Interpersonal Psychotherapy for Depression

Size: px
Start display at page:

Download "Interpersonal Psychotherapy for Depression"

Transcription

1 Interpersonal Psychotherapy for Depression Dr Paul Wilkinson University Lecturer and Consultant Child & Adolescent Psychiatrist IPT Therapist University of Cambridge, CPFT

2 IPT Why? NICE guidelines for paediatric depression, st line treatment for moderate-severe depression: CBT IPT Family therapy

3 Contents 1. What is IPT? 2. What is the evidence? 3. Brief case example 4. How to become an IPT therapist

4 1. What is IPT?

5 History A manualised synthesis of what was thought to be good 1:1 therapy for depressed individuals Not based on complex theory Not a placebo

6 IPT The Basics 1:1 psychological therapy Often uses parental support Short-term 12 sessions for adolescents Designed for depression Used in bulimia, bipolar disorder, PTSD, borderline personality, HIV, social anxiety, dementia.. Can be delivered in group format

7 Cognitive Behavioural Therapy Royal College of Psychiatrists CAP Institute 20 January 2012, London Core Beliefs Dysfunctional Conditional Assumptions Negative Automatic Thoughts Behaviours Emotions Physiological Symptoms

8 Interpersonal Therapy Emotions / Affect Interpersonal Relationships

9 IPT - Structure 1. Initial Phase Interpersonal Inventory Choose a problem area 2. Middle Phase Intensive work on the problem area 3. Termination Phase

10 1. Initial Phase Confirm diagnosis of depression Psychoeducation, sick role Life event details

11 Interpersonal Inventory Intensive exploration of interpersonal network Important people Details of relationship Frequency, quality, type of contact Emotional support (confiding) Social companionship (fun) Practical support (help) How satisfied is each member? Expectations Reciprocity Non-reciprocal role expectations

12 Agreed Formulation Agree a problem area: Grief Role transition Interpersonal disputes Interpersonal sensitivity (deficits) (Single parent family) Set clear collaborative goals

13 2. Middle Phase Use specific strategies to help the patient negotiate their interpersonal difficulties more successfully Within problem area(s)

14 Interpersonal Therapy Emotions / Affect Interpersonal Relationships

15 General Strategies Facilitate expression and acceptance of a range of emotions Attend to the therapeutic relationship Focus the session on an appropriate topic Monitor, support and acknowledge progress in addressing interpersonal problems Maintain IPT the therapeutic stance Directive techniques Role playing Decision analysis Clarification Exploratory techniques Communication analysis Explicit reference to the therapeutic relationship

16 Role Transitions Review depressive symptoms over the past week Relate depressive symptoms to difficulty in coping with the transition from one social role to another Review the positive and negative aspects of the old role and possible new one, and realistic evaluation Explore nature of and feelings about what was lost Explore feelings about the change itself Explore opportunities in the new role Encourage development and effective use of social support system and skills called for in the new role

17 Interpersonal Disputes Review depressive symptoms over the past week Relate symptoms onset to overt or covert dispute with significant other with whom the client is currently involved Determine the stage of the dispute Explain how non-reciprocal role expectations relate to the dispute Exploration and discussion of differences in expectations and values Exploration of parallels and differences between currently disputed and other past or present relationships Exploration and discussion of options available to the client to further resolution of the dispute and/or bring about desired change Discussion of communication patterns Exploration and discussion of how the dispute is perpetuated Explore use of wider network to understand or ameliorate the dispute

18 Grief Review depressive symptoms over the past week Relate depressive symptoms to death and/or absence of significant other Reconstruct the positive and negative aspects of the client s relationship with the deceased Describe events just prior to, during and after the death and response Evaluate availability and use of social support at the time of death and for current mourning Explore feelings about current impact of loss Consider ways of becoming involved with others

19 Interpersonal Sensitivities Review depressive symptoms over the past week Relate depressive symptoms to the problems of social dissatisfaction or isolation Review past significant relationships Explore repetitive dysfuntional patterns and expectations in past or present relationships Discuss clients positive and negative feelings re the therapist and explore parallels in other relationships The therapist conveys his/her own feelings and uses the therapeutic relationship to facilitate client s awareness of his/her impact on and role in interactions and as a model for satisfying relationships outside therapy Encourage formation of new relationships and development of existing relationships

20 3. Termination Phase Review useful strategies from middle phase Encourage mastery of the new skills Think about warning signs for relapse Identify techniques to deal with these Explicitly discuss feelings about ending Contrast grief with depression

21 Ending Explicit contract at start IPT is the learning of new techniques, designed to persist after ending Some discharge after the final session Patient with depression should really have periodic reviews until well into recovery Sometimes use: Booster IPT Maintenance IPT

22 Patient Selection Does patient have depression? Is the patient prepared to try psychological therapy? Is an interpersonal issue relevant in the aetiology? Is there an IPT therapist available?

23 IPT vs CBT IPT is simpler So cannot be used in as many situations OCD, anxiety, psychosis. Some patients find CBT quite difficult, and find IPT easier to understand

24 2. What is the Evidence?

