BACKGROUND:Best practice guidelines recommend CBT for everyone with psychosis, yet high rates of non-engagement and early drop-out result in many not receiving 'full dose' therapy. For those who do engage, effect sizes are typically modest. Most people with psychosis have an insecure attachment style, characterised by predictable and problematic patterns of beliefs, emotion regulation and interpersonal behaviours, including help-seeking. Attachment-congruent adaptations to CBT could improve retention and recovery outcomes for people who are also insecurely attached. AIMS:This is the first evaluation of attachment-congruent adaptations to CBT for psychosis. We assessed impact of therapy for the first five people (aged 30-50) to complete therapy and measures. METHOD:We used a single case ABC design and measured paranoia, voices, help-seeking, coping, and personal goals over baseline, intervention, and follow-up phases. We predicted that adapted CBT would lead to improved outcomes which would be maintained at follow-up. Trait measures of voices, paranoia, attachment, and recovery are used to describe the sample. RESULTS:Participants presented with complex needs, including paranoia, voices, and attachment insecurity. Baseline phases showed high and variable levels of psychosis. All showed improvements in paranoia, voices, willingness to seek help, ability to cope, and/or personal recovery goals over the intervention phase. Gains were largely maintained or improved further at follow-up. CONCLUSIONS:Attachment-congruent adaptations to CBT are likely to benefit people with psychosis who present with the additional cognitive, affective and behavioural complexities characteristic of insecure attachment, which threaten access and impact of recommended treatments if not addressed.
OBJECTIVE:Cognitive Behavioural Therapy-Ten (CBT-T) offers a briefer manualised approach to treatment of non-underweight eating disorders (EDs) compared with traditional therapy models, and has the potential to help services deliver timely access to care. This study evaluated CBT-T outcomes in a naturalistic setting, with a focus on session-by-session change patterns. METHOD:A total of 151 young adults received CBT-T in a no-threshold-to-access community ED service. Symptom trajectories were assessed using the ED-15 global scale and subscales (eating concern, weight/shape concern). Using intent-to-treat principle, linear mixed-effect models evaluated treatment effectiveness, and chi-squared and receiver operating characteristic (ROC) analyses explored associations between early symptom change and end-of-treatment remission. RESULTS:Treatment led to significant reductions in ED symptoms and psychosocial impairment, with large effect sizes. Reliable improvement in Weight/Shape Concern - but not Eating Concern - on ED-15 at session 4 significantly predicted ED symptom scores below the clinical cut-off at the last session. CONCLUSIONS:CBT-T is effective in reducing ED symptoms in young adults with non-underweight EDs. While engagement and progress prior to session 4 have been used to guide treatment planning, as stated in the treatment manual, only the change in weight/shape concern at session 4 appeared to be strongly predictive of outcome in this sample, whereas change in eating concern did not. Early changes in weight and shape concerns at initial sessions may be informative in predicting treatment outcome. The findings can support the future development of CBT-T and other brief ED interventions.
BACKGROUND:Cognitive behavioural therapy (CBT) is the first-line treatment for anxiety and related disorders. Limited research has explored long-term outcomes following CBT for anxiety-related disorders in naturalistic settings, particularly for generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). AIMS:This study examined long-term outcomes and attrition after group CBT for GAD, SAD, and PTSD in a naturalistic sample. Across disorders, it was hypothesized that gains would be maintained long-term, with a gradual return of clinically relevant symptoms observed at later follow-up points. METHOD:Data were collected from individuals completing CBT at a tertiary anxiety treatment clinic. Symptom changes pre- to post-treatment and over a 2-year follow-up were examined, as well as the influence of baseline depressive symptoms on change over time. Worry, social anxiety, and post-traumatic stress symptoms were assessed at pre- and post-treatment and 3, 6, 9, 12, and 24 months. RESULTS:On average, symptom improvements were maintained over the 2-year follow-up for all disorders. Higher pre-treatment depression was associated with greater symptom severity throughout the study but generally did not affect the magnitude of symptom change. The exception was PTSD, where baseline depression was also associated with changes in symptom severity across the whole study period. This effect was not observed for those with SAD and GAD. Attrition was high across the follow-up period. CONCLUSION:This study provides preliminary evidence for the long-term efficacy of CBT in a naturalistic setting. It also highlights challenges with retaining clients in long-term follow-up in naturalistic settings.
