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Hearing voices is a distressing and trans-diagnostic experience. Cognitive behavioural therapy (CBT) is an effective psychological treatment for distressing voices, but is offered to only a minority of patients. Limited resources are a barrier to accessing CBT. Evaluations of brief forms of CBT for voices have offered encouraging findings, but the ability of briefly-trained therapists to deliver these brief therapies has yet to be explored. We evaluated the outcomes of a brief form of CBT (Coping Strategy Enhancement, CSE) for voices when delivered by highly-trained and briefly-trained therapists. This was a service evaluation comparing pre–post outcomes in patients who had completed brief CSE over four sessions, within NHS Mental Health Services, delivered by highly-trained and briefly-trained therapists. The primary outcome was the negative impact scale of the Hamilton Program for Schizophrenia Voices Questionnaire. Data were available from 92 patients who completed a course of brief CSE – nearly half of whom received therapy from a briefly-trained therapist. Modest benefits across the sample were consistent with previous evaluations and did not seem to be influenced by the training of the therapist. This service evaluation offers further evidence that brief CSE can begin a therapeutic conversation about distressing voices within routine clinical practice. The usefulness of this initial conversation does not seem to be reliant upon the extent of therapist training, suggesting that briefly-trained therapists may play a role in increasing access to these conversations for patients distressed by hearing voices.
Key learning aims
(1) How can access to CBT be increased for patients distressed by hearing voices?
(2) Can a wider workforce of briefly-trained therapists start a CBT-informed conversation about distressing voices?
(3) How do the outcomes of these conversations compare with the same conversations facilitated by highly trained therapists?
In the last twenty years, the field of transitional justice has gone from being a peripheral concern to an ubiquitous feature of societies recovering from mass conflict or repressive rule. In both policy and scholarly realms, transitional justice has proliferated rapidly, with ever-increasing variety in terms of practical processes and analytical approaches. The sprawl of transitional justice, however, has not always produced concepts and practices that are theoretically sound and grounded in the empirical realities of the societies in question. Critical Perspectives in Transitional Justice takes stock of this burgeoning field and, in gathering the views of scholars and practitioners from a wide range of national and methodological backgrounds, explores four key concerns with current trends in transitional justice: the under-theorisation of the field, its disconnect from core academic disciplines, its tendency towards advocacy rather than analysis, and its emphasis on technical institutional responses without clear articulations of their objectives. This vital book - edited by Oxford Transitional Justice Research - is designed to deepen theoretical and empirical discussions within transitional justice by providing critical perspectives on common concepts, issues, methodologies, institutions and mechanisms. Its purpose is to clarify key terms, challenge core assumptions and highlight important tensions, inconsistencies and disagreements in the field with the ultimate aim of harnessing the enormous energy of transitional justice for more fruitful ends. The breadth of debates in this volume highlights the scope, inclusiveness and ambition of this field but also underscores that - despite its geographical, conceptual and disciplinary expanse - consistent questions arise regarding contextually appropriate objectives, the balance between individual and collective needs and interests, and securing the legitimacy of transitional processes among those affected by past violations.
We have derived absolute proper motions of stars in the Galactic bulge region combining the VVV InfraRed Astrometric Catalogue (VIRAC) and Gaia. We use the proper motions to study the kinematic structure of the bulge both integrated along the line-of-sight and in magnitude intervals using red clump stars as standard candles. In parallel we compare to a made-to-measure barred dynamical model, folding in the VIRAC selection function, to understand and interpret the structures that we observe. The barred dynamical model, which contains a boxy/peanut bulge, and has a pattern speed of 37.5 kms−1 kpc−1, is able to reproduce all structures impressively well.