Publications by year
In Press
Lambert J, Greaves C, Farrand P, Price LRS, Haase A, Taylor A (In Press). A pilot randomized controlled trial of a web-based intervention using behavioral activation and physical activity for adults with depression: the eMotion Study. Journal of Medical Internet Research
Farrand P, Greenberg N, Bloomfield T, Watkins E, Mullan E (In Press). Acceptability of a Step 2 psychological therapy service for UK Armed Forces Veterans and family members: a qualitative study. Occupational Medicine
Woodford J, Farrand P, Bessant M, Williams C (In Press). Recruitment into an RCT comparing supported computer-aided CBT self-help with routine GP care for depression: Problems faced and lessons learnt. Contemporary Clinical Trials.
Farrand P, Woodford J (In Press). Self-help books for depression and anxiety: a systematic review and meta-anaysis. Psychological Medicine.
2023
Coumoundouros C, Farrand P, Hamilton A, von Essen L, Sanderman R, Woodford J (2023). Cognitive behavioural therapy self-help intervention preferences among informal caregivers of adults with chronic kidney disease: an online cross-sectional survey.
BMC Nephrol,
24(1).
Abstract:
Cognitive behavioural therapy self-help intervention preferences among informal caregivers of adults with chronic kidney disease: an online cross-sectional survey.
BACKGROUND: Informal caregivers (i.e. family and friends) provide essential support to people with chronic kidney disease (CKD). Many informal caregivers experience mental health problems such as anxiety and depression due to the caregiving role, and commonly have unmet psychological support needs. One potential solution is cognitive behavioural therapy (CBT) self-help interventions that are less reliant on extensive involvement of healthcare professionals, which may increase access. Within the intervention development phase of the MRC framework, the study's primary objective was to examine informal caregivers' self-help intervention preferences (e.g. delivery format, content). Secondary objectives were to describe the informal caregiver's situation (e.g. type of care activities) and mental health (symptoms of depression, anxiety, and stress). METHODS: an online cross-sectional survey conducted in the United Kingdom. Informal caregivers of adults living with CKD were recruited via social media, websites, newsletters, magazine articles, a podcast episode, and paid Facebook advertisements. The survey examined: informal caregiver characteristics; care recipient characteristics; self-help intervention preferences; and informal caregiver's mental health using the DASS-21. Data were analysed using descriptive statistics. RESULTS: Sixty-five informal caregivers participated. The majority (85%) were female, caring for a male (77%) spouse/partner (74%). Responses indicated 58% of informal caregivers were experiencing at least mild depression. In total, 48% indicated they were likely to use a CBT self-help intervention, preferring an intervention provided via internet (e.g. website) (64%), workbook (56%), or individually in-person (54%). Regarding content, interventions should cover a wide range of topics including living with CKD, support services, informal caregiver's physical health, and diet. Overall, 48% reported a preference for a supported intervention, with support delivered in-person or via email by a trained professional at a community organisation. CONCLUSIONS: Results suggest CBT self-help interventions may be an acceptable way to provide psychological support to informal caregivers, however the study is limited by the small sample size. A wide range of intervention preferences were identified indicating a need to tailor intervention content and delivery to enhance acceptability and engagement. Results will inform development of a CBT self-help intervention for informal caregivers of people with CKD.
Abstract.
Author URL.
Lundgren J, Thiblin E, Lutvica N, Reuther C, Farrand P, Woodford J, von Essen L (2023). Concerns experienced by parents of children treated for cancer: a qualitative study to inform adaptations to an internet-administered, low-intensity cognitive behavioral therapy intervention.
Psychooncology,
32(2), 237-246.
Abstract:
Concerns experienced by parents of children treated for cancer: a qualitative study to inform adaptations to an internet-administered, low-intensity cognitive behavioral therapy intervention.
