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A cognitive–behavioural therapy assessment model for use in everyday clinical practice

  • Chris Williams and Anne Garland
Extract

Cognitive–behavioural therapy (CBT) is a shortterm, problem-focused psychosocial intervention. Evidence from randomised controlled trials and metaanalyses shows that it is an effective intervention for depression, panic disorder, generalised anxiety and obsessive–compulsive disorder (Department of Health, 2001). Increasing evidence indicates its usefulness in a growing range of other psychiatric disorders such as health anxiety/hypochondriasis, social phobia, schizophrenia and bipolar disorders. CBT is also of proven benefit to patients who attend psychiatric clinics (Paykel et al, 1999). The model is fully compatible with the use of medication, and studies examining depression have tended to confirm that CBT used together with antidepressant medication is more effective than either treatment alone (Blackburn et al, 1981) and that CBT treatment may lead to a reduction in future relapse (Evans et al, 1992). Generic CBT skills provide a readily accessible model for patient assessment and management and can usefully inform general clinical skills in everyday practice.

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References
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Beck, A. T., Rush, J. A., Shaw, B. F. et al (1979) Cognitive Therapy of Depression. New York: Guilford Press.
Blackburn, I. M., Bishop, S., Glen, I. M. et al (1981) The efficacy of cognitive therapy in depression: a treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. British Journal of Psychiatry, 139, 181189.
Department of Health (2001) Treatment Choice in Psychological Therapies and Counselling. London: Department of Health. For summary see http://www.doh.gov.uk/mentalhealth/treatmentguideline.
Evans, M. D., Hollon, S. D., DeRubeis, R. J. et al (1992) Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 49, 802808.
Garland, A., Fox, R. & Willaims, C. (2002) Overcoming reduced activity and avoidance. Advances in Psychiatric Treatment, 8, in press.
Paykel, E. S., Scott, J., Teasdale, J. D. et al (1999) Prevention of relapse in residual depression by cognitive therapy: a controlled trial. Archives of General Psychiatry, 56, 829835.
Williams, C.J. (2001) Overcoming Depression. London: Arnold.
Williams, C.J. & Garland, A. (2002) Indentifying and challenging unhelpful thinking: a Five Areas approach. Advances in Psychiatric Treatment, 8, in press.
Williams, J. M. G., Watts, T. N., Macleod, C. et al (1997) Cognitive Psychology and Emotional Disorders (2nd edn). Chichester: John Wiley & Sons.
Wright, B., Williams, C. J. & Garland, A. (2002) Using the Five Areas cognitive–behavioural therapy model in psychiatric in-patients. Advances in Psychiatric Treatment, 8, in press.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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A cognitive–behavioural therapy assessment model for use in everyday clinical practice

  • Chris Williams and Anne Garland
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