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Against the backdrop of the COVID‐19 pandemic, workplace wellbeing is a key priority for employers. Severe market and health conditions continue to bring inevitable problems that could be reduced with the application of psychological interventions to prevent mental and physical health issues, making this study a highly pertinent and valuable contribution to the field. This paper reports the effects of a rational emotive behaviour therapy (REBT) programme on the irrational beliefs and emotional reactivity of 56 office‐based sales professionals located in the northwest region of the UK. A pre‐test, post‐test experimental design was utilised, and a mixed model ANOVA (repeated measures) was adopted to assess changes in mean differences concerning irrational beliefs and emotional reactivity at pre and post‐test stages for the intervention group, in comparison to a control group. Results indicate that those in the REBT group reported significant reductions in irrational beliefs and emotional reactivity, whilst those in the control group reported no such changes. It is recommended that future research studies consider utilizing a mixed methods design and focus on a strategic collaboration of organisational and individual level interventions for improving the psychological wellbeing and performance of sales personnel. [ABSTRACT FROM AUTHOR]

This paper By Ward et al. (Journal of Child Psychology and Psychiatry, 2019) in the issue of the JCPP, is an excellent example of preparing a new programme for parents with children at high risk of present and future behaviour problems. It was to be delivered in a very deprived population in a township in South Africa. We discuss the paper but also raise questions about developing new programmes when they are already successful programmes available and discuss whether it is time for programme developers to meet to discuss what works best and for whom. Read the full article at doi: 10.1111/jcpp.13129 [ABSTRACT FROM AUTHOR]

Background: Almost no research has been published reporting on evaluations of the effectiveness of psychological interventions for people with severe to profound intellectual disabilities and depression. This paper describes the development and initial feasibility testing of an adapted Behavioural Activation therapy (BeatIt2) for this population. Method: Phase 1 of the study examined participant recruitment and willingness to be randomised in the context of a planned Randomised Controlled Trial (RCT). Phase 2 examined the feasibility of delivering the intervention. Results: Twenty adults with a severe or profound intellectual disability and clinically significant depression were recruited to Phase 1 of the study. In Phase 2, there was 100% participant retention for those recruited to the study at 6‐month follow‐up. The BeatIt2 therapy was reported to be acceptable for participants. Conclusion: COVID disruption meant that it was not possible to complete the planned feasibility RCT. The positive findings suggest that additional evaluation of BeatIt2 is warranted. [ABSTRACT FROM AUTHOR]

Accessible Summary: Lots of people with intellectual disabilities in the UK are given medication to manage their behaviours and the NHS wants this to stop. In Cornwall, we wanted to see how often we give medication to people instead of other health care such as communication or occupational assessments etc. We found that around half the people we work with because of their behaviours get medication to manage their feelings and many do not get other assessments. We want to change this in Cornwall and stop over medicating people by learning from this study. Abstract: Background: The use of psychotropic medication to manage challenging behaviours of people with intellectual disabilities is a contentious issue which NHS England has now focused on. This paper looks to evaluate this within the multidisciplinary context. Method: Records of clients (n = 106) open to a Community Intellectual Disabilities team for care relating to challenging behaviours were examined. Those recommended psychotropic medications in the absence of a mental health diagnosis were scrutinised for supporting MDT assessments. Results: Over half the clients with challenging behaviours were being prescribed psychotropic medications and many of those had very few MDT assessments to inform care. Conclusions: This study demonstrates the extent psychotropics are used in the absence of MDT informed support for people with intellectual disabilities and behaviours that challenge. A vision to simply withdraw such medication might be simplistic. Local MDT plans are in development to systematically reduce reliance on this type of restrictive practice. [ABSTRACT FROM AUTHOR]

