Implementing low intensity CBT in case management of clients with severe mental illness
Kavanagh, David J. & Deane, Frank P. (2010) Implementing low intensity CBT in case management of clients with severe mental illness. In Bennett-Levy, James, Richards, David, Farrand, Paul, Christensen, Helen, Griffiths, Kathy, Kavanagh, David J., et al. (Eds.) Oxford Guide to Low Intensity CBT Interventions. Oxford University Press Inc., New York, pp. 521-527.
In a previous chapter (Dean and Kavanagh, Chapter 37), the authors made a case for applying low intensity (LI) cognitive behaviour therapy (CBT) to people with serious mental illness (SMI). As in other populations, LI CBT interventions typically deal with circumscribed problems or behaviours. LI CBT retains an emphasis on self-management, has restricted content and segment length, and does not necessarily require extensive CBT training. In applying these interventions to SMI, adjustments may be needed to address cognitive and symptomatic difficulties often faced by these groups. What may take a single session in a less affected population may require several sessions or a thematic application of the strategy within case management. In some cases, the LI CBT may begin to appear more like a high-intensity (HI) intervention, albeit simple and with many LI CBT characteristics still retained. So, if goal setting were introduced in one or two sessions, it could clearly be seen as an LI intervention. When applied to several different situations and across many sessions, it may be indistinguishable from a simple HI treatment, even if it retains the same format and is effectively applied by a practitioner with limited CBT training. ----- -----
In some ways, LI CBT should be well suited to case management of patients with SMI. treating staff typically have heavy workloads, and find it difficult to apply time-consuming treatments (Singh et al. 2003). LI CBT may allow provision of support to greater numbers of service users, and allow staff to spend more time on those who need intensive and sustained support. However, the introduction of any change in practice has to address significant challenges, and LI CBT is no exception. ----- -----
Many of the issues that we face in applying LI CBT to routine case management in a mnetal health service and their potential solutions are essentially the same as in a range of other problem domains (Turner and Sanders 2006)- and, indeed, are similar to those in any adoption of innovation (Rogers 2003). Over the last 20 years, several commentators have described barriers to implementing evidence-based innovations in mental health services (Corrigan et al. 1992; Deane et al. 2006; Kavanagh et al. 1993). The aim of the current chapter is to present a cognitive behavioural conceptualisation of problems and potential solutions for dissemination of LI CBT.
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|Item Type:||Book Chapter|
|Additional Information:||Description Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. Features Low intensity CBT is a rapidly growing form of therapy, enabling people who have hitherto had no access to mental health services to benefit from evidence based treatments. This is the first book ever to address this need Edited and written by the people working at the frontiers of low intensity interventions With thousands of new therapists being trained over the coming years to deliver low intensity CBT, this will be the essential guide to this area Table of Contents Foreword , Isaac Marks Section 1 Low Intensity CBT Models and Conceptual Underpinnings Overview , James Bennett-Levy & Paul Farrand 1. Low Intensity CBT Interventions: A Revolution in Mental Health Services , 1. James Bennett-Levy, Dave Richards & Paul Farrand 2. Access and Organisation: Putting Low Intensity Interventions to Work in Clinical Services , Dave Richards 3. The STEPS Model: a High Volume, Multi-level, Multi-purpose approach to address Common Mental Health Problems , Jim White 4. Increasing Access and Effectiveness: Using the Internet to deliver Low Intensity