167 research outputs found
Using CORE to research outcome measurement
No full textChris Leach and Mike Lucock have been involved with CORE from its beginning. Jointly responsible for the
development of one of the first large databases of the use of CORE in routine clinical practice, they have
published a number of key papers looking at the relationship between CORE and other outcome measures,
and its use to track client progress during therapy
The importance of comparison in a phenomenological study of clients' experience on an assessment group for group psychotherapy
No full textUsing a grounded theory approach, this study explored the experiences of eight clients who attended a group assessment group (GAG) within a UK adult psychotherapy service. The aim of the GAG was to give clients a one off experience of group therapy to enable them to make a more informed decision about the suitability of analytic group therapy. The qualitative analysis revealed comparison to be a key theme for 7 of the 8 clients. Comparison with others was experienced in terms of similarity and dissimilarity of problems and issues and of the behaviour of the group members. These experiences related to issues such as deserving to be there and stigma and this influenced their decisions to opt for group work. Comparisons were also made between the GAG and subsequent group therapy. The issue of social comparison is discussed with reference to previous theory and research and the implications of the study for group therapy and group assessment groups are explored
Nutrition and mental health recovery
No full textThis review examines the relationship between nutrition and mental health recovery. It examined 22 papers and found that there is substantial evidence to show that people with mental health problems are more likely to engage in poor dietary practices compared to the general population. In addition, there is growing evidence supporting the link between diet and mental health and the benefits of the practical applications of nutritional interventions within mental health services. However, many of these studies are of association and do not prove causation. Therefore, further research is needed on nutrition interventions that utilise specific outcome measures and focus on nutrition in isolation to other factors such as physical activity. The implications of these findings are discussed focusing on mental health practice. This review will be relevant to individuals at all levels within the mental health service, including service users, carers, mental health professionals, managers and directors
Using evidence to improve Psychological Therapies Services
No full textPsychological therapy services offer help to clients with many different sorts of mental health problems using a variety of therapies provided by a range of different professional groups and are supported by a large amount of research evidence. However, applying evidence-based practice in routine clinical settings presents particular challenges. This paper outlines some of the difficulties applying research findings to routine settings and argues for a more inclusive approach to linking evidence with practice. It describes a systematic approach to service evaluation and practice based evidence within a large psychological therapies service. This approach is integrated into the service delivery. It enables clinicians to become engaged in the process of reflecting on evidence in a non-threatening way and allows innovative ways of enhancing reflective practice by linking evidence with practice in routine settings
Evaluating psychological therapies services: A review of outcome measures and their utility
No full textWe describe the use of a number of outcome measures that have been used over the
past eight years to evaluate adult psychological therapies services in the Wakefield &
Pontefract locality of the South West Yorkshire Mental Health NHS Trust. The
psychological therapies service now has a unique database of outcome measures
completed by 5563 clients, which has been used nationally and internationally for
service evaluation and research purposes. Internally, the database has informed the
clinical service, allowing prioritising of referrals and feedback to clinicians and
referral agencies on the quality of the service and appropriateness of referrals.
We describe the properties and intended use of the measures, the way results are fed
back to the service and evaluate the usefulness of the measures in routine service
settings. Implications for psychological therapies and other mental health services are
discussed including:
• Choice of generic or specific outcome measures
• How the measures relate to one another
• Clinical usefulness of the measures, including risk assessment
• Interpretation of results, including availability of norms and how to assess
change
• Practical utility, including cos
Rewiring efficacy studies to increase their relevance to routine practice
No full textCurrent efficacy literature relies heavily on the Beck Depression Inventory (BDI) as the gold standard patient self-report measure. In contrast, the evaluation of psychological therapies in routine practice relies heavily on the CORE-OM. Although the two measures are conceptually distinct, they have been shown to be highly correlated. This suggests the possibility of replacing one measure with the other - a procedure we refer to as rewiring - in service of making the results of efficacy studies using the BDI have greater relevance of practitioners who routinely use the CORE-OM. We tested this proposition using transformation tables (Leach et al., in press) to convert BDI-I scores into CORE-OM scores and reran the analysis of a major efficacy study of depression - the Second Sheffield Psychotherapy Project (Shapiro et al., 1994). Results showed a near perfect replication of the original results and examples of benchmarks concerning the overall effects of treatment as well as differences between treatments are provided against which outcomes in routine practice can be contrasted. The implications for bridging efficacy and effectiveness research are discussed
Shapes of early change in psychotherapy under routine outpatient conditions.
No full textAlthough improvement of clients' state is a central concern for psychotherapy, relatively little is known about how change in outcome variables unfolds during psychotherapy. Client progress may follow highly variable temporal courses, and this variation in treatment courses may have important clinical implications. By analyzing treatment progress using growth mixture modeling up to the 6th session in a sample of 192 outpatients treated under routine clinic conditions, the authors identified 5 client groups based on similar progress on the short form versions of the Clinical Outcomes in Routine Evaluation-Outcome Measure. The shapes of early change typical for these client groups were characterized by (a) high initial impairment, (b) low initial impairment, (c) early improvement, (d) medium impairment with continuous treatment progress, or (e) medium impairment with discontinuous treatment progress. Moreover, the shapes of early change were associated with different treatment outcomes and durations, and several intake variables (depression, anxiety, and age) enabled prediction of the shape of early change and/or prediction of individual treatment progress within client groups with similar shapes of change
Service users' views of self-help strategies and research in the UK
No full textBackground: Self-help approaches for mental health problems are a research and service development priority within the UK.
Aim: To engage service users in the research process through a consultation exercise, seek their views on the strategies they use to manage their lives and priorities for research into self-help.
Method: Service users were involved in planning and conducting a consultation event and in analysing, interpreting and disseminating the findings. Forty nine service users attended the consultation event. Notes and key points from focus groups discussions were analysed to identify main themes.
Results: Five themes for service user self-help strategies were identified; managing and structuring the day; empowerment; engaging others to help yourself; physical health and well being; and spirituality. Four research priority areas in self-help were identified: the importance of user-led research; research into self-help strategies to improve physical health and well being; mapping of available services and self-help approaches; and what works and why.
Conclusions: Self-help research and developments should take account of these service users' views of research priorities and the strategies they use to manage their lives.
Declaration of interest: The project was initiated by Psychological Therapies Network North (PsyReNN). Funding for the venue and service user expenses was provided by the NIMHE Regional Development Centre, North East, Yorkshire and Humberside and by the Tees and North East Yorkshire Mental Health and Learning Disabilities NHS Trust
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