25 Adults

26 1. Systematic Review, 2005 IPT superior to placebo (9 studies) IPT plus medication not superior to medication alone Acute, maintenance or prophylactic IPT significantly better than CBT De Mello et al, 2005 Eur Arch Psychiatry Clin Neurosci 255: 75

27 2. Most Recent CBT vs IPT, depressed adults Randomised to CBT or IPT No difference for mild-moderate depression MADRS < 39 CBT better for severe depression CBT better if personality disorder Luty et al; Joyce et al, 2007 BJPsych 190: &

28 3. Most Recent Review, 2011 CBT vs IPT 7 trials, 741 participants CBT slightly better, but not statistically significant Commented on poor methodological quality of all the trials Jakobsen et al, 2011 Pychological Medicine

29 Adolescents

30 1. Mufson et al, adolescents, New York, MDD No OCD, active suicidality, substance use, CD Random allocation to: 12 sessions weekly IPT Clinical monitoring every 2-4 weeks IPT better than clinical monitoring Mufson L et al, 1999 Arch Gen Psychiatry 1999;56(6):573-9.

31 2. Rosello & Bernal, subjects, Puerto Rico Aged RCT of IPT vs CBT vs waiting-list control Both CBT and IPT better than control No sig difference between CBT and IPT Rossello J, Bernal G., 1999 J Consult Clin Psychol 67:734

32 3. Mufson et al, adolescents, New York MDD or dysthymia, adjustment disorder Mean CGAS 53 (similar to TADS) Mean age 15.1 Exclusion: active suicidal ideation, psychosis, substance use Mufson L, et al, 2004 Arch Gen Psychiatry 61: 577

33 Treatments All treatment by mental health workers in school clinics IPT: 12 sessions over 16 weeks In school Treatment as usual Supportive counselling As normally given by school MHW

34 Results IPT better than TAU Conclusions IPT-A better than active counselling Effective IPT can be delivered by trained tier 1/2 professionals

35 3. A Case History

36 The Patient John 16 year old boy Depressed 1 ½ years Gradual onset since death of aunt No significant problems before then Under Cambridge CAMHS 10 months, little change CBT Family therapy Brief trial of fluoxetine

37 The Problem Area? Grief Role transition Interpersonal disputes Interpersonal sensitivity (deficits) Next stage?

38 Interpersonal Inventory Repeated pattern of IP interaction: When people do things he finds difficult: Doesn t know what he feels Doesn t know what he and the other should do Very hard to be angry Difficult to tell people how they have made him feel After aunt died, some people acted in ways he wished they hadn t Hard to be angry Hard to tell them Left with difficult, unidentifiable emotions

39 Formulation Lifelong maladaptive pattern of interpersonal passivity Poor emotional literacy Caused no problems when life was good When bereaved, this interfered with normal bereavement process and he ended up depressed It maintained the depression

40 The Problem Area Grief not an issue Interpersonal sensitivity Long-term maladaptive interpersonal functioning IP sensitivity must be addressed to get out of depression And decrease risk of relapse

41 Goals 1. John to be able to tell me how he has felt in difficult situations regularly 2. John to feel comfortable about feeling angry 50% of the time he feels like this 3. John to have one occasion during therapy when he talks to someone about something they ve done, that he finds difficult, and feels less awkward than in past 20 sessions

42 Middle Sessions 1. Tie emotions to specific interpersonal events Initially did it in sessions, then did at the time Started to recognise anger Discussions about anger Good vs bad Angry feelings vs angry actions

43 2. Maintain interpersonal activity Friends started 6 th form, he didn t Stay in touch with friends Get a job

44 3. Use anger Became comfortable with angry feeling Tells him he has been upset by someone Act appropriately

45 4. Success! Several situations where: People upset John John felt angry John told them how he felt, and what he wanted The other then acted better John felt better! People treated him better!!

46 Termination Review of progress Directly addressed feelings at termination John tried to avoid We used the transference Gradually increasing confidence he can act more assertively Move to 2 monthly maintenance Security blanket

47 Maintenance Gradually increased support network Used it appropriately and sensitively Coped with major stressors without being depressed Recognised subtle emotions Told people when they upset him Able to mentalise Increased confidence in ability to cope

48 4. How to be an IPT Therapist

49 IPT is simpler than CBT So training is simpler

50 IPT Therapist Attend initial training course 3-5 days Leicester, Edinburgh, UCL intensively-supervised cases Regular supervision, with audiotaped sessions Must be appropriate IPT case Adult/Older adolescent with depression

51 IPT Supervisor Rules currently changing 6 intensively supervised cases Supervisor training course Shadow another supervisor

52 Further Information Clinician s Quick Guide to Interpersonal Psychotherapy Weissman et al, 2007, Oxford University Press Interpersonal Psychotherapy for Depressed Adolescents Mufson, L. et al, 2004, Guilford Press, New York Contact me:

53 Summary IPT is an individual short-term psychological treatment for depression IPT is effective for depressed adolescents IPT is simple IPT looks at: Improving interpersonal functioning Recognising emotions Linking relationships and feelings

54 Questions / Discussion

Sunderland Psychological Wellbeing Service

Sunderland Psychological Wellbeing Service Sunderland Psychological Wellbeing Service Information for Referrers Offering a range of psychological therapies across Sunderland. To make a referral call 0191 566 5454 A partnership between Northumberland,

More information

Ability to develop a formulation

Ability to develop a formulation Ability to develop a formulation Formulation competencies are not a stand alone description of competencies, and should be read as part of the competency framework for individuals with personality disorder.