BACKGROUND:Panic disorder occurs in 1-3% of adolescents and without treatment often has a chronic course. Treatments need to be effective and efficient to be delivered in routine services. Given that a brief version of cognitive therapy has been shown to be effective in adults, an adapted version could be beneficial for adolescents with panic disorder. AIMS:We aimed to establish clinical and economic proof-of-concept for brief cognitive therapy for adolescent panic disorder and examine the feasibility of a future definitive trial compared with a brief generic form of CBT, using several well-defined criteria. METHOD:Thirty-four young people (aged 12-17 years) meeting diagnostic criteria for panic disorder and attending a routine clinical service, were randomly allocated to receive either brief cognitive therapy (B-CT) or a brief generic form of CBT; both involved five treatment sessions and up to two booster sessions and were delivered by Children's Wellbeing Practitioners. We examined patient outcomes, expectations, and experiences, as well as health economic factors post-treatment and at 3-month follow-up. We also explored panic severity 12 months after treatment completion. RESULTS:The trial met feasibility and acceptability criteria in relation to recruitment and there were no serious concerns around acceptability of treatment and trial procedures. CONCLUSIONS:This study provides preliminary evidence that both B-CT and a generic form of CBT are associated with positive outcomes, expectations, and experiences for adolescents, parents/carers and clinicians. However, there appear to be additional benefits from B-CT that are worthy of evaluation in a future definitive RCT.
BACKGROUND:The United Kingdom's Talking Therapies for Anxiety and Depression (TTAD) programme provides standardised definitions for recovery-related outcomes, allowing transparent and comparable reporting. This study aimed to descriptively examine recovery-related outcomes following cognitive behavioural therapy (CBT) in a Japanese clinical sample using established TTAD definitions. METHOD:Data were drawn from patients who received CBT in routine clinical practice. Depressive and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, respectively. Recovery, reliable improvement, and reliable recovery were classified according to the TTAD criteria. RESULTS:The sample consisted of 241 participants, of whom 178 (73.9%) met the criteria for caseness at baseline. Among those with baseline caseness, 75 participants (42.1%) met the criteria for recovery at the end of treatment. Across the full sample, 103 participants (47.2%) demonstrated reliable improvement. Reliable recovery, defined as meeting the criteria for both recovery and reliable improvement, was observed in 65 participants (36.5% of those with baseline caseness). CONCLUSIONS:Using standardised TTAD definitions, this study provides a descriptive account of recovery-related outcomes following CBT in routine clinical practice in Japan. The findings show the distribution of recovery and improvement outcomes in this sample and highlight the importance of clearly distinguishing between recovery-related indicators when interpreting outcomes in real-world clinical settings.
BACKGROUND:People with hoarding behaviours (PwHB) need to be able to access a range of support options in a timely manner for their own wellbeing as well as that of friends and family. In response to recent calls to understand more about support groups and the role of peers in relation to hoarding, we investigate an online forum for PwHB. AIMS:To explore the types of messages exchanged on the popular online discussion platform Reddit and the sort of information and support that is available. METHOD:We randomly scraped 100 threads from a hoarding subreddit or subcommunity on Reddit and undertook a thematic analysis of the 1297 individual messages collected. RESULTS:The analysis produced three themes: Emotional and practical support for help seekers; Seeking help on behalf of others; and Practical problems with discarding. The forum provides a place for exchanging emotional and practical support where posters detail their lived experience of practical strategies for reducing their 'hoard'. Progress updates provide a sense of continued connection and posters seeking advice on behalf of someone else are welcomed and supported. The forum exposes debate and frustration around the practicalities and ethics of disposing of items, highlighting additional obstacles for PwHB and the limitations of geographically dispersed support groups. CONCLUSIONS:The online forum provides both opportunities and challenges for PwHB. The type of content exchanged within the online forum helps us better understand support issues for PwHB and points to clinical implications for therapy.
Background Internet-delivered parent-led interventions can be useful for treating anxiety in children and adolescents, and they also help increase access to services while reducing time and cost.Aims This review aimed to investigate the effects of internet-delivered parent-led interventions on reducing anxiety in children and adolescents.Method A search of PubMed, PsycArticles, Cochrane Library, and Google Scholar databases identified 13 studies published between 2013 and 2024, which examined internet-delivered, parent-led interventions targeting anxiety in children.Results Internet-delivered parent-led interventions had overall positive effects on reduced anxiety in children and adolescents that could be maintained through follow-up. Interventions directly targeting anxiety symptoms had significant treatment effects.Discussion Internet-delivered parent-led interventions may be effective in reducing anxiety symptoms in children and adolescents, particularly when the intervention directly targets anxiety rather than focusing solely on parenting approaches. Interventions supplemented with therapist support, such as telephone consultations, appear to enhance treatment outcomes and help maintain effects over time. Two-thirds of the included studies had a moderate risk of bias, and one-third had a serious risk of bias. Further studies using rigorous methodologies are needed to strengthen the evidence base.