Cognitive Behaviour Therapy , Helen Christensen 5. A New Language for CBT: New ways of Working Require New Thinking as well as New Words , Chris Williams & Jill Morrison Section 2A: Introducing and Supporting Guided CBT Overview , Paul Farrand, Lee Ritterband & James Bennett-Levy 6. Low Intensity CBT Assessment: In Person or by Phone , Paul Farrand & Chris Williams 7. Monitoring & Evaluation in Low Intensity CBT Interventions , Judy Proudfoot & Jennifer Nicholas 8. Introducing and Supporting Written and Internet-Based Guided CBT , Mark Kenwright 9. Matching clients to CBT self-help resources , Rebecca Martinez & Chris Williams 10. Collaborative Care: The Effective Organization of Treatment for Depression , Dave Richards 11. Supervising low intensity workers , Dave Richards Section 2B Key Low Intensity CBT Interventions in Depression and Anxiety Overview , Mark Lau 12. Behavioural Activation for Depression , Dave Richards 13. Problem Solving Therapy for Depression , Laurence Mynors-Wallis & Mark Lau 14. Increasing Physical activity as a Low Intensity Treatment for Depression , Adrian Taylor 15. Key Components of Low Intensity Interventions for Anxiety , Nick Titov, Gavin Andrews & Peter McEvoy 16. Brief Motivational Interviewing for Depression and Anxiety , Leanne Hides, Steve Carroll, Dan I Lubman & Amanda Baker 17. Low Intensity Interventions for Chronic Insomnia , Norah Vincent & Maxine Holmqvist Section 2C: Guided CBT Interventions using Written Materials Overview , Chris Williams, Paul Farrand & James Bennett-Levy 18. Choosing self-help books wisely: Sorting the wheat from the chaff , Dave Richards & Paul Farrand 19. Using Guided Self-Help Book Prescription Schemes , Paul Farrand & Joanne Woodford 20. Delivering book based CBT Self-Help Classes in health service, further education and voluntary sector services , Marie Chellingsworth, Chris Williams, Ann McCreath, Paul Tanto & Kirsten Thomlinson Section 2D: Guided CBT Interventions using the Internet Overview , Judy Proudfoot & Britt Klein 21. Turn On, Tune In and (Don't) Drop Out: Engagement, Adherence, Attrition and Alliance with Internet-based CBT Interventions , Kate Cavanagh 22. Treatment Credibility and Satisfaction with Internet Interventions , Lee Ritterband, Frances Thorndike, Drew Saylor & Desi Vasquez 23. Internet-based Mental Health Screening , Tara Donker, Annemieke Van Straten & Pim Cuijpers 24. Standards and Operating Guidelines for Internet Interventions , Lisa Whitehead & Judy Proudfoot 25. Guided CBT Internet Interventions: Specific Issues in Supporting Clients with Depression, Anxiety and Co-Morbid Conditions , Proudfoot, Andersson, Carlbring, Klein, Kyrios, Lauder, Munro, Palermo, Riper, Blankers Section 2E Novel Uses of Communication Technologies: Supporting Low Intensity CBT in New Environments Overview , Judy Proudfoot & Britt Klein 26. Using different communication channels to support internet interventions , Gerhard Andersson & Per Carlbring 27. Supporting Low Intensity Interventions using the Telephone , Karina Lovell 28. Use of Short-Messaging Service (SMS) To Enhance Low Intensity CBT , Jennifer Shapiro & Stephanie Bauer 29. Email in Low Intensity CBT Interventions , Nick Titov 30. Online Mutual Support Bulletin Boards , Kathy Griffiths & Julia Reynolds 31. Low Intensity Cognitive Behavioural Therapies by Mail (M-CBT) , David Kavanagh, Jennifer Connolly, Amy Kelly, Angela White & Jan Parry Section 2F Stepping Further Outside the Box: Extending the Environments for Low Intensity CBT Overview , Mark Lau 32. Large group didactic CBT classes for common mental health problems , Jim White 33. Cognitive Behaviour Group Therapy (CBGT): Capitalizing on efficiency and humanity , Ingrid Sochting, Christopher Wilson & Theo DeGagne 34. Will you follow while they lead? Introducing a patient-led approach to low intensity CBT interventions , Tim Carey 35. The Advice Clinic or What I did in my thirty minutes , Jim White 36. Low intensity CBT Interventions by General Practitioners , Lee David 37. Adapting low intensity CBT for clients with severe mental disorder , Frank Deane & David Kavanagh Section 2G: Going Upstream: Using Low Intensity CBT Interventions to Prevent Mental Health Problems Overview , Kathy Griffiths 38. Group CBT for prevention of depression in adults , Pim Cuijpers 39. Internet-delivered prevention for anxiety and depression disorders in adults , Tahlee Marian & Justin Kenardy 40. Low intensity targeted group prevention of depression in adolescents and children , Greg Clarke 41. Internet-based anxiety and depression prevention programs for children and adolescents , Alison Calear, Helen Christensen, Kathy Griffiths 42. Parental programs for preventing behavioural and emotional problems in children , Matthew Sanders and James Kirby 43. Mindfulness-based cognitive therapy: a low intensity group program to prevent depressive relapse , Mark Lau Section 3 Training Low Intensity CBT Practitioners Overview , James Bennett-Levy & Dave Richards 44. Training low intensity workers , Dave Richards 45. Training Depression Care Managers , Dave Ekers 46. Training Peers to Provide Low Intensity CBT Support: The Value of Personal Experience , Sharon Lawn, Ann Smith, Kelly Hunter, Jim Smith, Nicki Hurst, Michael Nanai, & Kylie Neate 47. Training the Wider Workforce in the Use of Cognitive Behaviour Therapy Written Self-help Resources , Chris Williams, Catriona Kent & Anne Joice 48. Training GPs to prescribe depression self-management , Dan Bilsker & Elliot Goldner 49. Training Clinicians Online to be Etherapists: The 'Anxiety Online' model , David Austin, Britt Klein, Kerrie Shandley & Lisa Ciechomski 50. From Classroom to 'Shop Floor': Challenges Faced As A Low Intensity Practitioner , Jillian Telford & Rea Wilson Section 4A: Facilitating the Uptake of Low Intensity CBT Interventions: Changing Systems and Routine Practice Overview , David Kavanagh & James Bennett-Levy 51. Establishing the Improved Access to Psychological Therapies (IAPT) Program: Lessons from large-scale change in England , James Seward, Michael Clark 52. Implementing Low Intensity Interventions: What Governments want and why , Alex McMahon 53. Challenges and Potential Solutions in Integrating Internet-based CBT Interventions into Specialist Services , Gehard Andersson, Per Carlbring, Viktor Kaldo, Pim Cuijpers 54. Achieving widespread dissemination of low intensity evidence-based practices: The experience of the Triple P-Positive Parenting Program , Matthew Sanders & Majella Murphy Brennan 55. Practical Service Redesign: Helping GPs to Enhance Depression Care , Michael Smith 56. Implementing low-intensity CBT (LI CBT) in case management of clients with severe mental illness , David Kavanagh & Frank Deane 57. Effective Partnerships with Community Groups , Kevin Khayat Section 4B: Facilitating the Uptake of Low Intensity CBT Interventions: Adapting Interventions to Different Community Contexts Overview , David Kavanagh & James Bennett-Levy 58. Bringing the public on board: Health promotion and social marketing in deprived communities , Jim White 59. Enhancing Community Awareness of Depression and Access to Treatment: Experiences with beyondblue , Nicole Highet, Clare Shann & Leonie Young 60. Problems and Potentials in Rolling out Low Intensity CBT in Rural Communities , Mark Lau 61. Improving Access to Low intensity Interventions for Ethnic Minority Communities , Judy Leibowitz 62. Low intensity CBT with Indigenous consumers: Creative solutions for culturally appropriate mental health care , Arlene Laliberte, Tricia Nagel, & Melissa Haswell-Elkins|
|Keywords:||Low Intensity, Cognitive Behavioural Therapy, CBT, Case Management, Severe Mental Illness, SMI, LI|
|Subjects:||Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100)
Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > COGNITIVE SCIENCE (170200)
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
|Copyright Owner:||Copyright © 2010 Oxford University Press. All rights reserved.|
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|Deposited On:||03 Mar 2011 03:59|
|Last Modified:||29 Feb 2012 14:31|
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