More information

The treatment of. post-traumatic stress disorder (PTSD) in adults and children

The treatment of. post-traumatic stress disorder (PTSD) in adults and children The treatment of post-traumatic stress disorder (PTSD) in adults and children Understanding NICE guidance information for people with PTSD, their advocates and carers, and the public The paragraphs are

More information

Managing depression after stroke. Presented by Maree Hackett

Managing depression after stroke. Presented by Maree Hackett Managing depression after stroke Presented by Maree Hackett After stroke Physical changes We can see these Depression Emotionalism Anxiety Confusion Communication problems What is depression? Category

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. Using antidepressants in children and young people bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They

More information

SPECIALIST ARTICLE A BRIEF GUIDE TO PSYCHOLOGICAL THERAPIES

SPECIALIST ARTICLE A BRIEF GUIDE TO PSYCHOLOGICAL THERAPIES SPECIALIST ARTICLE A BRIEF GUIDE TO PSYCHOLOGICAL THERAPIES Psychological therapies are increasingly viewed as an important part of both mental and physical healthcare, and there is a growing demand for

More information

Good Practice, Evidence Base and Implementation Issues: Personality Disorder. Prof Anthony W Bateman SMI Stake Holder Event

Good Practice, Evidence Base and Implementation Issues: Personality Disorder. Prof Anthony W Bateman SMI Stake Holder Event Good Practice, Evidence Base and Implementation Issues: Personality Disorder Prof Anthony W Bateman SMI Stake Holder Event Treatment for Borderline Personality Disorder A range of structured treatment

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. Management of moderate to severe ere (including psychotic) depression in children and young people tiers 2 4 bring together all NICE guidance, quality standards and other NICE information on a specific

More information

What are Cognitive and/or Behavioural Psychotherapies?

What are Cognitive and/or Behavioural Psychotherapies? What are Cognitive and/or Behavioural Psychotherapies? Paper prepared for a UKCP/BACP mapping psychotherapy exercise Katy Grazebrook, Anne Garland and the Board of BABCP July 2005 Overview Cognitive and

More information

General Hospital Information

General Hospital Information Inpatient Programs General Hospital Information General Information The Melbourne Clinic is a purpose built psychiatric hospital established in 1975, intially privately owned by a group of psychiatrists

More information

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,

More information

Cognitive and behavioural therapy (CBT) for people with depression and anxiety What skills can service users expect their therapists to have?

Cognitive and behavioural therapy (CBT) for people with depression and anxiety What skills can service users expect their therapists to have? Cognitive and behavioural therapy (CBT) for people with depression and anxiety What skills can service users expect their therapists to have? Cognitive and behavioural therapy (CBT) for people with depression

More information

Client Information Leaflet

Client Information Leaflet The Dialectical Behaviour Therapy Endeavour Programme Creating a life worth living Client Information Leaflet HSE South - North Lee Adult Mental Health Service Dialectical Behaviour Therapy Programme July

More information

Mid Essex. Specialist Psychosis Service

Mid Essex. Specialist Psychosis Service Mid Essex Specialist Psychosis Service What is psychosis? Why have you been referred to us? Psychosis is general term used to describe a number of symptoms. Some of the symptoms of psychosis include: False

More information

Mental Health Services

Mental Health Services Mental Health Services At Maitland Private Hospital our team of professionals are committed to providing comprehensive assessment, treatment and support of people experiencing mental health issues. Located

More information

Brisbane Centre for Post Natal Disorders. Patient information brochure

Brisbane Centre for Post Natal Disorders. Patient information brochure Brisbane Centre for Post Natal Disorders Patient information brochure What is a Post Natal Disorder? A Post Natal Disorder may occur any time during the first two years after birth, or it may occur before

More information

Child & Adolescent Anxiety: Psychopathology and Neuroscience

Child & Adolescent Anxiety: Psychopathology and Neuroscience bbrfoundation.org Child & Adolescent Anxiety: Psychopathology and Neuroscience Daniel S. Pine, M.D. Chief, Child & Adolescent Research Mood & Anxiety Disorders Program National Institute of Mental Health

More information

mpv`elildf`^i=qob^qjbkqp=ñçê= ^åñáéíó=~åç=aééêéëëáçå h~íó=dê~òéäêççâ `äáåáå~ä=ié~çi=dêééåïáåü=qáãé=qç=q~äâ `çåëìäí~åí=`äáåáå~ä=mëóåüçäçöáëí

mpv`elildf`^i=qob^qjbkqp=ñçê= ^åñáéíó=~åç=aééêéëëáçå h~íó=dê~òéäêççâ `äáåáå~ä=ié~çi=dêééåïáåü=qáãé=qç=q~äâ `çåëìäí~åí=`äáåáå~ä=mëóåüçäçöáëí mpv`elildf`^i=qob^qjbkqp=ñçê= ^åñáéíó=~åç=aééêéëëáçå h~íó=dê~òéäêççâ `äáåáå~ä=ié~çi=dêééåïáåü=qáãé=qç=q~äâ `çåëìäí~åí=`äáåáå~ä=mëóåüçäçöáëí Plan of the presentation Summary of NICE recommended psychological

More information

Contents. Overview Treatments Inpatient Services Day Programs The Clinic What are the Costs? How to Get Started How to Find Us

Contents. Overview Treatments Inpatient Services Day Programs The Clinic What are the Costs? How to Get Started How to Find Us Lakeside Clinic Contents Overview Treatments Inpatient Services Day Programs The Clinic What are the Costs? How to Get Started How to Find Us Overview At some point in their lives, as many as one-in-five

More information

Pharmacotherapy/Psychotherapy Research: Psychotherapy Research T O P C O N F E R E N C E S H A N G H A I, C H I N A A L L A N T A S M A N, M. D.

