The purpose of this study was twofold: to examine predictors of disordered eating behaviours and body image dissatisfaction, including social networking, among type 1 diabetes population, and to qualitatively explore the relationship between type 1 diabetes management and body image. A convenience sample of 121 type 1 diabetes patients ( F = 106; Mage = 36 ± 6.5) was collected via online questionnaires, of which 98 patients responded to two open-ended questions. Young age and negative body image explained 58.8 per cent of disordered eating variance, while body weight and social networking negatively contributed to poor body image (29.9%). Qualitative analysis revealed three themes: no control over body weight, limitation in clothing options and discomfort towards medical equipment.
Objectives
This study explored the prevalence of childhood sexual/physical abuse (CSA/CPA) as identified by practitioners in Improving Access to Psychological Therapies (IAPT) services and clarified differences in clients’ characteristics with and without a history of CSA/CPA.
Methods
A retrospective analysis of a large dataset comprised of IAPT routine data and data from a local service evaluation reporting on clients’ presenting problems.
Results
14% of IAPT clients (n = 1,315) were identified with a record of CSA/CPA. CSA/CPA history was associated with longer duration and earlier age of onset of condition(s), greater number of presenting problems and post‐traumatic stress disorder co‐occurrence, higher intensity treatment delivery, and lower recovery rates.
Conclusions
CSA/CPA history appears as an important feature in a sizable minority of IAPT clients; further work is required to meet clients’ trauma‐related needs.
Practitioner points
A sizable minority of IAPT clients (14%) present with a history of CSA/CPA as recorded in clinical notes.
CSA/CPA history is associated with more complex and enduring presentations in IAPT clients.
The reported CSA/CPA frequency is likely to be underestimates of the actual prevalence and impact of adverse childhood experiences in IAPT clients.
Trauma‐informed inquiry and trauma‐specific screening tools would help practitioners to meet clients’ trauma‐related needs.
Purpose
Given the considerable variation in treatment effectiveness observed across Improving Access to Psychological Therapy (IAPT) services, the purpose of this study is to explore client- and service-related variables that predict successful treatment outcomes and clients’ dropout. Clinician-rated clients’ motivation to change was also explored as a potential predictor for both outcome variables.
Design/methodology/approach
A convenience sample of 1,135 (F = 752; Mage = 39.4) was collected from three IAPT services in the North West of England. The study adopts a quasi-experimental, observational design. The analysis involves the description of patients’ socio-demographic and clinical characteristics and the development of three outcome prediction models, using hierarchical logistic regression.
Findings
After adjusting for confounders, employment status and motivation to change as rated by clinicians were predictive of both recovery and reliable improvement. The higher number of IAPT re-referrals was negatively associated with recovery and positively with dropouts. Clients who indicated low motivation to change and received low intensity treatment at their last session presented a higher likelihood to dropout.
Research limitations/implications
Given that the evaluation of clients’ motivation to change was solely reliant on clinical judgement, as no validated measure was used, further robust research is recommended to draw sensible conclusions.
Originality/value
This is the first study evaluating clinician-rated motivation to change as a significant predictor of treatment outcomes and dropouts within the IAPT setting. Further research implications are discussed.
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