BACKGROUND:Despite its significant impact on parenting and child outcomes, postnatal anxiety receives less attention than postnatal depression. Intolerance of uncertainty (IU) and inflated responsibility (IR) may be vulnerability factors for postnatal anxiety and infant feeding outcomes. For this reason, we investigated the associations of postnatal anxiety and a range of factors including IR and IU. METHOD:Postnatal women (n=126), predominantly white Irish, completed an anonymous online survey assessing postnatal anxiety, IU and IR, and infant feeding. Hierarchical multiple regression analyses were tested for unique predictors of postnatal anxiety. Multivariate tests were used to assess variables associated with feeding outcomes. RESULTS:Although both IR and IU were significantly correlated with postnatal anxiety, regression analyses found only IR accounted for a significant amount of unique variance in postnatal anxiety. In terms of feeding outcomes, IR and IU were associated with reduced likelihood to breastfeed. CONCLUSIONS:IU and IR may have different impacts on postnatal anxiety. IU and IR may explain the higher incidence of anxiety in postnatal women and impact on a mother's decision to breastfeed her infant. Although important, these are results of a small cross-sectional study with some limitations. As such, they should be interpreted with caution. More investigation of these concepts would be beneficial.
BACKGROUND:Health anxiety by proxy (HAP) refers to parents' worries about their child's health. Research into HAP is in its infancy, but it is known that the children of those with HAP and the broader family system are affected by these elevated health concerns. AIMS:This study aimed to explore factors associated with HAP in parents of children with cancer, and parents of 'well' children, particularly parental health anxiety (HA), social support, and illness characteristics. METHOD:Cross-sectional online questionnaire design using social media and NHS paediatric oncology services to recruit parents of children with cancer (n=41) and parents of 'well' children (n=79). RESULTS:HAP (but not HA) was significantly higher in parents of children with cancer than those with 'well' children (p < .001). HAP was negatively associated with social support in parents of 'well' children only (p=.002), but both groups demonstrated a positive association between social support and HA (p=.006). Both HA (B=.588; p < .001) and health status of child (B=-30.281; p < .001) were significant independent predictors of HAP (controlling for interactions between group and variables) in a hierarchical regression. CONCLUSIONS:Parents of children with cancer have higher rates of HAP (but not HA), with HAP associated with lower levels of social support in both groups. Parental HA and child health status are key to understanding HAP. Further research is needed to establish underlying mechanisms and vulnerability to HAP to inform development of effective interventions for this group.
BACKGROUND:The beliefs about their items held by those experiencing hoarding disorder (HD) have been conceptualised as motivating and perpetuating factors. AIMS:This paper presents a measure named Beliefs about Items in Hoarding Disorder: designed to identify the presence and strength of beliefs about their items in HD to aid routine assessment and formulation. METHOD:Participants (n=226) who met the clinical threshold for HD completed a battery of questionnaire items based on previous measures of cognition in hoarding and qualitative research into beliefs held by people with HD about their items, which were subsequently analysed using factor analysis to refine the tool for clinical use. RESULTS:The findings of the analysis indicated three factors: items create emotional attachment and safety, items represent parts of me and my life, and items are useful and should not be wasted. CONCLUSIONS:This new measure, Beliefs about Items in Hoarding Disorder, provides an alternative to existing HD measures that do not include all the beliefs deemed important by more recent research and the sample in the current study. This tool has the potential to encourage open conversations with people experiencing HD about their beliefs and how these may be maintaining problems with hoarding. Further work is needed to support the reliability and validity of this measure in clinical practice, but presents an updated and novel tool to assist in developing a more comprehensive understanding of HD.