Background: Behavioural activation (BA) is effective in adults with depression but the evidence for young people (YP) is less clear. We therefore developed and tested a new coproduced BA programme. Method: In phase one (2014 to 2015 inclusive), we codeveloped with young people attending specialist child and adolescent mental health service (CAMHS) an 8‐session BA workbook. In Phase two (2019 to 2020 inclusive), we ran an uncontrolled feasibility study in two specialist CAMHS, with BA being offered to YP by less specialised staff. Results: In phase one, we tested the workbook with 15 YP with depression and other comorbidities. Satisfaction was good from both YP and staff, and 9 YP reported improvement in mood. In phase two, 51 YP were offered BA; 15 declined to take part. 36 consented with three dropping out after consent. 33 YP (mean age 14.6, 12 males, 24 females) continued treatment attending a mean of 6.6 sessions. At the end of treatment, youth‐rated Mood and Feeling Questionnaire (MFQ) mean score decreased from 43.2 to 27.6, difference 14.6 (95% CI 8.7 to 20.2; n = 28), and Clinician Global Assessment Score (CGAS) mean score increased from 52.3 to 69.8, difference 18.0 (95% CI 11.9 to 24.2; n = 29). Of the 33 YP who participated in therapy, 12 (36%) recovered and were discharged. Conclusions: This programme demonstrated preliminary evidence for effectiveness and utility. Less specialised staff were able to use BA, and this may reduce secondary waits for more specialist therapy. More research is needed about the role of BA in specialist CAMHS. [ABSTRACT FROM AUTHOR]

Objectives: Dialectical behaviour therapy (DBT) and mentalization‐based therapy (MBT) are widely used evidence‐based psychological treatments for borderline personality disorder (BPD). The study aimed to establish evidence on common and unique, and helpful and unhelpful, treatment processes. Design: Mixed‐methods. Methods: In‐depth qualitative interview data on patient experiences during treatment were combined with quantitative outcome measures in 73 patients diagnosed with a personality disorder and receiving DBT or MBT. Results: Across both DBT and MBT, accounts of learning not to react impulsively, learning to question one's thoughts and assumptions, learning to communicate more effectively, and exposure to painful emotions that may previously have been avoided were each associated with less baseline‐adjusted self‐harm at the end of treatment. Difficulties in interacting with other group members were more likely to be described by patients receiving MBT than DBT, whilst difficulties in the therapeutic relationship were equally common. Both of these types of difficult experience were associated with higher baseline‐adjusted levels of BPD traits and emotional dysregulation, at the end of the 12‐month study period. Conclusions: The findings identify novel evidence of common therapeutic processes across DBT and MBT that may help to reduce self‐harm. The findings also highlight the potential iatrogenic effect of difficulties in the alliance with therapists or with other group members. This underscores the importance of listening to patients' voices about what they are finding difficult during therapy and working to address these relational challenges, so that the patient is able to progress and make best use of the treatment. Practitioner points: Regardless of whether dialectical behaviour therapy or mentalization based therapy is used, helping service‐users to learn not to react impulsively, to question their thoughts and assumptions, and to communicate more effectively, may be beneficial for reducing self‐harm.Across both types of therapy, exposure to painful emotions is a difficult experience for service‐users, but may also be beneficial for reducing self‐harm, if carefully managed.Whilst service‐users' experiences across both types of therapy have much in common, accounts of mentalization based therapy stand out in more often describing both helpful and unhelpful experiences of interactions with therapy group members.Service‐users across both types of therapy report the benefits of learning intrapersonal mentalization skills, whilst recipients of mentalization based therapy uniquely extend this to learning interpersonal mentalization.Ruptures in the therapeutic alliance, and distressing interactions with group members, may be iatrogenic and must be carefully managed. [ABSTRACT FROM AUTHOR]

Describes a pilot Anger Management Programme aimed to reduce the challenging behavior of adults with learning disabilities in Great Britain through increased communication use. Multidisciplinary collaborative National Health Service health trust and social work team working practices; In-service training package; Client-group programs; Objectives, methodology and qualitative analysis.

