9 results on '"Serfaty, Marc"'
Search Results
2. A randomised controlled trial of acceptance and commitment therapy plus usual care compared to usual care alone for improving psychological health in people with motor neuron disease (COMMEND): study protocol
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Gould, Rebecca L., Thompson, Benjamin J., Rawlinson, Charlotte, Kumar, Pavithra, White, David, Serfaty, Marc A., Graham, Christopher D., McCracken, Lance M., Bursnall, Matt, Bradburn, Mike, Young, Tracey, Howard, Robert J., Al-Chalabi, Ammar, Goldstein, Laura H., Lawrence, Vanessa, Cooper, Cindy, Shaw, Pamela J., and McDermott, Christopher J.
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- 2022
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3. Views of healthcare professionals on recruiting to a psychosocial randomised controlled trial: a qualitative study
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Aspden, Trefor, Armstrong, Megan, and Serfaty, Marc
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- 2021
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4. Acceptance and Commitment Therapy for people living with motor neuron disease: an uncontrolled feasibility study.
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Gould, Rebecca L., Rawlinson, Charlotte, Thompson, Ben, Weeks, Kirsty, Gossage-Worrall, Rebecca, Cantrill, Hannah, Serfaty, Marc A., Graham, Christopher D., McCracken, Lance M., White, David, Howard, Robert J., Bursnall, Matt, Bradburn, Mike, Al-Chalabi, Ammar, Orrell, Richard, Chhetri, Suresh K., Noad, Rupert, Radunovic, Aleksandar, Williams, Tim, and Young, Carolyn A.
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ACCEPTANCE & commitment therapy ,MOTOR neuron diseases ,PSYCHOTHERAPY ,ADAPTABILITY (Personality) ,FEASIBILITY studies ,ABDOMINAL muscles - Abstract
Background: Motor neuron disease (MND) is a fatal, progressive neurodegenerative disease that causes progressive weakening and wasting of limb, bulbar, thoracic and abdominal muscles. Clear evidence-based guidance on how psychological distress should be managed in people living with MND (plwMND) is lacking. Acceptance and Commitment Therapy (ACT) is a form of psychological therapy that may be particularly suitable for this population. However, to the authors' knowledge, no study to date has evaluated ACT for plwMND. Consequently, the primary aim of this uncontrolled feasibility study was to examine the feasibility and acceptability of ACT for improving the psychological health of plwMND. Methods: PlwMND aged ≥ 18 years were recruited from 10 UK MND Care Centres/Clinics. Participants received up to 8 one-to-one ACT sessions, developed specifically for plwMND, plus usual care. Co-primary feasibility and acceptability outcomes were uptake (≥ 80% of the target sample [N = 28] recruited) and initial engagement with the intervention (≥ 70% completing ≥ 2 sessions). Secondary outcomes included measures of quality of life, anxiety, depression, disease-related functioning, health status and psychological flexibility in plwMND and quality of life and burden in caregivers. Outcomes were assessed at baseline and 6 months. Results: Both a priori indicators of success were met: 29 plwMND (104%) were recruited and 76% (22/29) attended ≥ 2 sessions. Attrition at 6-months was higher than anticipated (8/29, 28%), but only two dropouts were due to lack of acceptability of the intervention. Acceptability was further supported by good satisfaction with therapy and session attendance. Data were possibly suggestive of small improvements in anxiety and psychological quality of life from baseline to 6 months in plwMND, despite a small but expected deterioration in disease-related functioning and health status. Conclusions: There was good evidence of acceptability and feasibility. Limitations included the lack of a control group and small sample size, which complicate interpretation of findings. A fully powered RCT to evaluate the clinical and cost-effectiveness of ACT for plwMND is underway. Trial registration: The study was pre-registered with the ISRCTN Registry (ISRCTN12655391). [ABSTRACT FROM AUTHOR]
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- 2023
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5. Acceptance and commitment therapy for adults with advanced cancer (CanACT): study protocol for a feasibility randomised controlled trial
