Background: Recent research has suggested that too much self-control (overcontrol) underpins a ra... more Background: Recent research has suggested that too much self-control (overcontrol) underpins a range of mental health disorders including certain Axis I mood and eating disorders, and Axis II presentations such as obsessive compulsive personality disorder and avoidant personality disorder. A novel group therapy intervention, Group Radical Openness (GRO), is proposed as a suitable treatment for overcontrol.
ABSTRACT Aim: The qualitative experience of clients judged by quantitative measures as having ‘go... more ABSTRACT Aim: The qualitative experience of clients judged by quantitative measures as having ‘good’ or ‘poor’ outcome is not often the focus of outcome research. This exploratory study investigates client experience of psychological therapy in an inner-city primary care centre across two client groups, differentiated on the basis of their outcome scores on quantitative measures. Method: Clients (N�11) were allocated to one of two research groups, (a) good outcome (n�5), or (b) poor outcome (n�6) on the basis of their pre- and post-therapy outcome scores on the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). They participated in a face-to-face semi-structured interview. Data were recorded and analysed using a descriptive and interpretive qualitative method. Results: Both groups had broadly similar experiences of their current therapy although some differences in emphasis emerged. Good outcome clients described a greater sense of empowerment in therapy, commenting on a feeling of equality with their therapist and exhibiting greater autonomy overall. Poor outcome clients valued therapist support and while reporting increased awareness of problematic functioning described a reluctance to engage fully in the therapeutic process. Conclusion: There was very little difference in the qualitative accounts of therapy and its impact by the clients deemed by quantitative pre-post therapy measurement as either ‘good outcome’ or ‘poor outcome’. There is further research warranted, examining whether clients that seem to benefit from therapy according to standard pre-post measurement, experience therapy and its impact differently to clients whose pre-post results suggest that therapy did not work.
Generalized Anxiety Disorder (GAD) is typically considered a chronic condition characterized by e... more Generalized Anxiety Disorder (GAD) is typically considered a chronic condition characterized by excessive worry. Lifetime prevalence is 4.3–5.9%, yet only a small percentage seeks treatment. GAD is treatable and in recent years internet-delivered treatment interventions have shown promise. This paper aims to systematically search for lit- erature on internet-delivered psychological interventions for the treatment of GAD and conduct a meta-analysis to examine their efficacy. The purpose of the paper is to inform the community of researchers, program devel- opers and practitioners in internet delivered interventions of the current state-of-the-art and research gaps that require attention. A systematic search of the literature was conducted to find all studies of internet-delivered treatments for GAD (N = 20). Using Review Manager 5 all Randomized Controlled Trials (RCTs; n = 11) that met our established eligibility criteria were included into a meta-analysis that calculated effect sizes via the standard- ized mean difference. Compared to the waiting-list controls, the results demonstrate positive outcomes for GAD symptoms (d = − 0.91) and its central construct of pathological worry (d = − 0.74). The meta-analysis supports the efficacy of internet-delivered treatments for GAD including the use of disorder-specific (4 studies) and transdiagnostic treatment protocols (7 studies). Caution is advised regarding the results as the data is limited and highly heterogeneous, but revealing of what future research might be needed.
Background: Recent research has suggested that too much self-control (overcontrol) underpins a ra... more Background: Recent research has suggested that too much self-control (overcontrol) underpins a range of mental health disorders including certain Axis I mood and eating disorders, and Axis II presentations such as obsessive compulsive personality disorder and avoidant personality disorder. A novel group therapy intervention, Group Radical Openness (GRO), is proposed as a suitable treatment for overcontrol.
ABSTRACT Aim: The qualitative experience of clients judged by quantitative measures as having ‘go... more ABSTRACT Aim: The qualitative experience of clients judged by quantitative measures as having ‘good’ or ‘poor’ outcome is not often the focus of outcome research. This exploratory study investigates client experience of psychological therapy in an inner-city primary care centre across two client groups, differentiated on the basis of their outcome scores on quantitative measures. Method: Clients (N�11) were allocated to one of two research groups, (a) good outcome (n�5), or (b) poor outcome (n�6) on the basis of their pre- and post-therapy outcome scores on the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). They participated in a face-to-face semi-structured interview. Data were recorded and analysed using a descriptive and interpretive qualitative method. Results: Both groups had broadly similar experiences of their current therapy although some differences in emphasis emerged. Good outcome clients described a greater sense of empowerment in therapy, commenting on a feeling of equality with their therapist and exhibiting greater autonomy overall. Poor outcome clients valued therapist support and while reporting increased awareness of problematic functioning described a reluctance to engage fully in the therapeutic process. Conclusion: There was very little difference in the qualitative accounts of therapy and its impact by the clients deemed by quantitative pre-post therapy measurement as either ‘good outcome’ or ‘poor outcome’. There is further research warranted, examining whether clients that seem to benefit from therapy according to standard pre-post measurement, experience therapy and its impact differently to clients whose pre-post results suggest that therapy did not work.
Generalized Anxiety Disorder (GAD) is typically considered a chronic condition characterized by e... more Generalized Anxiety Disorder (GAD) is typically considered a chronic condition characterized by excessive worry. Lifetime prevalence is 4.3–5.9%, yet only a small percentage seeks treatment. GAD is treatable and in recent years internet-delivered treatment interventions have shown promise. This paper aims to systematically search for lit- erature on internet-delivered psychological interventions for the treatment of GAD and conduct a meta-analysis to examine their efficacy. The purpose of the paper is to inform the community of researchers, program devel- opers and practitioners in internet delivered interventions of the current state-of-the-art and research gaps that require attention. A systematic search of the literature was conducted to find all studies of internet-delivered treatments for GAD (N = 20). Using Review Manager 5 all Randomized Controlled Trials (RCTs; n = 11) that met our established eligibility criteria were included into a meta-analysis that calculated effect sizes via the standard- ized mean difference. Compared to the waiting-list controls, the results demonstrate positive outcomes for GAD symptoms (d = − 0.91) and its central construct of pathological worry (d = − 0.74). The meta-analysis supports the efficacy of internet-delivered treatments for GAD including the use of disorder-specific (4 studies) and transdiagnostic treatment protocols (7 studies). Caution is advised regarding the results as the data is limited and highly heterogeneous, but revealing of what future research might be needed.
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Papers by James McElvaney