OBJECTIVE: Childhood cancer treatment completion is associated with mental health difficulties and negative socioeconomic consequences for parents. However, psychological support needs are often unmet. We developed an internet-administered, guided, low-intensity cognitive behavioral therapy-based self-help intervention (EJDeR) and examined feasibility and acceptability with a single-arm feasibility trial (ENGAGE). Results suggest EJDeR is acceptable, however, adherence, especially for fathers, could be improved. Following the Medical Research Council complex interventions framework, this study explores concerns experienced by parents actively seeking support related to their child's cancer who were recruited into ENGAGE to inform further adaptation of EJDeR. METHOD: Seventy-three semi-structured interviews (26 fathers, 47 mothers) were conducted, with data analyzed using manifest content analysis. RESULTS: Analysis resulted in seven categories: (1) Feeling lost and lonely in life; (2) Low mood; (3) Parenting difficulties; (4) Productivity difficulties; (5) Relationship challenges; (6) Stress reactions; and (7) Worry. With the exception of subcategories Afraid of not being a good parent, Cancer recurrence, and Child's development and future a somewhat higher percentage of mothers than fathers mentioned all identified concerns. CONCLUSION: Parents described experiencing a range of concerns after their child had completed cancer treatment. EJDeR will be adapted to address these concerns and include indirect intervention modules targeting concerns such as stress. Information to support parenting, relationships, finance, and employment difficulties, alongside signposting to inform help-seeking, will be included. Findings also suggest a need to improve the gender-sensitivity of EJDeR.
Abstract.
Author URL.
Coumoundouros C, El Arab RA, Farrand P, Hamilton A, Sanderman R, von Essen L, Woodford J (2023). Potential Implementers' Perspectives on the Development and Implementation of an e-Mental Health Intervention for Caregivers of Adults with Chronic Kidney Disease: Qualitative Interview Study.
JMIR Hum Factors,
10Abstract:
Potential Implementers' Perspectives on the Development and Implementation of an e-Mental Health Intervention for Caregivers of Adults with Chronic Kidney Disease: Qualitative Interview Study.
BACKGROUND: e-Mental health interventions can improve access to mental health support for caregivers of people living with chronic kidney disease (CKD). However, implementation challenges often prevent effective interventions from being put into practice. To develop an e-mental health intervention for caregivers of people living with CKD that is optimized for future implementation, it is important to engage professionals that may endorse or deliver the intervention (ie, potential implementers) during intervention development. OBJECTIVE: This study aims to explore the perspectives of potential implementers working in kidney care, in mental health care, or at nonprofit organizations regarding the design and implementation of an e-mental health intervention for caregivers of people living with CKD. METHODS: Potential implementers (N=18) were recruited via National Health Service Trusts, email, and social media advertisements to participate in semistructured video interviews. Interview questions were informed by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using a deductive analysis approach using the CFIR, with inductive coding applied to relevant data not captured by the framework. RESULTS: a total of 29 generic categories, related to 17 CFIR constructs, were identified. The perceived fit between the intervention and implementation context (ie, existing service delivery models and work routines) and existing social networks among potential implementers were perceived as important factors in enhancing implementation potential. However, a need for capacity building among potential implementers to create systems to support the identification and referral of caregivers to an e-mental health intervention was identified. Equity concerns were raised regarding the intervention, highlighting the importance of incorporating an equity lens during intervention design to enhance accessibility and adoption. CONCLUSIONS: Potential implementers provided valuable insights into key design and implementation factors to help inform the development of an e-mental health intervention for caregivers of people living with CKD. Incorporating their feedback can help ensure the intervention is acceptable and inform the selection of future implementation strategies to enhance the implementation potential of the intervention. Potential implementers should continue to be engaged throughout intervention development.
Abstract.
Author URL.
Coumoundouros C, El Arab RA, Farrand P, Hamilton A, Sanderman R, von Essen L, Woodford J (2023). Potential Implementers’ Perspectives on the Development and Implementation of an e–Mental Health Intervention for Caregivers of Adults with Chronic Kidney Disease: Qualitative Interview Study (Preprint).
Abstract:
Potential Implementers’ Perspectives on the Development and Implementation of an e–Mental Health Intervention for Caregivers of Adults with Chronic Kidney Disease: Qualitative Interview Study (Preprint)
. BACKGROUND
. e–Mental health interventions can improve access to mental health support for caregivers of people living with chronic kidney disease (CKD). However, implementation challenges often prevent effective interventions from being put into practice. To develop an e–mental health intervention for caregivers of people living with CKD that is optimized for future implementation, it is important to engage professionals that may endorse or deliver the intervention (ie, potential implementers) during intervention development.
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. OBJECTIVE
. This study aims to explore the perspectives of potential implementers working in kidney care, in mental health care, or at nonprofit organizations regarding the design and implementation of an e–mental health intervention for caregivers of people living with CKD.
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. METHODS
. Potential implementers (N=18) were recruited via National Health Service Trusts, email, and social media advertisements to participate in semistructured video interviews. Interview questions were informed by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using a deductive analysis approach using the CFIR, with inductive coding applied to relevant data not captured by the framework.
