Cognitive behavioural therapy (CBT) is an effective psychological treatment for anxiety-related disorders (anxiety disorders, post-traumatic stress disorder, and obsessivecompulsive disorder). However, relapse of anxiety symptoms is common following completion of treatment. This study aimed to identify predictors of relapse of anxiety after CBT for adult (18+) patients to enable the identification of 'at-risk' patients who could potentially benefit from relapse prevention interventions. A systematic review and meta-analysis was conducted, including studies found in PsycINFO, PubMed, Scopus, and Web of Science, and through hand-searches of references lists and reverse citations. Nine studies met eligibility criteria (N=532 patients). On average, 23.8% of patients experienced relapse following completion of CBT. A total of 21 predictors were identified and grouped into seven categories: residual symptoms; personality disorders; medication; clinical features; stressful life-events; degree of improvement; and demographics. A meta-analysis of residual symptoms as a predictor of relapse yielded a moderate but non-significant pooled effect size (r=0.35; 95% CI -0.21, 0.74, p = .08). Further research with adequately powered samples and standardised operationalisations of relapse are required to identify robust predictors.

Purpose The novel coronavirus and associated mitigation efforts have caused significant increases in stress for adults with intellectual disabilities. Such increases in life stress predict an increased risk of relapse following psychological therapy. This contributes to the high global disease burden of common mental health difficulties. Therefore, this paper aims to explore service user experiences of maintaining gains following therapy within the context of the Covid-19 pandemic. Design/methodology/approach A mixed-methods evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. Descriptive statistics and effect size calculations were used to examine therapeutic outcomes pre-therapy, post-therapy, and at follow-up. These findings informed a framework analysis of eight semi-structured interviews. Findings Overall, outcome results improved post-therapy and regressed at follow-up. The framework analysis revealed facilitators to maintenance include a recollection of specific aspects of therapy and the regular utilisation of strategies and resources. Conversely, barriers to maintenance include a recollection focussed on personal outcome, a reliance on social support and an inability to remember therapy. Originality/value This is the only study to the authors’ knowledge examining service user experiences of maintaining gains following therapy within the context of Covid-19. It is hoped that these findings will inform further research and be useful for services in preparing service users for discharge as the Covid-19 pandemic continues and moves towards the post-pandemic phase.

We investigated the experiences of 10 counsellors undergoing training in a form of person-centred experiential therapy (PCET), known in the UK as Counselling for Depression (CfD). Training was delivered at a service level as part of the PRaCTICED trial. Counsellors who took part in the study either completed (n = 5), failed to complete (n = 3) or were ongoing (n = 2) in their PCET training. Framework analysis was selected to extract rich data and an in-depth account of counsellors' experiences. Inconsistencies were reported between counsellors' previous theoretical backgrounds and PCET. Difficulties were also reported in resolving person-centred and emotion-focused elements of PCET. Key facilitators and barriers to completing PCET training were identified, including counsellors' intrapersonal factors.

Objective: To evaluate the efficacy of different approaches to personalization in psychological therapy. Method: This was a systematic review and meta-analysis of randomized controlled trials that compared the mental health outcomes of personalized treatment with standardized treatment and other control groups. Eligible studies were identified through three databases (Scopus, APA PsycInfo, and Web of Science). We conducted a narrative synthesis and random effects meta-analysis of available outcomes date, including subgroup analyses to investigate sources of effect size heterogeneity. The review protocol was preregistered in the Open Science Framework. Results: Seventeen studies (N = 7,617) met inclusion criteria for the review, nine of which (N = 5,134) provided sufficient data for inclusion in meta-analysis. Eight studies were classed as having high risk of bias, eight had moderate risk, and one had low risk. There was no significant evidence of publication bias. A statistically significant effect size was found in favor of personalized treatment relative to standardized treatment (d = 0.22, 95% CI [0.05, 0.39], p = .011). When studies with a high risk of bias were removed, this effect size was smaller but remained statistically significant (d = 0.14, 95% CI [0.08, 0.20], p < .001). Conclusion: Current evidence indicates that personalization is an effective strategy to improve outcomes from psychological therapy, and the seemingly small effect size advantage of personalization could have an important impact at a clinical population level. Science Framework database prior to conducting the literature search (MD5: https://osf.io/tjpa7).

The aims of this study were to evaluate the current provision of patient information about nystagmus in orthoptic clinics in the UK and Ireland and to develop a standardised information pack about nystagmus. Methods: A questionnaire was circulated to orthoptists in the UK and Ireland asking whether they had information to provide to patients with nystagmus, what was included in this information and how it could be improved. Orthoptists were also asked what should be included in a standardised information pack about nystagmus. Results: Two hundred and thirty three orthoptists completed the questionnaire. One-third of responding orthoptists did not have information to provide to patients with nystagmus. Most reported the information available to them included details of support services and physical symptoms. Including information about living with nystagmus at different ages and long-term prognosis were the most common suggestions to improve information about nystagmus. More than half of orthoptists selected all the suggested topics to be included in a standardised information pack, with support services and long-term prognosis most frequently selected. Conclusions: Only 67% of responding orthoptists had information about nystagmus to give to patients or their families. Ways to improve the current information and content considered important by orthoptists were taken into account to create a nystagmus information pack, which is now available online.