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Background:The present paper describes the cognitive-behavioural approach evolved and adapted to treat survivors of the London bombings experiencing fear and avoidance of public transport (travel phobia). Method: Treatment outcomes for a consecutive case series (N= 11) are reported. Results: All individuals who completed treatment (N= 10) had returned to their pre-bombing use of transport and reported minimal symptoms. Conclusions:The need for appropriately tailored treatment based on differential diagnosis and formulation and the importance of incorporating skills for treatment of posttraumatic stress disorder are discussed. [ABSTRACT FROM AUTHOR]

This paper describes the development of protocols with interpreters employed in an East London psychological trauma clinic. The service treats traumatized refugee people with cognitive methods, according to the National Institute for Clinical Excellence (NICE) Guidelines for PTSD. NICE states that language should not be a barrier to treatment, but provides no further guidance to achieve this. These protocols for interpreting CBT are designed to be explicit, consistent and ethical. A telephone poll from a recent UK-wide trauma survey, a focus group with local interpreters, and practitioner reflection were all used to develop and refine the protocols and their rationale, which are described, together with implications for future culturally sensitive practice and research. [ABSTRACT FROM AUTHOR]

Background: Despite growing evidence of the effectiveness of cognitive-behavioural therapy (CBT) for psychosis, typically only about 50% of patients show a positive response to treatment. This paper reports the first comprehensive investigation of factors which predict treatment outcome.Method: In a randomised controlled trial of CBT for medication-resistant psychosis (see Part I) measures were taken at baseline of demographic, clinical and cognitive variables. Changes over time were assessed on the Brief Psychiatric Rating Scale and the relationship between potential predictor variables and outcome was investigated using analysis of variance and covariance.Results: A number of baseline variables were identified as predictors of good outcome in the CBT group. Key predictors were a response indicating cognitive flexibility concerning delusions (P = 0.005) and the number of recent admissions (P = 0.002). Outcome was less predictable in the control group and was not predicted by any cognitive variable.Conclusions: Good outcome is strongly predicted in patients with persistent delusions by a cognitive measure, while this was not the case in controls. Thus we argue that positive outcome in CBT is due in part to specific effects on delusional thinking. [ABSTRACT FROM AUTHOR]

Background: Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that will aid healthcare practitioners and allied professionals when working with this complex and vulnerable population.Method: UK experts from multiple disciplines in the fields of ADHD and ASD convened in London in December 2017. The meeting provided the opportunity to address the complexities of ADHD and ASD as a co-occurring presentation from different perspectives and included presentations, discussion and group work. The authors considered the clinical challenges of working with this complex group of individuals, producing a consensus for a unified approach when working with male and female, children, adolescents and adults with co-occurring ADHD and ASD. This was written up, circulated and endorsed by all authors.Results: The authors reached a consensus of practical recommendations for working across the lifespan with males and females with ADHD and ASD. Consensus was reached on topics of (1) identification and assessment using rating scales, clinical diagnostic interviews and objective supporting assessments; outcomes of assessment, including standards of clinical reporting; (2) non-pharmacological interventions and care management, including psychoeducation, carer interventions/carer training, behavioural/environmental and Cognitive Behavioural Therapy (CBT) approaches; and multi-agency liaison, including educational interventions, career advice, occupational skills and training, and (3) pharmacological treatments.Conclusions: The guidance and practice recommendations (Tables 1, 4, 5, 7, 8 and 10) will support healthcare practitioners and allied professionals to meet the needs of this complex group from a multidisciplinary perspective. Further research is needed to enhance our understanding of the diagnosis, treatment and management of individuals presenting with comorbid ADHD and ASD. [ABSTRACT FROM AUTHOR]

