What adaptions are effective to cognitive behavioural interventions for adults with long-term conditions and medically unexplained symptoms? 2020

What adaptions are effective to cognitive behavioural interventions for adults with long-term conditions and medically unexplained symptoms? A systematic review

Samantha Sanders, Shenede Coppin, Hannah Moulson, Joanna Meola, Jane Meyrick
University of the West of England (UWE), Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom

(I'm not sure why the only version of this paper seems to be in a Spanish journal /version)

Aim
Improving Access to Psychological Therapies (IAPT) services were set up in the United Kingdom in 2008. Recent service expansion now accommodates patients with long-term conditions (LTC) and medically unexplained symptoms (MUS) through the use of cognitive-behaviour therapy (CBT). A systematic review is yet to be completed to identify specific adaptions that may be effective for improving outcomes. Many countries are building upon this model within the United Kingdom; therefore, the findings can inform developing services internationally.

Methods
Electronic databases were searched and studies were screened against an inclusion/exclusion criteria. Studies evaluating the effectiveness of CBT interventions on mental health outcomes for adults with LTC/MUS within primary care were included. Data were extracted for analysis and a narrative synthesis was conducted. Quality assessments were made using the Effective Public Health Practice Project tool.

Results
Of 14,380 papers, eight papers were included within the review. Moderate to strong evidence found CBT adaptions were effective in improving outcomes, including the specific focus on the LTC/MUS within treatment, the inclusion of collaborative care or implementing a range of therapeutic skills. Weak methodology was associated with selection bias, lack of blinding and reporting around the validity and reliability of data collection tools.

Conclusions
CBT adaptions may be effective at improving mental health outcomes for those with LTC/MUS in the short term. Due to the small amount of studies included within the review, conclusions remain tentative. It is unclear as to whether interventions can sustain outcomes and provide financial gains in the long term.

https://www.elsevier.es/es-revista-...ons-are-effective-cognitive-S1134793720300300

https://www.sciencedirect.com/science/article/abs/pii/S1134793720300300?via=ihub

 

My experience is that most of the mental health harm caused comes from the theoretical framework that propose that distress is independent of context, is unjustified and caused by wrong thought processes (that is, the cause is found in the psyche, and not in circumstances). This is no accident: it's simply the expression of a culture that is opposed to helping people in need and in difficulty.

This harms people when they are most vulnerable in their lives.