Background/objectives: Substantial experimental research has explored mental contamination - feelings of internal pollution proposed to result from misinterpreting perceived violations. The Mental Contamination Report (MCR) was developed to measure in-the-moment experiences of mental contamination, and has been used in seminal experiments in this domain. However, the MCR has yet to be psychometrically evaluated. The aim of the current study was to evaluate the psychometric properties of the MCR, and if warranted, propose a revised version with improved research utility. Method: Data for this study were collected as part of a larger experiment examining the impact of moral self-violation on mental contamination. A sample of 150 undergraduate students completed the MCR, Vancouver Obsessional-Compulsive Inventory-Mental Contamination Subscale, and the Vancouver Obsessional-Compulsive Inventory. Results: The original Emotions Subscale of the MCR demonstrated excellent internal consistency (=0.92) but contained emotions non-specific to mental contamination. We conducted an exploratory factor analysis (EFA) of the emotion items to identify which items load more heavily onto a mental contamination-specific factor. The EFA revealed a two-factor solution, with five items items loading strongly on the mental contamination-specific factor. For the 5-item mental contamination-specific Emotions Subscale, we found excellent internal consistency (=0.90), strong known groups validity, F-2,F-147=63.17, p<.001, eta(2)(p)=.46, good convergent validity and mixed results for divergent validity. For the Behavioural Urges Subscale, we found overall mixed psychometric properties. Conclusions: Based on the results of the psychometric analysis, a revised version of the MCR is proposed.
BACKGROUND:There can be heterogeneity in outcomes for individuals receiving targeted CBT for voices (CBTv), and rates of drop-out require investigation. To promote the directed provision of interventions to those most likely to benefit, it is necessary to elucidate the relationship between the factors driving the variability in engagement and response to these interventions. AIMS:This study aimed to explore the possible predictors of engagement and outcome for a transdiagnostic cohort of service users receiving Guided self-help cognitive behaviour intervention for VoicEs (GiVE), a brief, manualised CBTv intervention. METHOD:This study utilised a quasi-experimental approach to explore and analyse potential predictors of engagement and outcome for service users offered a course of GiVE within routine clinical practice. The sample consisted of 142 service users who were assessed between January 2017 and September 2019 and were offered the GiVE intervention. RESULTS:The offer of the intervention was accepted by 108 (76%) service users and completed by 74 (52%). Clinically meaningful benefits on the primary outcomes of voice-related distress and recovery were reported by 54% and 48% of the service users who completed the intervention, respectively. For the prediction of engagement, only higher age was found to be associated with increased engagement, particularly for those aged 45-54 and 55-64. For the prediction of outcome, the only clinical measure found to be associated with poorer outcome was an increased anxiety score at baseline. CONCLUSIONS:Engagement with and outcomes from the GiVE intervention may be enhanced with a pre-intervention consideration of age and the reduction of anxiety, respectively.
BACKGROUND:Community crime against older people is of increasing concern but the relationship between safety-seeking behaviours and continued psychological distress has not been examined. As existing assessment tools have limited validity, we aimed to investigate this by designing a novel person-reported safety-seeking behaviour measure (PRSBM) and conducting preliminary evaluation of its wider applicability. METHOD:We collected mixed-methods data from n=100 initially distressed older victims at 3 months post-crime, using the PRSBM. This asked older victims how often they engaged in six behaviours (checking, reassurance-seeking, rumination, avoidance, rituals, hypervigilance), what these were, how often, and how much they had changed since the crime. We measured continued distress using the two-item General Anxiety Disorder and Patient Health Questionnaires. We analysed qualitative behaviour data using codebook thematic analysis, quantitative data on behaviour frequency and change using logistic regression adjusted for gender, age and crime type, and explored the PRSBM psychometric structure using unique variable analysis. RESULTS:Older victims reported a wide range of safety-seeking behaviours conceptually consistent with their experiences. Some were highly restrictive; others may help maintain independence. The frequency of checking, avoidance, and hypervigilance, and a change in avoidance, were most strongly associated with continued distress. The PRSBM was acceptable, comprehensive, and captured differences and commonalities in safety-seeking. CONCLUSIONS:As older victims identified as avoidant appear at risk of losing their independence, referral for treatment is recommended. The PRSBM appears promising as a research and clinical tool in a range of settings, suggesting further testing in different populations would be worthwhile.