Pharmacotherapy/Psychotherapy Research: Psychotherapy Research T O P C O N F E R E N C E S H A N G H A I, C H I N A A L L A N T A S M A N, M. D. Pharmacotherapy/Psychotherapy Research: Psychotherapy Research T O P C O N F E R E N C E S H A N G H A I, C H I N A A L L A N T A S M A N, M. D. Psychotherapy Research Research in psychiatry has expanded

More information

Depression Assessment & Treatment

Depression Assessment & Treatment Depressive Symptoms? Administer depression screening tool: PSC Depression Assessment & Treatment Yes Positive screen Safety Screen (see Appendix): Administer every visit Neglect/Abuse? Thoughts of hurting

More information

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1 What is bipolar disorder? There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated

More information

Bipolar Disorder: Psychosocial Factors and Psychological Therapies. Steve Jones Spectrum Centre for Mental Health Research

Bipolar Disorder: Psychosocial Factors and Psychological Therapies. Steve Jones Spectrum Centre for Mental Health Research Bipolar Disorder: Psychosocial Factors and Psychological Therapies Steve Jones Spectrum Centre for Mental Health Research Overview Scale of the Problem Factors associated with Bipolar course and outcome

More information

EATING DISORDERS PROGRAM

EATING DISORDERS PROGRAM EATING DISORDERS PROGRAM Exceptional Care in an Exceptional Setting Silver Hill Hospital is an academic affiliate of Yale University School of Medicine, Department of Psychiatry. SILVER HILL HOSPITAL HIGHLIGHTS

More information

Some helpful reminders on depression in children and young people. Maria Moldavsky Consultant Child and Adolescent Psychiatrist

Some helpful reminders on depression in children and young people. Maria Moldavsky Consultant Child and Adolescent Psychiatrist Some helpful reminders on depression in children and young people Maria Moldavsky Consultant Child and Adolescent Psychiatrist The clinical picture What art and my patients taught me Albert Durer (1471-1528)

More information

Early Intervention in Psychosis (EIP) Information for Carers, Families and Friends

Early Intervention in Psychosis (EIP) Information for Carers, Families and Friends Early Intervention in Psychosis (EIP) Information for Carers, Families and Friends Welcome to the Early Intervention Service We understand that having involvement with mental health services can be a confusing

More information

Treatment Interventions for Suicide Prevention. Kate Comtois, PhD, MPH University of Washington

Treatment Interventions for Suicide Prevention. Kate Comtois, PhD, MPH University of Washington Treatment Interventions for Suicide Prevention Kate Comtois, PhD, MPH University of Washington Suicide prevention has many forms Treating Depression Gatekeeper Training Public health or injury prevention

More information

Emotional issues after a stroke. Bridgepoint Stroke Education Series

Emotional issues after a stroke. Bridgepoint Stroke Education Series Emotional issues after a stroke Bridgepoint Stroke Education Series Learning Objectives Describe the adjustments patients and caregivers have in the rehab setting Give examples of 3 ways to maximize recovery

More information

Preferred Practice Guidelines Bipolar Disorder in Children and Adolescents

Preferred Practice Guidelines Bipolar Disorder in Children and Adolescents These Guidelines are based in part on the following: American Academy of Child and Adolescent Psychiatry s Practice Parameter for the Assessment and Treatment of Children and Adolescents With Bipolar Disorder,

More information

Humanistic Experiential Psychotherapies (HEPs) for Depression: Evidence and Effective Practice. Robert Elliott University of Strathclyde

Humanistic Experiential Psychotherapies (HEPs) for Depression: Evidence and Effective Practice. Robert Elliott University of Strathclyde Humanistic Experiential Psychotherapies (HEPs) for Depression: Evidence and Effective Practice Robert Elliott University of Strathclyde Depression: General Perspectives Together with substance abuse, the

More information

Using Dialectical Behavioural Therapy with Eating Disorders. Dr Caroline Reynolds Consultant Psychiatrist Richardson Eating Disorder Service

Using Dialectical Behavioural Therapy with Eating Disorders. Dr Caroline Reynolds Consultant Psychiatrist Richardson Eating Disorder Service Using Dialectical Behavioural Therapy with Eating Disorders Dr Caroline Reynolds Consultant Psychiatrist Richardson Eating Disorder Service Contents What is dialectical behavioural therapy (DBT)? How has

More information

Psychology Externship Program

Psychology Externship Program Psychology Externship Program The Washington VA Medical Center (VAMC) is a state-of-the-art facility located in Washington, D.C., N.W., and is accredited by the Joint Commission on the Accreditation of

More information

Depression in children and young people. Identification and management in primary, community and secondary care

Depression in children and young people. Identification and management in primary, community and secondary care NICE guideline May 2005 Issue date: September 2005 Depression in children and young people Identification and management in primary, community and secondary care Clinical Guideline 28 Developed by the

More information

Step 4: Complex and severe depression in adults

Step 4: Complex and severe depression in adults Step 4: Complex and severe depression in adults A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

Advances in Psychological Treatments for Adult ADHD

Advances in Psychological Treatments for Adult ADHD Advances in Psychological Treatments for Adult ADHD Dr Antonia Dittner Senior Clinical Psychologist Maudsley Adult ADHD Service antonia.dittner@slam.nhs.uk The need for a multidisciplinary approach to

More information

FACT SHEET 4. Bipolar Disorder. What Is Bipolar Disorder?

