Improving access to evidence-based mental health care

Gratzer, David

doi:10.1503/cmaj.200156

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…To the author's knowledge, there have been no reviews of the therapist schema literature in CBT practitioners published. Given the length of time that has passed since Leahy (2001) first proposed this concept, and with an unprecedented increase in the number of CBT practitioners recruited to work in the English Improving Access to Psychological Therapies (IAPT) programme (see Clark, 2011) and similar models of care having been developed in Sweden, Norway and Australia (Clark, 2013; Gratzer, 2020), such a review is timely.…”

Section: A Case For Examining the Real‐world Impact Of Maladaptive Th...mentioning

confidence: 99%

“…Cognitive behavioural therapy (CBT) is an evidence‐based, psychological treatment that is applied to a wide range of mental health problems across the world (Butler et al, 2006; Gratzer, 2020). For example, in the United Kingdom (UK), CBT is recommended as the first line intervention by the National Institute for Clinical Excellence (NICE) for the treatment of obsessive compulsive disorder (OCD), body dysmorphic disorder (BDD), generalised anxiety disorder (GAD), panic disorder (Panic), social anxiety disorder (SAD), post traumatic stress disorder (PTSD) and Psychosis (NICE, 2005, 2009, 2011, 2013, 2014, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review

Roscoe

Taylor

2023

Clin Psychology and Psychoth

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Usage of any items from the University of Cumbria's institutional repository 'Insight' must conform to the following fair usage guidelines.Any item and its associated metadata held in the University of Cumbria's institutional repository Insight (unless stated otherwise on the metadata record) may be copied, displayed or performed, and stored in line with the JISC fair dealing guidelines (available here) for educational and not-for-profit activities provided that• the authors, title and full bibliographic details of the item are cited clearly when any part of the work is referred to verbally or in the written form This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as

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Section: A Case For Examining the Real‐world Impact Of Maladaptive Th...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review

Roscoe

Taylor

2023

Clin Psychology and Psychoth

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“…Overdiagnosis could occur in patients with mild temporary symptoms, who might meet a screening cut-off score, leading to further evaluation and possible referral to specialty mental health services, but who would not benefit as the symptoms would subside on their own. 25 Given the substantial challenges to accessing mental health services in Canada, 26,27 the unnecessary redirection of resources from the treatment of patients with mental health disorders could be an unintended harm of screening. In a 15-minute clinical encounter, even 1-2 minutes spent reviewing the results of a formal screening instrument without proven value comprises a substantial amount of time.…”

Section: Box 2: Summary Of Recommendation For Clinicians and Policy-m...mentioning

confidence: 99%

Recommendation on instrument-based screening for depression during pregnancy and the postpartum period

Lang

Colquhoun

LeBlanc

et al. 2022

CMAJ

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Depression during pregnancy and the postpartum period can have far-reaching impacts on the child-bearing individual and their infant, as well as on parent-infant interactions and relationships with partners. 1 Consequences for the child-bearing individual include increased likelihood of future anxiety or depression, lower quality of life, increases in risky behaviours (e.g., tobacco smoking or alcohol consumption) and suicidal ideation. 1 Impacts on the infant could include delays in physical and mental development, such as cognitive and language de velopment, and overall infant health concerns. 1 Impacts on parent-infant interactions can include reduced breastfeeding and poor parent-infant bonding. 1,2 Diagnostic criteria for major depressive disorder require patients to have at least 5 symptoms, including depressed mood or diminished interest in activities, and to be experiencing significant distress or functional impairment nearly every day for at least 2 weeks. 3 Symptoms may include significant weight or appetite change, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt, reduced concentration or indecisiveness, and thoughts of death or suicidal ideation. 3 A 2005 systematic review estimated that the point prevalence of major depression during pregnancy and postpartum ranges from 1% to 6% at different time points (from the first trimester of pregnancy to 1 year postpartum), based on 2-6 studies at any given time point (n = 111 to 2104 participants). 4 A 2008 national survey from the United States of more than 14 000 participants aged 18-50 years reported that the 12-month period prevalence of depression was 8% among pregnant individuals and 9% in postpartum individuals, compared with 8% among nonpregnant individuals. 5

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“…Le surdiagnostic pourrait survenir chez des personnes ayant de légers symptômes passagers qui obtiendraient le score prédéfini lors du dépistage, entraînant une évaluation plus approfondie et une possible consultation auprès de services spécialisés en santé mentale, mais qui n'en tireraient aucun bénéfice puisque leurs symptômes auraient disparus de toute façon 25 . Étant donné qu'il est déjà très difficile d'accéder à des services en santé mentale au Canada 26,27 , le fait d'accaparer ainsi indûment les ressources au détriment d'autres patients atteints de troubles de santé mentale pourrait constituer un préjudice involontaire du dépistage. Lors d'une consultation clinique de 15 minutes, passer 1-2 minutes à revoir les résultats d'un instrument de dépistage formel n'ayant pas une validité éprouvée est exagéré.…”

Section: Justificationunclassified

Recommandation sur l’utilisation d’instruments de dépistage de la dépression durant la grossesse et la période postnatale

Lang

Colquhoun

LeBlanc

et al. 2022

CMAJ

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Points clés• Le Groupe d'étude canadien sur les soins de santé préventifs déconseille le dépistage systématique de la dépression durant la grossesse et la période postnatale (jusqu'à 1 an après l'accouchement) au moyen de questionnaires (recommandation conditionnelle, données de très faible certitude).• Le dépistage repose sur l'utilisation d'un instrument, tel qu'un questionnaire, chez toutes les personnes dans un contexte particulier (p. ex., en milieu clinique), qu'elles présentent ou non des symptômes, et sur l'utilisation d'un score prédéfini pour déterminer quels cas nécessitent une évaluation plus approfondie.• Les données recensées par le groupe d'étude étaient très incertaines en ce qui concerne les bienfaits du dépistage par rapport aux soins cliniques habituels.• Cette recommandation présuppose que les soins habituels durant la grossesse et la période postnatale incluent une prise en compte minutieuse de l'état de santé mentale et du bien-être des personnes. Messages clés pour le public• La dépression durant la grossesse ou la première année postnatale est un important problème de santé pour lequel il existe des traitements efficaces.• Il est très incertain que l'utilisation systématique d'un questionnaire de dépistage de la dépression à toutes les personnes dans un milieu clinique ou dans un autre contexte améliore les issues cliniques.• Dans le cadre des soins habituels, votre professionnel de la santé devrait s'informer de votre bien-être et pourrait aussi vous interroger sur de possibles symptômes de dépression.• Il est important d'aborder avec votre professionnel de la santé tout symptôme tel que tristesse, anhédonie (difficulté à ressentir le plaisir lors d'activités habituellement agréables), sentiment de dévalorisation ou de culpabilité, fatigue ou manque d'énergie et troubles du sommeil inhabituels.• Si vous recevez un diagnostic de dépression, votre professionnel de la santé peut vous proposer diverses solutions en matière de soutien et au traitement.

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Improving access to evidence-based mental health care

Cited by 8 publications

References 10 publications

Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review

Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review

Recommendation on instrument-based screening for depression during pregnancy and the postpartum period

Recommandation sur l’utilisation d’instruments de dépistage de la dépression durant la grossesse et la période postnatale

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