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56 results

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  • Improving patient flow in acute psychiatric wards: enhanced bed management and trusted assessment

  • Douglas Turkington, Steve Moorhead, Gordon D. Turkington, Carla King, Leigh Bell, Denise Pickersgill
  • Journal:
    BJPsych Bulletin / Volume 44 / Issue 4 / August 2020
    Published online by Cambridge University Press:
    19 February 2020, pp. 159-162
    Print publication:
    August 2020
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  • Aims and method

    In three localities in a mental health trust in England, an enhanced bed management team was established to improve patient flow and reduce out-of-area placements. Trusted assessments were provided to support risk management and conflict resolution. Two measures of flow were compared before and after the team was established.

    Results

    The trusted assessment recommendation was for discharge in 70% of cases. The number of out-of-area placements was significantly reduced (P < 0.05), saving £616 876 over a 12-month period. Patient flow was significantly improved in one of the three localities as measured by patients/bed/6-month period (P < 0.05). In one of the other localities increased use of trusted assessment input and reduced numbers of patients being transferred in are recommended to improve flow.

    Clinical implications

    Mental health trusts should consider the establishment of an enhanced bed management team, including trusted assessment, as a safe and cost-effective approach to improving patient flow and reducing the need for out-of-area placement.

  • Cognitive behavioural therapy for psychosis targeting trauma, voices and dissociation: a case report

  • Laura McCartney, Maggie Douglas, Filippo Varese, Douglas Turkington, Anthony P. Morrison, Robert Dudley
  • Journal:
    The Cognitive Behaviour Therapist / Volume 12 / 2019
    Published online by Cambridge University Press:
    01 March 2019, e18

  • Trauma and dissociation may be important factors contributing to the experiences of distressing voice hearing. However, there is scant mention of how to target and treat such processes when working with people with psychosis. This case study reports on an initial attempt to work with dissociation and trauma memories in a person with voices. A single case approach was used, with standardized measures used before, during and after 24 sessions of cognitive therapy, and at 6-month follow-up. In addition, session-by-session measures tracked frequency and distress associated with voices and dissociation. The participant reported significant improvements in terms of reduced frequency and distress of dissociation, and voice hearing, as well as improvement in low mood at the end of treatment. At follow-up there were enduring benefits in terms of dissociation and trauma-related experiences, as well as broad recovery but not of change in voices. This case illustrated the potential benefit of targeting dissociation and exposure to trauma memories in producing general symptom improvement and specific reductions in dissociation and voice hearing at end of treatment.

Back to Life, Back to Normality
  • CBT Informed Recovery for Families with Relatives with Schizophrenia and Other Psychoses
  • Volume 2
  • Edited by Douglas Turkington, Helen M. Spencer
  • Published online:
    16 November 2018
    Print publication:
    29 November 2018
  • What do I do when my son or daughter appears to be hallucinating, paranoid or has stopped looking after themselves? Written for family members and friends of those who suffer from schizophrenia and other psychoses, Back to Life, Back to Normality 2 describes the typical symptoms and problems of those suffering from psychotic disorders and discusses how a relative can best listen, interact and communicate their support. Research conducted by authors Douglas Turkington and Helen Spencer has shown that individuals without psychiatric training and qualifications can easily learn and safely use some basic cognitive behavioural therapy (CBT) techniques to help communicate effectively and provide support to their loved one suffering from psychosis. These techniques are described and illustrated with examples throughout this book, to allow carers to learn how to provide the best possible support and help facilitate a recovery for those suffering.

  • Befriending: active placebo or effective psychotherapy?

  • Douglas Turkington, Helen Spencer, Latoyah Lebert, Robert Dudley
  • Journal:
    The British Journal of Psychiatry / Volume 211 / Issue 1 / July 2017
    Published online by Cambridge University Press:
    02 January 2018, pp. 5-6
    Print publication:
    July 2017
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  • Befriending allows for control of the non-specific factors of the therapist–patient interaction in psychosocial research. Manualised befriending is at the very least an active placebo and potentially an effective intervention. Befriending now merits increased research attention to determine indications for use and to elucidate mechanisms of action.