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Low, Joseph, Serfaty, Marc, Davis, Sarah, Vickerstaff, Victoria, Gola, Anna, Omar, Rumana Z., King, Michael, Tookman, Adrian, Austen, Janet St John, Turner, Karen, and Jones, Louise
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Adult ,Randomised control trial ,Patient Selection ,Acceptance and commitment therapy ,Medicine (miscellaneous) ,Feasibility ,Study Protocol ,Clinical Protocols ,psychological therapy ,Advanced cancer ,Data Interpretation, Statistical ,Neoplasms ,Humans ,Pharmacology (medical) - Abstract
Background One-third of people with cancer experience psychological distress and may suppress distressing thoughts, emotions, and concerns, leading to further problems. Conventional psychological treatments reduce distress by problem solving, but in advanced cancer, when ill health is progressive and death may be approaching, physical and psychological difficulties are complex and have no simple solutions. Acceptance and Commitment Therapy encourages acknowledgement and acceptance of mental experiences, increasing people’s ability to work with problems that cannot be solved. Previous pilot work in advanced cancer confirms that distress can be associated with an avoidance of experiencing uncomfortable thoughts and emotions. Methods/Design This feasibility randomised controlled trial of Acceptance Commitment Therapy aims to establish parameters for a larger trial. Fifty-four participants with advanced cancer will be randomly allocated to up to eight sessions (each 1 hour) of Acceptance Commitment Therapy or a talking control. Participants will be recruited from those attending outpatient services and hospice day care at three specialist palliative care units in North and East London, United Kingdom. The primary outcome is a measure of functioning in four areas of life (physical, social/family, emotional, and general activity) using the Functional Assessment of Cancer Therapies - General questionnaire at 3 months after randomisation. Secondary outcomes are (i) acceptance using the Acceptance and Action Questionnaire; (ii) psychological distress using the Kessler Psychological Distress Scale; (iii) physical functioning using a timed walk and sit-to-stand test; and (iv) quality of life measures including the Euroqol-5 Dimensions and ICECAP Supportive Care measures. Qualitative data will be collected at 3 months to explore the participants’ experiences of the trial and therapy. Data will be collected on the costs of care. Discussion Data generated on the recruitment, retention, and experience of the interventions and the usefulness of the outcome measures will inform the adaptations required and whether changes in function are consistent with existing data when planning for a sufficiently powered randomised controlled trial. Trial registration ISRCTN13841211 (registered 22 July 2015). Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1169-8) contains supplementary material, which is available to authorized users.
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- 2016
6. The clinical and cost effectiveness of cognitive behavioural therapy plus treatment as usual for the treatment of depression in advanced cancer (CanTalk): study protocol for a randomised controlled trial.
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Serfaty, Marc, King, Michael, Nazareth, Irwin, Tookman, Adrian, Wood, John, Gola, Anna, Aspden, Trefor, Mannix, Kathryn, Davis, Sarah, Moorey, Stirling, and Jones, Louise
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COUNSELING of cancer patients , *CANCER diagnosis , *COGNITIVE therapy , *MENTAL depression , *THERAPEUTICS , *CANCER patient medical care , *PSYCHOLOGY , *TUMOR diagnosis , *ANTIDEPRESSANTS , *COMBINED modality therapy , *COMPARATIVE studies , *COST effectiveness , *EXPERIMENTAL design , *MEDICAL care costs , *RESEARCH protocols , *PSYCHOLOGICAL tests , *QUALITY of life , *QUESTIONNAIRES , *RESEARCH funding , *TIME , *TUMORS , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *BLIND experiment , *QUALITY-adjusted life years , *DISEASE complications , *ECONOMICS ,TUMORS & psychology - Abstract