FACT SHEET 4. Bipolar Disorder. What Is Bipolar Disorder? FACT SHEET 4 What Is? Bipolar disorder, also known as manic depression, affects about 1 percent of the general population. Bipolar disorder is a psychiatric disorder that causes extreme mood swings that

More information

Psychological support for adults living with HIV

Psychological support for adults living with HIV Psychological support for adults living with HIV Everyone living with HIV is entitled to specialist psychological support Although many people living with HIV do not have psychological problems, specialist

More information

Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives

Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives Dr Helen Killaspy Reader and honorary consultant in rehabilitation

More information

Applying ACT to Cases of Complex Depression: New Clinical and Research Perspectives

Applying ACT to Cases of Complex Depression: New Clinical and Research Perspectives Applying ACT to Cases of Complex Depression: New Clinical and Research Perspectives Part I: Depression with Psychosis and Suicidality Brandon Gaudiano, Ph.D. Assistant Professor of Psychiatry Grant Support:

More information

Questions and Answers about Child Sexual Abuse Treatment

Questions and Answers about Child Sexual Abuse Treatment Questions and Answers about Child Sexual Abuse Treatment An Interview with Judith Cohen, MD Dr. Judith Cohen is a member of the and Medical Director of the Center for Traumatic Stress in Children, Department

More information

Post-Traumatic Stress Disorder - PTSD

Post-Traumatic Stress Disorder - PTSD Post-Traumatic Stress Disorder - PTSD Introduction Post-Traumatic Stress Disorder, or PTSD, is a common disorder in which a person experiences disabling anxiety after a traumatic event. People with PTSD

More information

A Guide to Cognitive- Behavioural Therapy (CBT)

A Guide to Cognitive- Behavioural Therapy (CBT) A Guide to Cognitive- Behavioural Therapy (CBT) Cognitive-behavioural Therapy (CBT) aims to help you to change the way that you think, feel and behave. It is used as a treatment for various mental health

More information

Making sense of CBT. Making sense CBT

Making sense of CBT. Making sense CBT Making sense of CBT Making sense CBT Making sense of CBT This booklet is for anyone who wants to know more about cognitive behavioural therapy (CBT). It explains what it is, what it helps with, what happens

More information

ADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines - 2015

ADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines - 2015 The Clinical Level of Care Guidelines contained on the following pages have been developed as a guide to assist care managers, physicians and providers in making medical necessity decisions about the least

More information

What works for bipolar disorder and how should this be delivered in practice?

What works for bipolar disorder and how should this be delivered in practice? What works for bipolar disorder and how should this be delivered in practice? Daniel Smith daniel.smith@glasgow.ac.uk W4 Improving the diagnosis and management of bipolar disorder: screening, integrated

More information

POSTGRADUATE DIPLOMA IN COGNITIVE BEHAVIOURAL THERAPY

POSTGRADUATE DIPLOMA IN COGNITIVE BEHAVIOURAL THERAPY Department for Continuing Education with Oxford Cognitive Therapy Centre Inspiring Excellence in CBT Training, Therapy & Research POSTGRADUATE DIPLOMA IN COGNITIVE BEHAVIOURAL THERAPY A ONE-YEAR PART-TIME

More information

Borderline Personality Disorder and Treatment Options

Borderline Personality Disorder and Treatment Options Borderline Personality Disorder and Treatment Options MELISSA BUDZINSKI, LCSW VICE PRESIDENT, CLINICAL SERVICES 2014 Horizon Mental Health Management, LLC. All rights reserved. Objectives Define Borderline

More information

Addendum to clinical guideline 28, depression in children and young people

Addendum to clinical guideline 28, depression in children and young people : National Institute for Health and Care Excellence Final Addendum to clinical guideline 28, depression in children and young people Clinical guideline addendum 28. Methods, evidence and recommendations

More information

STEP-BD. Methods. STEP-BD Baseline Findings. Lessons from STEP-BD for the Treatment of Bipolar Disorder

STEP-BD. Methods. STEP-BD Baseline Findings. Lessons from STEP-BD for the Treatment of Bipolar Disorder Lessons from for the Treatment of Bipolar Disorder Andrew A. Nierenberg, MD Massachusetts General Hospital Harvard Medical School Systematic Treatment Enhancement Program for Bipolar Disorder www.stepbd.org

More information

CBT Treatment. Obsessive Compulsive Disorder

CBT Treatment. Obsessive Compulsive Disorder CBT Treatment Obsessive Compulsive Disorder 1 OCD DEFINITION AND DIAGNOSIS NORMAL WORRIES & COMPULSIONS DYSFUNCTIONAL/ABNORMAL OBSESSIONS DSM IV DIAGNOSIS 2 OCD DIAGNOSIS DSM IV & ICD 10 A significant

More information

Let s talk about Eating Disorders

Let s talk about Eating Disorders Let s talk about Eating Disorders Dr. Jane McKay Dr. Ric Arseneau Dr. Debbie Rosenbaum Dr. Samantha Kelleher Dr. Julia Raudzus Role of the Psychiatrist Assessment and diagnosis of patients with eating

More information

Psychotherapy Treatment of Bipolar Disorders

Psychotherapy Treatment of Bipolar Disorders Psychotherapy Treatment of Bipolar Disorders Jenifer L. Culver, Ph.D. Clinical Assistant Professor Bipolar Disorders Clinic Stanford University School of Medicine Overview Overview of research-based psychotherapies

More information

Suicidal. Caring For The Person Who Is. Why might a person be suicidal?

