Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
28,991
result(s) for
"Behavior Therapy methods."
Sort by:
Exercise versus usual care after non-reconstructive breast cancer surgery (UK PROSPER): multicentre randomised controlled trial and economic evaluation
AbstractObjectiveTo evaluate whether a structured exercise programme improved functional and health related quality of life outcomes compared with usual care for women at high risk of upper limb disability after breast cancer surgery.DesignMulticentre, pragmatic, superiority, randomised controlled trial with economic evaluation.Setting17 UK National Health Service cancer centres.Participants392 women undergoing breast cancer surgery, at risk of postoperative upper limb morbidity, randomised (1:1) to usual care with structured exercise (n=196) or usual care alone (n=196).InterventionsUsual care (information leaflets) only or usual care plus a physiotherapy led exercise programme, incorporating stretching, strengthening, physical activity, and behavioural change techniques to support adherence to exercise, introduced at 7-10 days postoperatively, with two further appointments at one and three months.Main outcome measuresDisability of Arm, Hand and Shoulder (DASH) questionnaire at 12 months, analysed by intention to treat. Secondary outcomes included DASH subscales, pain, complications, health related quality of life, and resource use, from a health and personal social services perspective.ResultsBetween 26 January 2016 and 31 July 2017, 951 patients were screened and 392 (mean age 58.1 years) were randomly allocated, with 382 (97%) eligible for intention to treat analysis. 181 (95%) of 191 participants allocated to exercise attended at least one appointment. Upper limb function improved after exercise compared with usual care (mean DASH 16.3 (SD 17.6) for exercise (n=132); 23.7 (22.9) usual care (n=138); adjusted mean difference 7.81, 95% confidence interval 3.17 to 12.44; P=0.001). Secondary outcomes favoured exercise over usual care, with lower pain intensity at 12 months (adjusted mean difference on numerical rating scale −0.68, −1.23 to −0.12; P=0.02) and fewer arm disability symptoms at 12 months (adjusted mean difference on Functional Assessment of Cancer Therapy-Breast+4 (FACT-B+4) −2.02, −3.11 to −0.93; P=0.001). No increase in complications, lymphoedema, or adverse events was noted in participants allocated to exercise. Exercise accrued lower costs per patient (on average −£387 (€457; $533) (95% confidence interval −£2491 to £1718; 2015 pricing) and was cost effective compared with usual care.ConclusionsThe PROSPER exercise programme was clinically effective and cost effective and reduced upper limb disability one year after breast cancer treatment in patients at risk of treatment related postoperative complications.Trial registrationISRCTN Registry ISRCTN35358984.
Journal Article
Actissist: Proof-of-Concept Trial of a Theory-Driven Digital Intervention for Psychosis
Abstract
Background
Timely access to intervention for psychosis is crucial yet problematic. As such, health care providers are forming digital strategies for addressing mental health challenges. A theory-driven digital intervention that monitors distressing experiences and provides real-time active management strategies could improve the speed and quality of recovery in psychosis, over and above conventional treatments. This study assesses the feasibility and acceptability of Actissist, a digital health intervention grounded in the cognitive model of psychosis that targets key early psychosis domains.
Methods
A proof-of-concept, single, blind, randomized controlled trial of Actissist, compared to a symptom-monitoring control. Thirty-six early psychosis patients were randomized on a 2:1 ratio to each arm of the trial. Actissist was delivered via a smartphone app over 12-weeks; clinical and functional assessment time-points were baseline, post-treatment and 22-weeks. Assessors’ blind to treatment condition conducted the assessments. Acceptability was examined using qualitative methods.
Results
Actissist was feasible (75% participants used Actissist at least once/day; uptake was high, 97% participants remained in the trial; high follow-up rates), acceptable (90% participants recommend Actissist), and safe (0 serious adverse events), with high levels of user satisfaction. Treatment effects were large on negative symptoms, general psychotic symptoms and mood. The addition of Actissist conferred benefit at post-treatment assessment over routine symptom-monitoring and treatment as usual.
Conclusions
This is the first controlled proof-of-concept trial of a theory-driven digital health intervention for early psychosis. Actissist is feasible and acceptable to early psychosis patients, with a strong signal for treatment efficacy.
Trial Registration: ISRCTN: 34966555.