BACKGROUND:Individuals with hoarding disorder exhibit heightened attachment to objects, but little is known about possible drivers of object attachment and associated object saving behaviors. Theory and preliminary evidence posit that the heightened object attachment characteristic of hoarding disorder may be partially explained by the experience of vivid, 'Proustian' memories related to objects. AIMS:The current study piloted a novel Proustian Memory Task to examine whether self-reported vividness of memories associated with cherished objects, mundane objects, and non-objects was associated with greater urge to save objects and greater hoarding symptoms. METHOD:Participants (N=443) included a non-selected community sample recruited from the crowd-sourcing platform Prolific. Participants were asked to identify and describe a memory associated with their most cherished belonging, a mundane belonging, and a recent vacation (i.e. non-object control). Participants also reported their urge to save the identified objects and completed a self-report measure of hoarding symptoms. RESULTS:Hoarding symptoms were not associated with vividness of memories of cherished objects, or with non-objects, but were associated with greater vividness of memories of mundane objects. Greater vividness of memories associated with objects was associated with a greater urge to save both cherished and mundane objects; however, this relationship was stronger for mundane compared with cherished objects. The relationship between memory vividness and urge to save objects was not impacted by hoarding symptoms. CONCLUSIONS:Findings provide preliminary evidence that the experience of Proustian memories, particularly those related to mundane objects, may play a role in object attachment and hoarding symptoms.
BACKGROUND:Low educational literacy is associated with high rates of mental health problems. In Pakistan, only 60% of the population is literate. Traditional CBT requires literacy skills. Interventions to address the literacy barriers need to be developed. AIMS:To evaluate the feasibility, acceptability, and preliminary efficacy of a culturally adapted CBT-based animated 'Shorts' series for depression and anxiety in individuals with no or low educational literacy. METHOD:This randomized, rater-blind randomized controlled trial (RCT) compared an animated Shorts series and treatment as usual (TAU) with TAU alone in Pakistan. The primary outcomes were feasibility (recruitment, retention, adherence to treatment and trial processes) and acceptability (drop-outs and participants' feedback). The secondary outcomes included the Hospital Anxiety and Depression Scale (HADS) and the WHO Disability Assessment Schedule 2 (WHODAS 2). Thirty consenting participants were randomly allocated to one of the groups in a 1:1 ratio and were assessed at baseline and the end of the intervention at 12 weeks. RESULTS:The intervention was feasible and acceptable and was successful in reducing the symptoms of depression and anxiety. However, these findings need to be further confirmed in a larger RCT. CONCLUSIONS:These preliminary findings are encouraging, and if future studies confirm that this approach can work, we should be able to overcome the literacy barrier in low- and middle-income countries.
BACKGROUND:Perinatal obsessive-compulsive disorder (PNOCD) can impact up to one in five individuals in the perinatal period. Whilst effective treatment for PNOCD is available, parents experience barriers accessing this evidence-based psychological therapy. Healthcare professionals' perspectives on barriers to accessing support are valuable to develop targeted interventions to increase access to support for PNOCD. AIM:This study aimed to prioritise a list of barriers to accessing therapy for PNOCD, in terms of importance and amenability to change, from the perspective of healthcare professionals. METHOD:203 healthcare professionals from across primary, community and secondary care services completed a survey where they ranked barriers in terms of importance and amenability to change. Barriers were ranked within clusters and across cluster names; 47 barriers were organised into seven clusters. Rankings were analysed using descriptive statistics and the non-parametric Friedman's test. RESULTS:Professionals ranked healthcare professionals' knowledge and training on PNOCD as the barrier which was most important and amenable to change. Parents' knowledge and awareness of PNOCD and services, their attitudes to mental health problems, and their attitudes towards healthcare professionals and services were ranked as the second most important and amenable to change. CONCLUSION:Professionals view their colleagues' knowledge and training on PNOCD as the most important barrier impacting parents access to evidence-based therapy for PNOCD. Training for professionals could be targeted to increase access. Parents' awareness and attitudes surrounding PNOCD, mental health and services were also identified by professionals as an important barrier and is recommended to be targeted to increase access.
BACKGROUND:Intrusive re-experiencing of traumatic events is a cornerstone of post-traumatic stress disorder (PTSD). Clinicians notice that clients also experience intrusive mental images of what they think might happen during a traumatic event. As mental imagery has a powerful impact on emotion, imagination-based imagery may be implicated in the peaks of distress ('hotspots') during a trauma. AIMS:A data-only study was undertaken of cognitive therapy for PTSD 'hotspot' charts used by Grenfell Health and Wellbeing Service clinicians after the Grenfell fire disaster. The aim was to establish the prevalence and nature of peri-traumatic 'imagination-based hotspots' in this sample. METHOD:Hotspots are described as the worst moments within a trauma. Two clinicians independently rated anonymised hotspot charts (N=26) for the presence and content of 'imagination-based hotspots', defined as 'a peak of emotion during a traumatic event that is related to something imagined "in the mind's eye" as opposed to directly perceived with the senses'. RESULTS:81% (N=21) of individuals reported an imagination-based hotspot; 38% of all hotspots (n=159) contained an imagination-based component. The most common was an image in which the person watching the fire imagined themselves in the 'shoes' of a tower resident. CONCLUSIONS:Imagination-based mental imagery appears to be linked to the 'hotspots' of a high proportion of people experiencing PTSD in this sample. Results underline the importance of enquiring about the presence of mental imagery during PTSD treatment. The presence of peri-traumatic mental images has implications for effective updating of 'hotspots' in PTSD treatment.