  • Brief cognitive–behavioural therapy for patients in the community with schizophrenia: Randomised controlled trial in Beijing, China - RETRACTION

  • Zhi-Hua Guo, Zhan-Jiang Li, Yun Ma, Jing Sun, Jun-Hua Guo, Wen-Xiu Li, Zhi-Qiang Wang, Hui-Li Xu, Roger M. K. Ng, Douglas Turkington, David Kingdon
  • Journal:
    The British Journal of Psychiatry / Volume 210 / Issue 3 / March 2017
    Published online by Cambridge University Press:
    02 January 2018, pp. 223-229
    Print publication:
    March 2017
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  • Background

    Brief cognitive–behavioural therapy (CBT) is an emerging treatment for schizophrenia in community settings; however, further trials are needed, especially in non-Western countries.

    Aims

    To test the effects of brief CBT for Chinese patients with schizophrenia in the community (trial registration: ChiCTR-TRC-13003709).

    Method

    A total of 220 patients with schizophrenia from four districts of Beijing were randomly assigned to either brief CBT plus treatment as usual (TAU) or TAU alone. Patients were assessed at baseline, post-treatment and at 6- and 12-month follow-ups by raters masked to group allocation.

    Results

    At the post-treatment assessment and the 12-month follow-up, patients who received brief CBT showed greater improvement in overall symptoms, general psychopathology, insight and social functioning. In total, 37.3% of those in the brief CBT plus TAU group experienced a clinically significant response, compared with only 19.1% of those in the TAU alone group (P = 0.003).

    Conclusions

    Brief CBT has a positive effect on Chinese patients with schizophrenia in the community.

  • Psychological treatments for schizophrenia spectrum disorder: What is around the corner?

  • Douglas Turkington, Latoyah Lebert
  • Journal:
    BJPsych Advances / Volume 23 / Issue 1 / January 2017
    Published online by Cambridge University Press:
    02 January 2018, pp. 16-23
    Print publication:
    January 2017
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  • The evidence base for cognitive-behavioural therapy (CBT), family therapy, psychoeducation and cognitive remediation as adjuncts to antipsychotic medication in the treatment of schizophrenia is well established. It is, however, clear that the moderate effect size of the best researched of these treatments (CBT) compared with treatment as usual reduces to small when compared with an active psychological treatment. It would seem that many different psychosocial interventions de liver benefit in schizophrenia. We are now at a stage in their development when new treatments are being energetically piloted and combination treatments tested. This article outlines the most promising of these new interventions and attempts to answer the crucial question as to their differential effects on different psychotic presentations.

    Learning Objectives

    • Be aware of the most promising new psychosocial treatments for schizophrenia

    • Learn the key elements of each intervention

    • Understand which of these approaches might be best suited to particular presentations of schizophrenia spectrum disorder

  • Auditory hallucinations in schizophrenia: helping patients to develop effective coping strategies

  • Douglas Turkington, Latoyah Lebert, Helen Spencer
  • Journal:
    BJPsych Advances / Volume 22 / Issue 6 / November 2016
    Published online by Cambridge University Press:
    02 January 2018, pp. 391-396
    Print publication:
    November 2016
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  • Auditory hallucinations (voices) are the most common symptom in schizophrenia, occurring in 70% of those with the diagnosis. A proportion respond to antipsychotic medication, but despite adequate concordance with prescribed medication, voices may still remain. Voice hearers often inadvertently activate coping strategies that maintain the symptoms and linked distress. Assessment can identify ineffective strategies. Effective strategies can then be initiated, starting with distraction to reduce distress in the short term and leading to focusing approaches that give an improved understanding of voice maintenance. This article describes how to recognise voice hearers' ineffective coping strategies and how to teach effective approaches that are a crucial catalyst in the recovery process.

  • Authors' reply

  • Anthony P. Morrison, Paul Hutton, David Shiers, Douglas Turkington
  • Journal:
    The British Journal of Psychiatry / Volume 201 / Issue 6 / December 2012
    Published online by Cambridge University Press:
    02 January 2018, pp. 494-495
    Print publication:
    December 2012
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