Suicidal. Caring For The Person Who Is. Why might a person be suicidal? Caring For The Person Who Is Suicidal For further information see also the following MIND Essentials resource Conducting a suicide risk assessment. Suicidal thoughts and behaviours are not unique to mental

More information

ABOUT US. and Expressive Therapy (Dance/Movement, Art, Drama) in addition to individual, group and family therapy by skilled therapists.

ABOUT US. and Expressive Therapy (Dance/Movement, Art, Drama) in addition to individual, group and family therapy by skilled therapists. ABOUT US n Riveredge Hospital maintains the treatment philosophy of Trauma Informed Care. n Our commitment to providing the highest quality of care includes offering Animal Assisted Therapy, and Expressive

More information

The Schema Therapy model

The Schema Therapy model The Schema Therapy model Presented by Dr Christopher Lee Chris.Lee@murdoch.edu.au Schema Modes Moment to moment emotional states that reflect the current clusters of cognitions, emotions and behaviour

More information

Psychosocial treatment of late-life depression with comorbid anxiety

Psychosocial treatment of late-life depression with comorbid anxiety Psychosocial treatment of late-life depression with comorbid anxiety Viviana Wuthrich Centre for Emotional Health Macquarie University, Sydney, Australia Why Comorbidity? Comorbidity is Common Common disorders,

More information

Evidence based therapy for children and young people

Evidence based therapy for children and young people Evidence based therapy for children and young people Paul Stallard, Professor of Child & Family Mental Health, University of Bath Head of Psychological Therapies, OBMH Overview Focus on childhood anxiety

More information

Breaking the cycles of Borderline Personality Disorder

Breaking the cycles of Borderline Personality Disorder Breaking the cycles of Borderline Personality Disorder Borderline Personality Disorder (BPD) is a complex and difficult to treat condition affecting up to 2 % of the UK s adult population, and 50 % of

More information

Ouch! Eek! & Sigh! 02/18/04 Buch, Garrett & Bannerman 1

Ouch! Eek! & Sigh! 02/18/04 Buch, Garrett & Bannerman 1 Ouch! Eek! & Sigh! 02/18/04 Buch, Garrett & Bannerman 1 Divergent Treatment Solutions For Disability s Top Three Presentation, CARP BC 2004, February 18, 2004 Drs. Buch, Garrett & Bannerman Behavioural

More information

Depression in children and young people. Quick reference guide. Issue date: September 2005

Depression in children and young people. Quick reference guide. Issue date: September 2005 Quick reference guide Issue date: September 2005 Depression in children and young people Identification and management in primary, community and secondary care Clinical Guideline 28 Developed by the National

More information

Case Formulation in Cognitive-Behavioral Therapy. What is Case Formulation? Rationale 12/2/2009

Case Formulation in Cognitive-Behavioral Therapy. What is Case Formulation? Rationale 12/2/2009 Case Formulation in Cognitive-Behavioral Therapy What is Case Formulation? A set of hypotheses regarding what variables serve as causes, triggers, or maintaining factors for a person s problems Description

More information

No single substance abuse

No single substance abuse National Survey of Substance Abuse Treatment Services The N-SSATS Report October 14, 010 Clinical or Therapeutic Approaches Used by Substance Abuse Treatment Facilities In Brief In 009, the majority of

More information

MBBS; MRCPsych Mood & anxiety disorders OCD Adult ADHD Autism Elderly psychiatry Cognitive disorders PTSD Addictions

MBBS; MRCPsych Mood & anxiety disorders OCD Adult ADHD Autism Elderly psychiatry Cognitive disorders PTSD Addictions Consultants Dr Hamilton S McBrien Consultant Child & Adolescent Psychiatrist Medical Director MB BCh BAO MRCPsych Affective disorders Bipolar Obsessive Compulsive Disorder Post Traumatic Disorder Psychosis

More information

Capacity to Care: Building Competency in Geriatric Mental Health Care Evidence Based Practices & Psychosocial Interventions

Capacity to Care: Building Competency in Geriatric Mental Health Care Evidence Based Practices & Psychosocial Interventions Capacity to Care: Building Competency in Geriatric Mental Health Care Evidence Based Practices & Psychosocial Interventions Nancy P. Kropf School of Social Work Georgia State University Define Evidence

More information

OUTREACH VERSION. SERVICES FOR TEENS AT RISK STAR Center Western Psychiatric Institute and Clinic (412) 246-5619

OUTREACH VERSION. SERVICES FOR TEENS AT RISK STAR Center Western Psychiatric Institute and Clinic (412) 246-5619 OUTREACH VERSION SERVICES FOR TEENS AT RISK STAR Center Western Psychiatric Institute and Clinic (412) 246-5619 All Rights Reserved 2007 UPMC Health System TABLE OF CONTENTS INTRODUCTION 2 WHAT IS DEPRESSION?

More information

Clinical guideline Published: 28 January 2009 nice.org.uk/guidance/cg78

Clinical guideline Published: 28 January 2009 nice.org.uk/guidance/cg78 Borderline personality disorder: recognition and management Clinical guideline Published: 28 January 2009 nice.org.uk/guidance/cg78 NICE 2009. All rights reserved. Your responsibility The recommendations

More information

PROFESSIONAL MASTER DEGREE IN COGNITIVE BEHAVIOR THERAPY A TWO YEAR PART-TIME ACADEMIC ROGRAM

PROFESSIONAL MASTER DEGREE IN COGNITIVE BEHAVIOR THERAPY A TWO YEAR PART-TIME ACADEMIC ROGRAM PROFESSIONAL MASTER DEGREE IN COGNITIVE BEHAVIOR THERAPY A TWO YEAR PART-TIME ACADEMIC ROGRAM This program aims to expand the scope of clinical training opportunities available in the Department of Psychiatry

More information

Guy S. Diamond, Ph.D.