Background: The prevalence of depressive disorder in adults with advanced cancer is around 20 %. Although cognitive behavioural therapy (CBT) is recommended for depression and may be beneficial in depressed people with cancer, its use for depression in those with advanced disease for whom cure is not likely has not been explored.Methods: People aged 18 years and above with advanced cancer attending General Practitioner (GP), oncology or hospice outpatients from centres across England will be screened to establish a DSM-IV diagnosis of depression. Self-referral is also accepted. Eligible consenters will be randomised to a single blind, multicentre, randomised controlled trial of the addition to treatment as usual (TAU) of up to 12 one-hour weekly sessions of manualised CBT versus TAU alone. Sessions are delivered in primary care through Increasing Access to Psychological Care (IAPT) service, and the manual includes a focus on issues for people approaching the end of life. The main outcome is the Beck Depression Inventory-II (BDI-II). Subsidiary measures include the Patient Health Questionnaire, quality of life measure EQ-5D, Satisfaction with care, Eastern Cooperative Oncology Group-Performance Status and a modified Client Service Receipt Inventory. At 90 % power, we require 240 participants to enter the trial. Data will be analysed using multi-level (hierarchical) models for data collected at baseline, 6, 12, 18 and 24 weeks. Cost effectiveness analysis will incorporate costs related to the intervention to compare overall healthcare costs and QALYs between the treatment arms. We will conduct qualitative interviews after final follow-up on patient and therapist perspectives of the therapy.Discussion: This trial will provide data on the clinical and cost effectiveness of CBT for people with advanced cancer and depression. We shall gain an understanding of the feasibility of delivering care to this group through IAPT. Our findings will provide evidence for policy-makers, commissioners and clinicians in cancer and palliative care, and in the community.Trial Registration: Controlled Trials ISRCTN07622709 , registered 15 July 2011. [ABSTRACT FROM AUTHOR]- Published
- 2016
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7. Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a pilot randomised controlled trial.
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Hassiotis, Angela, Serfaty, Marc, Azam, Kiran, Strydom, Andre, Martin, Sue, Parkes, Charles, Blizard, Robert, and King, Michael
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BEHAVIOR therapy , *MENTAL depression , *ANXIETY , *BECK Depression Inventory , *AFFECTIVE disorders - Abstract
Background: Several studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT). Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations) in people with ID. Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. To date, two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID. However, there is no individual manualised programme for anxiety or depression in people with intellectual disabilities. The aims of the study are to determine the feasibility of conducting a randomised controlled trial for CBT in people with ID. The data will inform the power calculation and other aspects of carrying out a definitive randomised controlled trial. Methods: Thirty participants with mild ID will be allocated randomly to either CBT or treatment as usual (TAU). The CBT group will receive up to 20 hourly individual CBT over a period of 4 months. TAU is the standard treatment which is available to any adult with an intellectual disability who is referred to the intellectual disability service (including care management, community support, medical, nursing or social support). Beck Youth Inventories (Beck Anxiety Inventory & Beck Depression Inventory) will be administered at baseline; end of treatment (4 months) and at six months to evaluate the changes in depression and anxiety. Client satisfaction, quality of life and the health economics will be secondary outcomes. Discussion: The broad outcome of the study will be to produce clear guidance for therapists to apply an established psychological intervention and identify how and whether it works with people with intellectual disabilities. Trial registration: ISRCTN: ISRCTN38099525 [ABSTRACT FROM AUTHOR]
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- 2011
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8. Cost-effectiveness of cognitive behaviour therapy versus talking and usual care for depressed older people in primary care.
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Holman, Amanda J., Serfaty, Marc A., Leurent, Baptiste E., and King, Michael B.