Journal Article
The skills training manual for Radically open dialectical behavior therapy : a clinician's guide for treating disorders of overcontrol
\"The Skills Training Manual for Radically Open Dialectical Behavior Therapy offers a groundbreaking, transdiagnostic approach for clients with difficult-to-treat overcontrol (OC) disorders, such as anorexia nervosa, treatment-resistant depression, and obsessive-compulsive disorder (OCD). Written by the founder of RO-DBT and published for the first time, this manual offers clinicians step-by-step guidance for implementing this evidence-based therapy in their practice\"-- Provided by publisher.
Book
Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study
Self-harm and suicidal behaviors are prevalent among autistic adults without intellectual disability (ID). Emotion dysregulation (ED), the difficulty in modulating emotions, has been identified as an important risk factor. Dialectical behavior therapy (DBT) has been proved effective to treat ED in disorders other than autism spectrum disorder. Our study aimed at assessing the feasibility, acceptability and preliminary efficacy of DBT in seven autistic adults without ID exhibiting self-harm and/or suicidal behaviors linked to severe ED. Our results suggest that DBT is feasible and highly acceptable to autistic adults without ID. Additionally, mean scores on the Difficulties in Emotion Regulation Scale decreased significantly post-treatment and at 4-month follow-up, suggesting that DBT might be efficacious in reducing ED in this population.
Journal Article
Problematic and risk behaviours in psychosis : a shared formulation approach
\"In spite of improved access to psychosocial interventions, many people with psychosis continue to experience persistent problems which act as significant barriers to their recovery. This book investigates risk and problem behaviours in psychosis including staff and service factors that can impede the delivery of effective care. Working with Problematic Behaviour in Psychosis provides a new approach for assessment formulation and intervention with such problem behaviours in a team context. Of particular interest will be: an outline of the SAFE (Shared Assessment, Formulation and Education) approach an integrative model for understanding risk and problematic behaviour shared risk assessment and management processes the use of CBT in day-to-day interactions with clients a set of formulation driven strategies for managing problematic behaviours case studies and vignettes providing guidance and highlighting the benefits of the approach. This book will have particular appeal to professionals working in residential care for those with complex mental health problems as well as those working in intensive community based services. It is also an excellent resource for those training in psychological therapies for complex mental health problems, risk assessment and management\"--Provided by publisher.
Book
Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder
Dialectical behaviour therapy (DBT) and mentalisation-based therapy (MBT) are both widely used evidence-based treatments for borderline personality disorder (BPD), yet a head-to-head comparison of outcomes has never been conducted. The present study therefore aimed to compare the clinical outcomes of DBT v. MBT in patients with BPD.
A non-randomised comparison of clinical outcomes in N = 90 patients with BPD receiving either DBT or MBT over a 12-month period.
After adjusting for potentially confounding differences between participants, participants receiving DBT reported a significantly steeper decline over time in incidents of self-harm (adjusted IRR = 0.93, 95% CI 0.87-0.99, p = 0.02) and in emotional dysregulation (adjusted β = -1.94, 95% CI -3.37 to -0.51, p < 0.01) than participants receiving MBT. Differences in treatment dropout and use of crisis services were no longer significant after adjusting for confounding, and there were no significant differences in BPD symptoms or interpersonal problems.
Within this sample of people using specialist personality disorder treatment services, reductions in self-harm and improvements in emotional regulation at 12 months were greater amongst those receiving DBT than amongst those receiving MBT. Experimental studies assessing outcomes beyond 12 months are needed to examine whether these findings represent differences in the clinical effectiveness of these therapies.
Journal Article
The effectiveness and safety of dialectical behavior therapy for suicidal ideation and behavior in autistic adults: a pragmatic randomized controlled trial
Many autistic people in mental health are suicidal. This study evaluated the effectiveness of dialectical behavior therapy (DBT)
treatment as usual (TAU) in reducing suicidal ideation and suicide attempts.
At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (
= 63) or TAU control group (
= 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes.
At end-of-treatment, DBT significantly reduced both suicidal ideation (
= -2.24;
= 0.025;
= -4.41; s.e. = 197.0) and suicide attempts (
= -3.15;
= 0.002;
= 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (
= -1.99;
= 0.046:
= -2.74; s.e. = 1.37) remaining so at 12 months (
= -2.46;
= 0.014;
= -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition.
DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.
Journal Article