BACKGROUND:Approximately 24% of stroke survivors develop post-stroke depression (PSD), which is associated with poor psychological recovery, identity disruption, and reduced self-esteem. Psychological interventions often fail to address these broader challenges. The Wisdom Enhancement Timeline technique, which facilitates autobiographical reflection, has shown promise for depression in older adults. It has not yet been studied in a post-stroke population. AIMS:This study evaluated the effectiveness of the Wisdom Enhancement Timeline technique in stroke. It was hypothesised that wisdom would improve first, followed by identity/self-esteem and mood. METHOD:A multiple-baseline single-case experimental design (SCED) was used across three stroke survivors. Daily visual analogue scale (VAS) ratings measured mood, identity, self-esteem, and wisdom during the trial. The Patient Health Questionnaire-9 (PHQ-9) measured depressive symptoms at pre- and post-intervention. Visual analysis, Tau-U, generalised least squares regression (adjusting for autocorrelation), and piecewise regression evaluated intervention effects. RESULTS:Improvements were observed across all participants and outcomes. Tau-U analysis indicated small-to-large effect sizes across outcomes (effect size range: 0.30-0.92). Breakpoints confirmed wisdom improved first, followed by identity/self-esteem and mood last. Regression confirmed significant level shifts across all outcomes. All participants showed clinically meaningful reductions in PHQ-9 scores, operationalised as a shift from pre-intervention scores above 10 to post-intervention scores below 10. CONCLUSIONS:Wisdom-based interventions could be beneficial in a stroke population, promoting improvements in mood, identity coherence, self-esteem and wisdom. The Wisdom Enhancement Timeline technique shows promise for PSD treatment, although further research is needed to validate these effects.
BACKGROUND:People experiencing psychosis in acute crisis should be offered cognitive behavioural therapy for psychosis (CBTp); however, there are few crisis-focused CBTp-informed models to underpin formulation development for people experiencing psychosis and receiving inpatient mental health care. AIMS:This paper draws on existing CBTp and crisis theories to conceptualise a psychotic crisis from a cognitive behavioural perspective to inform the delivery of therapy in inpatient settings. METHOD:Previous literature is reviewed, critiqued, and synthesised. It draws upon relevant crisis and CBTp theories to outline how to best formulate a psychotic crisis. DISCUSSION:Drawing on existing research and theory, this paper outlines how a psychotic crisis can develop and be maintained. It highlights the importance of the person's context including the social, political, and cultural context, interpersonal context and trauma, and previous and current inpatient experience. It then outlines the key triggers, cognitive, behavioural, and emotional components of the crisis, and personal strenghts, values and resources. A crisis-focused CBTp-informed approach is outlined, which can be used to underpin formulation and brief therapy strategies for people experiencing a psychotic crisis. More research is required to explore the efficacy of such therapies.
BACKGROUND:While around one-fifth of UK secondary school pupils exhibit clinically significant eating pathology, in-school mental health provision does not include interventions to address such eating pathology. AIMS:This preliminary qualitative study aimed to explore the views of staff, parents and pupils, on the idea of introducing a school-based brief cognitive behavioural therapy programme for non-underweight eating disorders. METHOD:31 pupils, 22 parents and 27 staff participated in 12 focus groups across four schools. The semi-structured interview guide covered topics around the practicalities of a potential eating disorders treatment programme, the acceptability of the intervention, and likelihood of future uptake. RESULTS:Five over-arching themes and 12 subthemes emerged, reflecting the scale of eating and body image concerns, management limitations, and the importance of prioritising mental health over education. Advantages, challenges, considerations, and solutions were proposed for an in-school eating disorders treatment programme. CONCLUSIONS:These qualitative data show that there is support for an appropriately implemented in-school delivery of brief, evidence-based treatment, demonstrating the potential scope of such an approach to support children and adolescents to receive early help with their eating problems and body image concerns.