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COST effectiveness , *BEHAVIOR therapy , *PSYCHOTHERAPY , *PRIMARY care , *DEPRESSED persons - Abstract
Background: Whilst evidence suggests cognitive behaviour therapy (CBT) may be effective for depressed older people in a primary care setting, few studies have examined its cost-effectiveness. The aim of this study was to compare the cost-effectiveness of cognitive behaviour therapy (CBT), a talking control (TC) and treatment as usual (TAU), delivered in a primary care setting, for older people with depression. Methods: Cost data generated from a single blind randomised controlled trial of 204 people aged 65 years or more were offered only Treatment as Usual, or TAU plus up to twelve sessions of CBT or a talking control is presented. The Beck Depression Inventory II (BDI-II) was the main outcome measure for depression. Direct treatment costs were compared with reductions in depression scores. Cost-effectiveness analysis was conducted using non-parametric bootstrapping. The primary analysis focussed on the cost-effectiveness of CBT compared with TAU at 10 months follow up. Results: Complete cost data were available for 198 patients at 4 and 10 month follow up. There were no significant differences between groups in baseline costs. The majority of health service contacts at follow up were made with general practitioners. Fewer contacts with mental health services were recorded in patients allocated to CBT, though these differences were not significant. Overall total per patient costs (including intervention costs) were significantly higher in the CBT group compared with the TAU group at 10 month follow up (difference £427, 95% CI: £56 - £787, p < 0.001). Reductions in BDI-II scores were significantly greater in the CBT group (difference 3.6 points, 95% CI: 0.7-6.5 points, p = 0.018). CBT is associated with an incremental cost of £120 per additional point reduction in BDI score and a 90% probability of being considered cost-effective if purchasers are willing to pay up to £270 per point reduction in the BDI-II score. Conclusions: CBT is significantly more costly than TAU alone or TAU plus TC, but more clinically effective. Based on current estimates, CBT is likely to be recommended as a cost-effective treatment option for this patient group if the value placed on a unit reduction in BDI-II is greater than £115. Trial Registration: isrctn.org Identifier: ISRCTN18271323 [ABSTRACT FROM AUTHOR]
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- 2011
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9. The clinical and cost-effectiveness of a Victim Improvement Package (VIP) for the reduction of chronic symptoms of depression or anxiety in older victims of common crime (the VIP trial): study protocol for a randomised controlled trial.
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Serfaty, Marc, Aspden, Trefor, Satchell, Jessica, Kessel, Anthony, Laycock, Gloria, Brewin, Chris R, Buszewicz, Marta, O'Keeffe, Aidan, Hunter, Rachael, Leavey, Gerard, Cuming-Higgs, Jon, Drennan, Vari, Riveros, Monica, Andrew, David, and Blanchard, Martin
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CRIME victims , *MEDICAL quality control , *COST effectiveness , *BECK Anxiety Inventory , *MEDICAL care costs , *RAILROAD safety measures , *ANXIETY , *ANXIETY treatment , *CLINICAL trials , *PSYCHOLOGY of crime victims , *TREATMENT effectiveness , *RANDOMIZED controlled trials , *MENTAL depression , *QUALITY of life , *BLIND experiment , *RESEARCH funding , *LONGITUDINAL method - Abstract
Background: Older people are vulnerable to sustained high levels of psychosocial distress following a crime. A cognitive behavioural therapy (CBT)-informed psychological therapy, the Victim Improvement Package (VIP) may aid recovery. The VIP trial aims to test the clinical and cost-effectiveness of the VIP for alleviating depressive and anxiety symptoms in older victims of crime.Methods/design: People aged 65 years or more who report being a victim of crime will be screened by Metropolitan Police Service Safer Neighbourhood Teams within a month of the crime for distress using the Patient Health Questionnaire-2 and the Generalised Anxiety Disorder-2. Those who screen positive will be signposted to their GP for assistance, and re-screened at 3 months. Participants who screen positive for depression and/or anxiety at re-screening are randomised to a CBT informed VIP added to treatment as usual (TAU) compared to TAU alone. The intervention consists of 10 individual 1-h sessions, delivered weekly by therapists from the mental health charity Mind. The primary outcome measure is the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI), used as a composite measure, assessed at 6 months after the crime (post therapy) with a 9-month post-crime follow-up. Secondary outcome measures include the EQ-5D, and a modified Client Service Receipt Inventory. A total of 226 participants will be randomised VIP:TAU with a ratio 1:1, in order to detect a standardised difference of at least 0.5 between groups, using a mixed-effects linear-regression model with 90% power and a 5% significance level (adjusting for therapist clustering and potential drop-out). A cost-effectiveness analysis will incorporate intervention costs to compare overall health care costs and quality of life years between treatment arms. An embedded study will examine the impact of past trauma and engagement in safety behaviours and distress on the main outcomes.Discussion: This trial should provide data on the clinical and cost-effectiveness of a CBT-informed psychological therapy for older victims of crime with anxiety and/or depressive symptoms and should demonstrate a model of integrated cross-agency working. Our findings should provide evidence for policy-makers, commissioners and clinicians responding to the needs of older victims of crime.Trial Registration: International Standard Randomised Controlled Trials Number, ID: ISRCTN16929670. Registered on 3 August 2016. [ABSTRACT FROM AUTHOR]- Published
- 2020
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