Mindfulness-Based Cognitive Therapy versus self-help for students with clinical perfectionism: a pilot randomised study ; Psycho-social risk factors for Generalised Anxiety Disorder: an exploratory literature review of current knowledge

• Main Author: James, Kirsty Michelle
• Other Authors: Russell, Ailsa
• Published: University of Bath 2014
• Subjects: 150
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633159

Abstracts Mindfulness-Based Cognitive Therapy versus self-help for students with clinical perfectionism: A pilot randomised study Objective: This pilot study compared a mindfulness-based cognitive therapy (MBCT) intervention with a self-help guide based on a cognitive behaviour therapy (CBT) approach for students with clinical perfectionism. Method: Participants were randomised to either MBCT or self-help. Questionnaires were completed at baseline, eight weeks later (the primary outcome point, corresponding to the end of MBCT) and at ten-week follow-up. Results: Post-intervention intention-to-treat (ITT) analyses identified that MBCT participants (n = 28) had significantly lower levels of unhealthy perfectionism and stress than self-help participants (n = 32). There was also significant MBCT superiority for changes in unhelpful beliefs about emotions, rumination, mindfulness, self-compassion and decentering. At ten-week follow-up, effects were maintained in the MBCT group and both ITT and completer (per-protocol) analyses showed superior MBCT outcomes for unhealthy perfectionism and daily impairment caused by perfectionism. Mediational analysis showed that pre-post changes in self-compassion mediated the group differences in pre-post changes in clinical perfectionism. Conclusions: MBCT is a promising intervention for students with clinical perfectionism, which may result in larger improvements than self-help. The findings require replication with a larger sample. Session-by-session outcome monitoring in CAMHS: Clinicians beliefs The CYP-IAPT programme emphasises the meaningful contribution session-by-session routine outcome monitoring (ROM) can make to clinical practice and its importance in highlighting services’ effectiveness. Two studies on issues related to the implementation of ROM in children’s services were conducted. Study one was qualitative; twelve CAMHS professionals participated in focus groups. Themes identified included the idea that ROM could provide objectivity, could be collaborative and empowering. Concerns included how measures may adversely influence therapeutic sessions and how the information may be used by the service. These themes were used to develop a questionnaire about professional’s experience of and views on session-by-session ROM. In study two, 59 professionals from four CAMHS teams completed the questionnaire. It was found that only 6.8% reported “almost always” utilising session-by-session ROM. Detailed analysis of questionnaire responses suggested two factors reflecting the perceived negative and positive impact of session-by-session ROM. It was found that clinicians who currently use session-by-session ROM hold stronger positive and negative beliefs than clinicians who do not. This study suggests that session-by-session ROM is not currently routine practice within CAMHS and highlights the importance of considering how this practice can be best implemented within this setting with reference to clinician attitudes. Psycho-social risk factors for Generalised Anxiety Disorder: An exploratory literature review of current knowledge Research around worry and its central role within Generalised Anxiety Disorder (GAD) has primarily focused on characteristics and treatment, with little investigation into factors involved in its development. The current paper reviews literature to explore our existing understanding of risk factors involved in the aetiology of worry and GAD and briefly reviews how well current cognitive models account for identified aetiological factors. Collectively, current cognitive models vary in their focus on, and explanation of, aetiological factors of worry and GAD and require further theoretical development. Further research within this field focused on the role of parenting and insecure attachment styles, life events and the course of symptoms across gender and the lifespan will be beneficial.