Guy S. Diamond, Ph.D. Guy S. Diamond, Ph.D. Director, Center for Family Intervention Science at The Children s Hospital of Philadelphia Associate Professor, University of Pennsylvania, School of Medicine Center for Family Intervention

More information

Addiction takes a toll not only on the

Addiction takes a toll not only on the FAMILY PROGRAM Addiction takes a toll not only on the individual, but on the family, as well. When using, addicts are selfish and selfcentered; their wants and needs are placed ahead of the ones they love.

More information

Making sense of cognitive behaviour therapy (CBT)

Making sense of cognitive behaviour therapy (CBT) Making sense of cognitive behaviour therapy (CBT) Making sense of cognitive behaviour therapy What is cognitive behaviour therapy? 4 How does negative thinking start? 6 What type of problems can CBT help

More information

Acceptance and Commitment Therapy (ACT) and Chronic Pain

Acceptance and Commitment Therapy (ACT) and Chronic Pain Acceptance and Commitment Therapy (ACT) and Chronic Pain Lance M. McCracken, PhD Centre for Pain Services Royal National Hospital for Rheumatic Diseases Centre for Pain Research University of Bath Bath

More information

Mental Health and Substance Abuse Reporting Requirements Section 425 of P.A. 154 of 2005

Mental Health and Substance Abuse Reporting Requirements Section 425 of P.A. 154 of 2005 Mental Health and Substance Abuse Reporting Requirements Section 425 of P.A. 154 of 2005 By April 1, 2006, the Department, in conjunction with the Department of Corrections, shall report the following

More information

Amicus Trust have been providing support to vulnerable people for over 40 years

Amicus Trust have been providing support to vulnerable people for over 40 years Training Brochure Introduction Amicus Trust have been providing support to vulnerable people for over 40 years We are now sharing our knowledge and skills to others by offering training The training is

More information

Borderline. Personality

Borderline. Personality A Guide to Accessing Ser vices for Borderline Personality Disorder in Victoria ABOUT THIS GUIDE: WHAT IS Borderline Personality Disorder (BPD)? This guide refers to the National Health and Medical Research

More information

QUALIFICATIONS: BSc (Hons) Psychology 1995 Doctorate in Clinical Psychology 2001 MSc Forensic Psychology 2012

QUALIFICATIONS: BSc (Hons) Psychology 1995 Doctorate in Clinical Psychology 2001 MSc Forensic Psychology 2012 Dr Dawn Bailham Consultant Clinical Psychologist BSc, MSc, Doctorate in Clinical Psychologist, Affiliated Member of the British Psychological Society, AFBPS Contact: Expert Witness Department Expert in

More information

Looking after someone with Depression or Anxiety. Providing services we would be happy for our own families to use

Looking after someone with Depression or Anxiety. Providing services we would be happy for our own families to use Looking after someone with Depression or Anxiety Providing services we would be happy for our own families to use About this booklet: Picking up this booklet means that you are looking after someone with

More information

What is Specialist CAMHS? And your role in it!

What is Specialist CAMHS? And your role in it! What is Specialist CAMHS? And your role in it! The Service We Provide Consultation, Liaison & Mental Health Promotion Urgent Mental Health Assessment Psychological Therapy Diagnostic assessment/intervention

More information

in young people Management of depression in primary care Key recommendations: 1 Management

in young people Management of depression in primary care Key recommendations: 1 Management Management of depression in young people in primary care Key recommendations: 1 Management A young person with mild or moderate depression should typically be managed within primary care services A strength-based

More information

PTSD Ehlers and Clark model

PTSD Ehlers and Clark model Problem-specific competences describe the knowledge and skills needed when applying CBT principles to specific conditions. They are not a stand-alone description of competences, and should be read as part

More information

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 ed #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 effects of alcohol in the brain 100 Top 30 698 heroin addiction 100

More information

The Priory Hospital Roehampton

The Priory Hospital Roehampton The Priory Hospital Roehampton Expert mental health and addiction treatment A REAL AND LASTING DIFFERENCE FOR EVERYONE WE SUPPORT Priory is the UK's leading provider of therapy and consultant-led mental

More information

TIDELANDS COUNSELING CINDY STRICKLEN, M.S., I.M.F. LICENSE #61293 1411 Marsh Street Suite 105, San Luis Obispo, CA 93401

TIDELANDS COUNSELING CINDY STRICKLEN, M.S., I.M.F. LICENSE #61293 1411 Marsh Street Suite 105, San Luis Obispo, CA 93401 TIDELANDS COUNSELING CINDY STRICKLEN, M.S., I.M.F. LICENSE #61293 1411 Marsh Street Suite 105, San Luis Obispo, CA 93401 Minor Consent for Treatment and Service Agreement Welcome to Tidelands Counseling!

More information

Royal Commission Into Institutional Responses to Child Sexual Abuse Submission on Advocacy and Support and Therapeutic Treatment Services

Royal Commission Into Institutional Responses to Child Sexual Abuse Submission on Advocacy and Support and Therapeutic Treatment Services Royal Commission Into Institutional Responses to Child Sexual Abuse Submission on Advocacy and Support and Therapeutic Treatment Services Dr Michael Salter School of Social Sciences and Psychology Western

More information

Testifying in Court about Trauma: How to Prepare

Testifying in Court about Trauma: How to Prepare Testifying in Court about Trauma: How to Prepare It is critical that therapists willingly go to court to try to impart their knowledge to the judge. The judge will only make a good decision if he or she

More information

For further information or to schedule appointment, please contact Day Program Intake Clinician on 8416 3800.

