The dark side of universal prevention: Limited effectiveness and harmful effects of classroom-based CBT in preventing adolescent depression

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Depression is a common problem in adolescence, with statistics showing that around 20% of young people will go through at least one clinically depressive episode by the age of 18 years. Given the significant impairment and deleterious consequences of depression, sustained efforts have been dedicated to preventive and early intervention. In a recent large trial [read the full story...]

Psychosis and schizophrenia in adults: updated NICE guidance for 2014

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While the organisation’s name may change frequently, currently National Institute for Health and Care Excellence (NICE), its role remains constant – to provide clear published guidance on the role of treatment options within the NHS. The publication of new NICE guidance represents a significant event as clinical recommendations shape the nature of provided care nationally [read the full story...]

Pilot study suggests that CBT may be a viable alternative to antipsychotics for people with schizophrenia, or does it?

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People with schizophrenia stop taking their antipsychotics for a wide range of reasons (e.g. debilitating side effects or a belief that they will not help them), but when they do health professionals often find it extremely difficult to care for these patients, because the alternative treatment options available to them are very limited. Of course, [read the full story...]

Be Mindful of the Gap: What we know about ‘third wave’ cognitive behavioural therapies compared to other psychological therapies

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Breathe. Hold in your mind your view of what constitutes the most effective psychological therapy for acute depression. Try not to identify with your favourite therapy but simply observe it and let it be. Wish it well. And breathe again. This was not the approach of the Cochrane Depression, Anxiety and Neurosis Group when it [read the full story...]

“Everyone’s a winner, all must have prizes!” but which psychotherapy for depression wins, if any?

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Previous meta-analyses in the field of depressive disorders have yielded mixed conclusions about which the most efficacious treatment is.  Within the process of any therapy, there are universal features such as; the therapeutic relationship, rationale for treatment, a patient and therapist belief in treatment, a confidential and respectful space for the patient and so on.  [read the full story...]

Focal psychodynamic therapy or CBT vs optimised treatment as usual in outpatients with anorexia

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Anorexia nervosa has long been known to have a poor prognosis and few effective treatments are available (Kaplan and Garfinkel, 1999). Research in this area is limited, particularly in regards to evidence-based guidance.  The NICE eating disorders guidance (2004) is in need of an update, although there is a more recently produced care pathway. Other [read the full story...]

RCT compares two different versions of enhanced cognitive behavioural therapy for anorexia nervosa in an inpatient setting

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A general misconception about anorexia is that it’s just about eating and ‘being thin’, but it’s more complex than that. The illness affects multiple aspects of a person’s life, and often goes hand in hand with other psychological issues such as low mood, or excessive worry. In addition, the jury is still out on the exact [read the full story...]

No evidence that behavioural therapies are any better than other psychological therapies for depression

Depression is a big problem.  In fact, it’s the third leading cause of disease burden worldwide (WHO, 2004 - as cited in Shinohara et al, 2013) and the largest source of nonfatal disease burden in the world (Ustun, 2004 – as cited in Shinohara et al, 2013).   What’s more, the number of people affected by it [read the full story...]

Which psychological therapies work best for borderline personality disorder?

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This systematic review of psychological therapies for borderline personality disorder (BPD), conducted in Spain, takes an interesting approach to reviewing the literature. Unfortunately, there appear to have been challenges in translating the systematic review from Spanish and the text can be difficult to follow at times. This is a real shame as it is an [read the full story...]

Counselling is as effective as CBT for depression, according to a reanalysis of RCT data

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In recent years, cognitive-behavioural therapy (CBT) has become the most widely delivered therapy for depression within the NHS.  CBT interventions are recommended by NICE for people with mild, moderate and severe depression. By contrast, recent NICE guidelines recommend counselling only for people with persistent subthreshold depressive symptoms or mild to moderate depression who decline another [read the full story...]