Background: Dentists need training in the management of children's anxiety (DA), fear (DF) and behaviour management problems (DBMP) but little is known of their competence on this topic. Aim: To report dentists' opinions and attitudes about protective stabilisation and pharmacological techniques for the management of children with DA/DF/DBMP; to propose a postgraduate curriculum focussing on DA/DF/DBMP. Design: A survey of 301 Brazilian dentists and later a modified Delphi process to outline the curriculum in two phases: (a) face‐to‐face discussions with 33 early career researchers mentored by six researchers, both from UK and Brazil; (b) online discussions by eight early and senior researchers on the knowledge, experience, and competencies necessary for a specialist in paediatric dentistry in Brazil that should be included in the core curriculum of postgraduate courses. Results: Almost all (99.0%) of the survey respondents provide treatment to children with DA/DF/DBMP, and 91.2% do not systematically diagnose these conditions; 94.3% use protective stabilisation, and 20.0%‐30.0% have training in pharmacological techniques. The four‐domain framework supporting the proposed curriculum is as follows: DA/DF/DBMP assessment, non‐pharmacological and pharmacological approaches, and decision‐making. Conclusion: Dental curricula should be customised to solve the misconceptions and promote a comprehensive and positive attitude to DA/DF/DBMP by paediatric oral healthcare practitioners. [ABSTRACT FROM AUTHOR]

Background: Extended brief interventions for alcohol misuse are effective in the general population. The process of manualising the first ever such intervention for people with mild to moderate intellectual disabilities in the UK is the focus of this study. Methods: The manual was an adaptation of existing manuals based on Motivational Enhancement and Cognitive Behaviour Therapy and was used in a feasibility randomized controlled trial, the EBI-LD study. The sessions were recorded and scored using an adapted version of the Yale Adherence and Competence Scale (YACS II). Feedback was provided by therapists. The trial is closed. Registered: isrctn.com; ISRCTN58783633. Results: The quality of the sessions provided was rated as good. Therapists were able to cover all topics within each session. Main challenges included session duration and homework task completion. Conclusions: We recommend the duration of the sessions to be extended to 40 min to accommodate carers in the session and to enhance their support in homework task completion. [ABSTRACT FROM AUTHOR]

Background and aims There is evidence that low-risk drinking is possible during the course of alcohol treatment and can be maintained following treatment. Our aim was to identify characteristics associated with low-risk drinking during treatment in a large sample of individuals as they received treatment for alcohol dependence. Design Integrated analysis of data from the Combined Pharmacotherapies and Behavioral Intervention (COMBINE) study, Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) and the United Kingdom Alcohol Treatment Trial (UKATT) using repeated-measures latent class analysis to identify patterns of drinking and predictors of low-risk drinking patterns during treatment. Setting United States and United Kingdom. Participants Patients ( n = 3589) with alcohol dependence receiving treatment in an alcohol clinical trial were primarily male (73.0%), white (82.0%) and non-married (41.7%), with an average age of 42.0 (standard deviation = 10.7). Measurements Self-reported weekly alcohol consumption during treatment was assessed using the Form-90 and validated with biological verification or collateral informants. Findings Seven patterns of drinking during treatment were identified: persistent heavy drinking (18.7% of the sample), increasing heavy drinking (9.6%), heavy and low-risk drinking (6.7%), heavy drinking alternating with abstinence (7.9%), low-risk drinking (6.8%), increasing low-risk drinking (10.5%) and abstinence (39.8%). Lower alcohol dependence severity and fewer drinks per day at baseline significantly predicted low-risk drinking patterns [e.g. each additional drink prior to baseline predicted a 27% increase in the odds of expected classification in heavy drinking versus low-risk drinking patterns; odds ratio = 1.27 (95% confidence interval (CI) = 1.10, 1.47, P = 0.002]. Greater negative mood and more heavy drinkers in the social network were significant predictors of expected membership in heavier drinking patterns. Conclusions Low-risk drinking is achievable for some individuals as they undergo treatment for alcohol dependence. Individuals with lower dependence severity, less baseline drinking, fewer negative mood symptoms and fewer heavy drinkers in their social networks have a higher probability of achieving low-risk drinking during treatment. [ABSTRACT FROM AUTHOR]