For further information or to schedule appointment, please contact Day Program Intake Clinician on 8416 3800. Day Programs General Information Day Programs at the Melbourne Clinic (TMC) offer therapy treatment to people with a range of psychiatric conditions. The programs are evidence based and are facilitated

More information

Borderline personality disorder

Borderline personality disorder Understanding NICE guidance Information for people who use NHS services Borderline personality disorder NICE clinical guidelines advise the NHS on caring for people with specific conditions or diseases

More information

Module 5 Problem-Solving Treatment SECTION A Introduction

Module 5 Problem-Solving Treatment SECTION A Introduction Module 5 Problem-Solving Treatment SECTION A Introduction PST for Depression Brief Common sense Evidence-based Practical to apply Easily learned by therapist and patient High patient receptiveness and

More information

antidepressants depression in children Should be used to treat and adolescents?

antidepressants depression in children Should be used to treat and adolescents? Should antidepressants be used to treat depression in children and adolescents? Key advisor: Dr Sally Merry, Senior lecturer in child and adolescent psychiatry, Werry Centre for Child and Adolescent Mental

More information

Personality disorder. Caring for a person who has a. Case study. What is a personality disorder?

Personality disorder. Caring for a person who has a. Case study. What is a personality disorder? Caring for a person who has a Personality disorder Case study Kiara is a 23 year old woman who has been brought to the emergency department by her sister after taking an overdose of her antidepressant

More information

AGENCY OVERVIEW MFT & MSW Intern-Trainee Program Training Year

AGENCY OVERVIEW MFT & MSW Intern-Trainee Program Training Year FAMILY SERVICE AGENCY OF MARIN, A Division of Buckelew Programs 555 Northgate Drive, Suite 100, San Rafael, CA 94903-3680 Phone (415) 491-5700 - FAX (415) 491-5750 - www.fsamarin.org AGENCY OVERVIEW MFT

More information

Mechanisms of change in cognitive therapy and interpersonal therapy for depression: preliminary results from an ongoing trial

Mechanisms of change in cognitive therapy and interpersonal therapy for depression: preliminary results from an ongoing trial Mechanisms of change in cognitive therapy and interpersonal therapy for depression: preliminary results from an ongoing trial Marcus Huibers and Lotte Lemmens Department of Clinical Psychological Science,

More information

Treating Mood and Anxiety Disorders in Children & Adolescents

Treating Mood and Anxiety Disorders in Children & Adolescents Treating Mood and Anxiety Disorders in Children & Adolescents Daniel S. Pine, MD Section on Development & Affective Neuroscience Disclosures: Conflicts Sources of Research Support National Institute of

More information

Jeff, what are the essential aspects that make Schema Therapy (ST) different from other forms of psychotherapy?

Jeff, what are the essential aspects that make Schema Therapy (ST) different from other forms of psychotherapy? An Interview with Jeffrey Young This is a revised transcription of an interview via internet on Dec. 30 th 2008. The interviewer was Eckhard Roediger, the current secretary of the ISST. Jeff, what are

More information

Interpersonal Psychotherapy: An overview

Interpersonal Psychotherapy: An overview Interpersonal Psychotherapy: An overview M I C H A E L R O B E R T S O N, P A U L R U S H T O N a n d C H R I S T O P H E R W U R M Despite inclusion in Federal Government funded Medicare programs such

More information

Supporting the return to work of employees with depression or anxiety

Supporting the return to work of employees with depression or anxiety Supporting the return to work of employees with depression or anxiety Advice for employers Around one million Australian adults live with depression. Over two million have an anxiety disorder. On average,

More information

Identification and Treatment Manual

Identification and Treatment Manual Therapeutic Identification of Depression in Young People Identification and Treatment Manual The TIDY project The Academic Unit of Child and Adolescent Psychiatry, Imperial College London & Lonsdale Medical

More information

Psychotropic Medications: Their Role in Trauma Treatment

Psychotropic Medications: Their Role in Trauma Treatment Psychotropic Medications: Their Role in Trauma Treatment Robert Foltz, Psy.D. Associate Professor Child & Adolescent Track Chicago School of Professional Psychology Overview Scope of the Problem Trauma

More information

Mental Health Needs Assessment Personality Disorder Prevalence and models of care

Mental Health Needs Assessment Personality Disorder Prevalence and models of care Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual

More information

Behavioral & Mental Health Care Career Guide P199, Dr. Patton Part 2. Clarify Career & Training Goals Seek Training in the MOST Effective Therapies

Behavioral & Mental Health Care Career Guide P199, Dr. Patton Part 2. Clarify Career & Training Goals Seek Training in the MOST Effective Therapies Behavioral & Mental Health Care Career Guide P199, Dr. Patton Part 2. Clarify Career & Training Goals Seek Training in the MOST Effective Therapies Take a few minutes to think about the following questions.

More information

Northside Cremorne Clinic

Northside Cremorne Clinic Northside Cremorne Clinic Contents Overview Treatments Inpatient Services Day Programs The Clinic What are the Costs? How to Get Started The Northside Group of Clinics How to Find Us Overview At some point

More information