought to be an important model for working with people with intellectual disabilities who display behaviours challenging to service. The purpose of this paper is to explore clinical and service user outcomes associated with the delivery of PBS by a Complex Behaviour Service (CBS). Design/methodology/approach – Clinical outcomes of 24 service users treated by the CBS team were assessed at baseline, six and 12 months and compared with those of 22 peers who received usual care. The main outcome was reduction in challenging behaviour measured by the Aberrant Behaviour Checklist (ABC). Secondary outcomes included measures of mental health needs, risk and social care supports. Findings – At six months improvements were seen across all ABC domains in both groups, with greater improvement in the CBS group, compared to usual care in irritability and stereotypy. Between group differences were maintained only for stereotypy at 12 months. No other differences were found. Originality/value – This paper suggests that PBS delivered by trained and dedicated staff may provide clinical benefits to individuals with challenging behaviours. However, there are issues around integration into existing services that need to be addressed in order to maximise efficiency. [ABSTRACT FROM AUTHOR]

Purpose Measuring “impact” is an important aspect of the dissemination of evidence-based practice and relevant to all disciplines. However, it has only recently become a focus of enquiry and is not commonly directly researched within the learning disabilities field. The purpose of this paper is to describe the process of developing a logic model for the UK Positive Behavioural Support (PBS) Academy as part of an evaluation and impact study of its work to date.Design/methodology/approach Logic models are a visual representation of the relationship between a project’s resources, activities and outputs and identified outcomes, in relation to key stakeholder groups. This representation allows for key impact measures to be identified and can be a useful tool for evaluation purposes. The authors used the process outlined by McLaughlin and Jordan (1998) to develop a bespoke logic model for the PBS Academy.Findings The model was particularly helpful in making clear the distinction between output and impact, identifying impact criteria differentiated by stakeholder group and across time scales, and highlighting areas of activity that are needed to increase the impact of the work of the PBS Academy in the longer term.Originality/value In the absence of any generalised impact evaluation frameworks in the learning disabilities field, the authors suggest that logic models may provide a useful framework for evaluating the impact of policy, practice, and research interventions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to propose and examine a conceptual model delineating how two different types of appearance-related self-discrepancies (i.e. the ideal appearance self-discrepancy vs. the ought appearance self-discrepancy) influence retail therapy shopping behavior through motivational route (i.e. approach motivation vs. avoidance motivation). Design/methodology/approach: This study utilized the online survey for data collection. Using a national sample of 532 US consumers who had retail therapy shopping experience, the conceptual model was tested through various statistical techniques, including confirmatory factor analysis, exploratory factor analysis and structural equation modeling. Findings: Results revealed that the ought appearance self-discrepancy positively influenced retail therapy shopping behavior through avoidance motivation and emotion-focused coping strategy, whereas the ideal appearance self-discrepancy did not influence retail therapy shopping behavior. The results also suggested that the effect of two different types of appearance-related self-discrepancies on motivations in retail therapy shopping context varied depending on the gender (i.e. male vs. female). Originality/value: Results suggest implications regarding potential target market strategies to retailers and provide a better understanding of retail therapy shoppers' characteristics and psychological mechanisms for consumer researchers. [ABSTRACT FROM AUTHOR]

Purpose - There are many treatments and interventions available to families and carers of children with autism, many without any solid evidence base. This paper aims to present and discuss the literature on some of the commonly used and better researched interventions.Design/methodology/approach - Research literature drawing on systematic reviews in particular, where available, was collated and summarised under the subheadings of psycho-educational, psycho-pharmacological, and complementary interventions or therapies.Findings - There are very few interventions that have a solid research base. Even those with the strongest evidence base, such as early intensive behavioural intervention, have not necessarily been found to have a universally positive impact. Recent studies have been methodologically stronger, but there are still many weaknesses in the research to date.Originality/value - This paper attempts to provide a balanced and independent view of the literature on different interventions for autism. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the evidence base for alcohol-related brain injury (ARBI) and describes how this has been used to develop a pilot programme for the treatment of ARBI. Key components include: detoxification, assessment, social behaviour network therapy, cognitive rehabilitation and systematic instruction. The programme is being delivered and evaluated in the north of England by Swanswell, a national drug and alcohol treatment charity. [ABSTRACT FROM AUTHOR]

This paper has been written following an influential therapeutic encounter that we experienced while working with an emotionally distressed woman. The barriers that can get in the way of providing a structured therapeutic approach are discussed. The paper focuses on dialectical behaviour therapy as a treatment model, and discusses how the concept of 'dialectics' can provide an over-riding context for case conceptualisation (Linehan, 1993). The dialectical dilemmas and powerful dynamics that can be enacted between individuals, teams and patients in their endeavours to cope with distress will be illustrated. The dialectical philosophy is described and elaborated upon, providing a framework for the synthesis of clinical interpersonal encounters and metaphorical concepts of a therapy seesaw. The paper discusses how these ideas can guide us in our work with emotionally distressed individuals. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to evaluate the effectiveness of the dialectical behavior therapy (DBT) training which was provided to community agency staff (N=18) implementing DBT in the community with street-involved youth.Design/methodology/approach Staff participated in a multi-component approach to training which consisted of webinars, online training, self-study manuals, and ongoing peer consultation. To evaluate assess the effectiveness of the training, questionnaires assessing evaluating DBT skills knowledge, behavioral anticipation and confidence, and DBT skills use, were completed at baseline, immediately post-training, four to six months post-training, and 12-16 months post-training. Additionally, the mental health outcomes for youth receiving the DBT intervention are reported to support the effectiveness of the training outcomes.Findings Results demonstrate that the DBT skills, knowledge, and confidence of community agency staff improved significantly from pre to post-training and that knowledge and confidence were sustained over time. Additionally, the training was clinically effective as demonstrated by the significant improvement in mental health outcomes for street-involved youth participating in the intervention.Practical implications Findings suggest that this evidence-based intervention can be taught to a range of staff working in community service agencies providing care to street-involved youth and that the intervention can be delivered effectively.Originality/value These findings help to close the knowledge-practice gap between evidence-based treatment (EBT) research and practice while promoting the implementation of EBT in the community to enhance positive youth outcomes. [ABSTRACT FROM AUTHOR]

Purpose External facilitation has been shown to increase the implementation and aid sustainment of new clinical practices. The purpose of this paper is to describe the addition of facilitation to web-based training on dialectical behavior therapy (DBT) skills to promote adoption of this intervention among diverse mental health providers at US Veterans Health Administration facilities.Design/methodology/approach In total, 41 participants completed six web-based modules and met in two groups monthly over nine months by telephone with a facilitator who was also an experienced DBT skills group therapist. All participants agreed to conduct a DBT skills group as part of training. The facilitators employed a variety of engagement strategies to meet the evolving needs of participants during the training period. Participants completed an online evaluation of the modules and their facilitation experience at six weeks post-training and responded to an e-mail query at five months post-training about conducting a DBT group.Findings Overall, participants found the training and monthly interprofessional calls with the facilitator useful. Five months post-training, 33 of 41 participants reported conducting a DBT skills group, thus improving access to this intervention. Participants said the biggest barrier to training was finding time during clinic hours to complete the modules, despite assurances of support from local leaders.Originality/value This project provides evidence that virtual facilitation enhances training and promotes the adoption of new clinical practices. [ABSTRACT FROM AUTHOR]