This study aimed to address the gap in the literature considering empirical evidence in support of the assumption that Mindfulness is the mediating factor in the positive outcomes of Mindfulness Based Cognitive Therapy (MBCT) and Mindfulness Based Stress Reduction (MBSR) programmes, and to further examine the link between Mindfulness and Subjective Well Being. The research question was whether MBCT would increase participants' levels of Mindfulness and Satisfaction with Life and decrease participants' level of Negative Affect. A Repeated Measures (Test - Retest) within participants design was employed and fifteen Counselling students at the University of East London provided data anonymously at the beginning and end of MBCT programme by completing the Freiburg Mindfulness Inventory (FMI) (Walach, Buchheld, Buttenmuller, Kleinknecht, & Schmidt, 2006), Satisfaction With Life Scale (SWLS) (Diener, Emmons, Larsen & Griffin, 1985) and Positive and Negative Affect Schedule (PANAS) (Watson, Clark & Tellegen, 1988). The results indicated that by the end of the MBCT programme: participants' level of Mindfulness significantly increased; Positive Affect remained unchanged; Negative Affect significantly decreased; a strong trend in the data indicated an increase in participants' Satisfaction With Life but failed to reach a statistically significant level; Mindfulness and Negative Affect were significantly negatively correlated, while Mindfulness and Satisfaction With Life were not found to be associated. A longer practice time of Mindfulness during the programme was found to be significantly correlated with a higher level of Mindfulness at the end of the programme. The results were interpreted in support of the assumption that Mindfulness has an important role as a mediating factor in symptoms relief and positive outcomes following participation on Mindfulness programmes. The results also support of Brown and Ryan's (2003) conclusion regarding the role of Mindfulness in enhancing Well Being. A Positive Psychology framework was applied in interpreting the data and it was suggested that there was ground to believe that Mindfulness can be integrated well, as a concept and as a therapeutic intervention, into the field of Positive Psychology. [ABSTRACT FROM AUTHOR]

There is controversy about the value of psychological interventions offered to refugee people through an interpreter, but little empirical evidence in this field. This study compared routine clinical outcomes of three groups of PTSD patients receiving CBT: refugees who required interpreters; refugees who did not require an interpreter; and English-speaking non-refugees. The aim of the study was to ascertain whether interpreted CBT is feasible. All three groups attended a similar number of sessions and showed significant improvements after treatment. Refugees receiving treatment with and without interpreting did not differ in treatment outcomes. The findings suggest that interpreters can be used with positive outcome in treating PTSD patients with CBT. This study supports NICE (2005) recommendations that CBT should be offered regardless of language need. [ABSTRACT FROM AUTHOR]

BackgroundEmotional distress has major implications for employees and employers. Cognitive behavioural therapy (CBT) is a recommended treatment, but demand outstrips supply. CBT is well suited to computerization. Most employee assistance programmes have not been systematically evaluated and computerized CBT has not previously been studied in the workplace.AimsTo evaluate the effect of an 8 week computerized cognitive behavioural therapy programme, ‘Beating The Blues’, on emotional distress in employees with recent stress-related absenteeism, and to explore the reasons for non-participation.MethodsAn open, randomized trial in a London NHS occupational health department. Forty-eight public sector employees, with 10 or more cumulative days stress-related absenteeism in the last 6 months, randomized equally to ‘Beating The Blues’ plus conventional care, or conventional care alone. Main outcome measures were Hospital Anxiety and Depression Scale and Attributional Style Questionnaire scores at end of treatment and 1, 3 and 6 months later; and reasons for non-participation.ResultsAt end of treatment and 1 month later, adjusted mean depression scores and adjusted mean negative attributional style scores were significantly lower in the intervention group. One month post-treatment, adjusted mean anxiety scores were also significantly lower in the intervention group. The differences were not statistically significant at 3 and 6 months post-treatment. Non-participation was common and related to access problems, preference for other treatments, time commitment, scepticism about the intervention and the employer connection.Conclusions‘Beating The Blues’ may accelerate psychological recovery in employees with recent stress-related absenteeism. Greater flexibility and accessibility might improve uptake. [ABSTRACT FROM AUTHOR]