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This book provides a concise and up-to-date guide to Cognitive Behavioural Therapy (CBT), from the history and supporting theory, through to the most recent empirical evidence and practical aspects of delivery. Starting with an overview of the structure of CBT, practitioners can utilise this detailed guide to deliver therapy in clinical practice, whilst its coverage of various adaptations of CBT, such as group therapy and working with older adults, allow therapy to be tailored to different settings with different timeframes attached. Covering all the major CBT protocols necessary to work with a wide range of common mental health conditions. A comprehensive resource for a wide range of practitioners providing practical approaches, goals, and strategies to manage mental health problems using CBT. Part of the Cambridge Guides to the Psychological Therapies series, offering all the latest scientifically rigorous, and practical information on a range of key, evidence-based psychological interventions for clinicians.
Given the complex challenges facing people experiencing homelessness, existing mental health recovery models are probably insufficient for this population.
Aims
To investigate qualitative accounts of mental health personal recovery in people with experience of homelessness, and to adapt the widely adopted connectedness, hope, identity, meaning and empowerment (CHIME) model of personal recovery to better represent the experiences of this population.
Method
PROSPERO registration no. CRD42023366842. A systematic review identified qualitative studies investigating first-person accounts of mental health personal recovery in people with experience of homelessness. Nine databases were searched: CINAHL, SCOPUS, Embase, Medline, PsychINFO, PubMed, Web of Science, ASSIA and Social Services Abstracts. Risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) Qualitative Studies Checklist. Included studies underwent ‘best fit’ framework synthesis, comprising deductive analysis using the CHIME first- and second-order themes, as well as inductive analysis to capture aspects not covered by the a priori framework.
Results
The review expanded the CHIME model and identified the following recovery processes in this population: security and stability; encouragement and hope; constructing identity; understanding and meaning; relationships and connectedness; and empowerment and dual recovery (SECURED). Importantly, security and stability were identified as a necessary prerequisite for the other recovery processes. Challenges within each recovery process were also identified.
Conclusions
SECURED offers a transdiagnostic framework to support understanding of mental health personal recovery in the context of homelessness. Findings support the Housing First model of service provision. However, findings also highlight that housing alone is not sufficient and that the other processes must also be supported.
Human milk and direct breastfeeding provide the optimal, biologically normative nutrition for hospitalised infants, with well-established benefits for immune, gut, cardiac, brain, and maternal health. Despite these benefits, human milk and breastfeeding rates for infants with CHD in high-resource countries are typically low, and there are no formal guidelines to drive CHD breastfeeding practice. Our aim is to (1) summarise the evidence on breastfeeding for infants with CHD, (2) discuss key barriers to and facilitators of breastfeeding in this population, (3) identify critical research and practice gaps to improve breastfeeding care in CHD, and (4) provide recommendations for clinical practice and future research.
Primary breastfeeding barriers for infants with CHD include (1) concern for dysphagia/aspiration, (2) concerns related to weight gain, (3) clinical instability/sickness, (4) developmental considerations, (5) general breastfeeding challenges, and (6) workflow and implementation issues, with racism and health disparities also contributing. The evidence to support these barriers is limited and often conflicting. Breastfeeding facilitators for preterm infants are well described, but facilitators may require modification for infants with CHD. Most lactation interventions have not been tested in CHD populations. Current evidence does not support automatic withholding of breastfeeding from infants with CHD; rather, the benefits of breastfeeding likely outweigh many potential concerns. There is a critical need for research and quality improvement to identify interventions that equitably and effectively support breastfeeding for infants with CHD and to evaluate the effect of breastfeeding on short- and long-term physical, psychological, and developmental outcomes for infants and families.
The chapter will help you to be able to explain what BDD is and how it typically presents, including a preoccupation with either imagined or minor physical flaws, and the resultant safety behaviours to manage the feared impact of others perceiving this flaw, describe and use Veale & Neziroglu’s CBT protocol for BDD, explain the importance of using mirror retraining in treatment, develop a treatment plan for CBT for BDD, using appropriate measures, and take account of comorbidity in managing CBT for BDD, including that of depression, social anxiety and OCD.
The chapter will help you to be able to explain what OCD is and how it typically presents, describe and use evidence-based CBT protocols for OCD, choose and use appropriate formulation models for CBT for OCD, describe the importance of using Exposure and Response Prevention and/or Behavioural Experiments in any treatment plan, develop a treatment plan for CBT for OCD, using appropriate measures, and take account of comorbidity in managing CBT for OCD
The chapter will help you to be able to describe the evolution of disorder specific CBT protocols, explain the value of using a disorder specific protocol over a generic CBT approach, consider the relative efficacy of CBT in different populations, and so choose whether CBT is appropriate for your patient, and if so, which adaptation of CBT would be most helpful
This chapter acts as a clear guide to your theoretical understanding of CBT to enhance your knowledge across protocols, clinical populations and clinical presentations.
You will gain a working knowledge of the theoretical basis of Beck’s model CBT and how theories and models remain important for advancing clinical practice.
You will be able to more effectively apply CBT across protocols as you will have a better elaborated account of how this therapy has integrated elements across conditions and client presentations.
You will become knowledgeable about the theoretical mechanism of change in CBT
You will become more skilled in using theoretical principles of CBT to stay true to execution of treatment protocols.
The chapter will help you to be able to describe the development of Cognitive, Behavioural, and Integrative approaches to Couple’s Therapy, apply a range of dyadic formulation processes to couples, and apply the key interventions in couple’s therapy, including empathic joining, unified detachment and dyadic behavioural change processes
Access essential information to add to your existing clinical knowledge and skills so as to more effectively work with older people using CBT.Work collaboratively with older people using CBT, planning treatment interventions unencumbered by stereotypical beliefs about ageing and older people and expect symptom reduction consistent with standard treatment protocols.Apply ideas from theories of the science of ageing (gerontology), such as wisdom and emotional development, in order to help your client make use of lifeskills when helping themselves overcome common mental health problems.Use and apply new techniques associated with a developmentally appropriate frame of reference when working with older people.
The chapter will help you to be able to describe the development of remote delivery CBT, both by phone, videoconferencing, and text-based systems, explain the costs and benefits of the various remote formats to both the provider and client, and help your clients choose the most appropriate format for their therapy
The chapter will help you to be able to define Cognitive Behaviour Therapy, explain the key processes within CBT, describe the key features of good CBT as described in therapy rating scales such as the CTSr and CTRS, and consider how to best incorporate the key components of CBT in terms of structure, style and content
The chapter will help you to be able to explain the structure of CBT as a whole, including the purpose of each stage of therapy, effectively structure a treatment session of CBT, so as to ensure the best possible experience for patients, and develop a strong therapeutic alliance with this process, based on active collaboration and genuine empathy, warmth and unconditional positive regard
The chapter will help you to be able to describe the development of Group CBT, explain the costs and benefits of group CBT to both the provider and client and apply best practice when running CBT groups
The chapter will help you to be able to explain what PTSD is and how it typically presents, including the nature of trauma memories and associated re-experiencing, describe and use evidence-based CBT protocols for PTSD, choose and use appropriate formulation models for CBT for PTSD, describe the importance of reprocessing in any treatment plan, develop a treatment plan for CBT for PTSD, and take account of comorbidity in managing CBT for PTSD.