The systemic therapy literature is dominated by clinic-based accounts of therapy. The work of an outreach, home-based therapy team is described, in a tradition of systemic therapies which directly seek to challenge service access constraints and social injustice. In paying careful attention to the micro-interactions of initial contact, seeking permission is suggested as an interviewing stance for connecting with families who are not engaged with services, where there have been histories of partner violence. [ABSTRACT FROM AUTHOR]

This study aimed to examine the meanings that nurses attached to the 'treatments' administered to cure 'sexual deviation' ( SD) in the UK, 1935-1974. In the UK, homosexuality was considered a classifiable mental illness that could be 'cured' until 1992. Nurses were involved in administering painful and distressing treatments. The study is based on oral history interviews with fifteen nurses who had administered treatments to cure individuals of their SD. The interviews were transcribed for historical interpretation. Some nurses believed that their role was to passively follow any orders they had been given. Other nurses limited their culpability concerning administering these treatments by adopting dehumanising and objectifying language and by focussing on administrative tasks, rather than the human beings in need of their care. Meanwhile, some nurses genuinely believed that they were acting beneficently by administering these distinctly unpleasant treatments. It is envisaged that this study might act to reiterate the need for nurses to ensure their interventions have a sound evidence base and that they constantly reflect on the moral and value base of their practice and the influence that science and societal norms can have on changing views of what is considered 'acceptable practice'. [ABSTRACT FROM AUTHOR]

Aim To explore the experience of 'lay therapists' of a group-based cognitive behaviour therapy ( CBT) anger management intervention. Background Staff employed in daytime opportunity services for adults with intellectual disabilities took on the role of 'lay therapist' to facilitate CBT groups. Methods They were trained and supervised by clinical psychologists and interviewed 2-6 weeks after the last group session. Their experiences were explored by means of a qualitative approach, interpretative phenomenological analysis ( IPA). Results Several key themes emerged from the interview data such as 'hopes and fears', 'having a framework', 'making it work', 'observing progress', 'ingredients of success', 'the therapist role' and 'taking the group forward'. Conclusions These themes indicate that participants' experiences had been perceived as positive for themselves, the service users as well as the relevant organization although initially the therapist role had appeared daunting. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the guest editors discuss articles in the special edition of the journal on developments in the field of couple therapy and review therapeutic models like integrated systemic therapy and cognitive behavioral therapy (CBT).

To date, the feasibility of computer-aided psychotherapy as an intervention has only been recognised in primary care practice. The present study sought to evaluate the impact of 'Beating the Blues' (BtB), an established computerised cognitive behaviour therapy (CCBT) self-help programme for the management of anxiety and depression, within an NHS CBT specialist healthcare centre. Of the 555 service users who used BtB as part of routine care, with follow-up assessment at six to eight weeks, 71% completed all eight sessions. Statistically significant differences on the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) were found in completer and intention-to-treat analyses; 50% of completers achieved reliable change on the BDI-II and approximately 25% of completers achieved reliable and clinically significant change on both measures. Outcomes were benchmarked against outcomes in studies of routine face-to-face CBT. These findings provide evidence that BtB may be of value to service users in secondary mental healthcare centres, alleviating current burdens on public health and therapeutic resources. Future research directions should include examining which factors influence individuals' decisions to try computer-aided psychotherapy, which individuals are best suited to using these interventions, and why some users drop out prior to programme completion. [ABSTRACT FROM AUTHOR]

The mechanism whereby incoming noxious stimuli result in emotional and behavioural changes is centred within cognitive processes. The mechanism is activated for all forms of pain but variations in the emotions generated and coping styles and strategies adopted occur. They are related to each individual's appraisal of their pain and the condition giving rise to it--major differences in appraisal relate to the presence or absence of malignancy with its potential threat to life. The psychological treatments of cognitive behavioural therapy have a role in the management of all chronic pain but historically have been employed more in non-cancer pain conditions than in patients with cancer pain. In the United Kingdom, the facilities for the treatment of pain by cognitive behavioural therapy are very limited and for that reason counselling, long used in aiding cancer patients, is likely to remain the main form of psychological treatment in that group. [ABSTRACT FROM AUTHOR]