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. RESULTS
. A total of 29 generic categories, related to 17 CFIR constructs, were identified. The perceived fit between the intervention and implementation context (ie, existing service delivery models and work routines) and existing social networks among potential implementers were perceived as important factors in enhancing implementation potential. However, a need for capacity building among potential implementers to create systems to support the identification and referral of caregivers to an e–mental health intervention was identified. Equity concerns were raised regarding the intervention, highlighting the importance of incorporating an equity lens during intervention design to enhance accessibility and adoption.
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. CONCLUSIONS
. Potential implementers provided valuable insights into key design and implementation factors to help inform the development of an e–mental health intervention for caregivers of people living with CKD. Incorporating their feedback can help ensure the intervention is acceptable and inform the selection of future implementation strategies to enhance the implementation potential of the intervention. Potential implementers should continue to be engaged throughout intervention development.
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Abstract.
alHarbi H, Farrand P, Laidlaw K (2023). Understanding the beliefs and attitudes towards mental health problems held by Muslim communities and acceptability of Cognitive Behavioral Therapy as a treatment: systematic review and thematic synthesis.
Discov Ment Health,
3(1).
Abstract:
Understanding the beliefs and attitudes towards mental health problems held by Muslim communities and acceptability of Cognitive Behavioral Therapy as a treatment: systematic review and thematic synthesis.
BACKGROUND: Muslims experience the lowest recovery rate from mental health difficulties across all religious groups. The aim of this research is to understand the barriers that prevent Muslims from accessing Cognitive Behavioral Therapy (CBT) and the extent to which these may vary across country of residence. METHODS: Systematic review and thematic synthesis for quantitative, qualitative, and mixed methods studies published in English and Arabic informed by the SPIDER search tool. Methodological quality and risk of bias of included papers were critically appraised independently according to the Mixed Methods Appraisal Tool. RESULTS: a search of seven databases in the Arabic and English language yielded 3836 studies with 210 studies assessed for eligibility. Employing the Mixed Methods Appraisal Tool resulted in 14 studies included in the thematic synthesis. Seven studies adopted a qualitative methodology employing semi-structured interviews and seven were quantitative descriptive studies. CONCLUSIONS: Muslim communities experience barriers accessing Cognitive Behavioral Therapy at the level of the individual, culture, provider and management. The main barriers were experienced at the individual level which was dominated by the influence of Islam regarding the cause of mental health difficulties, which also influenced the way in which difficulties were managed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO and registration number: CRD42020192854.
Abstract.
Author URL.
Farrand P, Raue P, Ward E, Repper D, Areán P (2023). Use and Engagement with Low-Intensity Cognitive Behavioral Therapy Techniques Employed Within an App to Support Worry Management: Analysis of Log Data (Preprint). JMIR mHealth and uHealth
Farrand P, Raue P, Ward E, Repper D, Areán P (2023). Use and Engagement with Low-Intensity Cognitive Behavioural Therapy Techniques Employed Within an App to Support Worry Management: Analysis of Log Data (Preprint).
Abstract:
Use and Engagement with Low-Intensity Cognitive Behavioural Therapy Techniques Employed Within an App to Support Worry Management: Analysis of Log Data (Preprint)
. BACKGROUND
. Low-Intensity Cognitive Behavioural Therapy (LICBT) has been implemented by the Improving Access to Psychological Therapies services across England to manage excessive worry associated with Generalized Anxiety Disorder (GAD) and support emotional wellbeing. However, barriers to access limit scalability. A solution has been to incorporate LICBT techniques derived from an evidence-based protocol within the Iona Mind Wellbeing app for Worry management (IMWW) with support provided through an algorithmically driven conversational agent.
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. OBJECTIVE
. Examine engagement with a mobile phone app to support worry management with specific attention directed towards interaction with treatment specific LICBT techniques and examine the potential to reduce symptoms of anxiety.
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. METHODS
. Log data was examined with respect to a sample of ‘engaged’ users that had completed at least one lesson related to the Worry Time and Problem Solving in-app modules that represented the ‘minimum dose’. Paired samples t-tests were undertaken to examine the potential for IMWW to reduce worry and anxiety, with multivariate linear regressions examining the extent to which completion of each of the techniques led to reductions in worry and anxiety.
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. RESULTS
. There was good engagement with the range of specific LICBT techniques included within IMWW. The vast majority of engaged users were able to interact with the CBT model and successfully record types of worry. When working through Problem Solving, the conversational agent was successfully employed to support the user with lower levels of engagement. With Worry Time, several users engaged with it out-of-app. Forgetting to use the app was the most common reason for lack of engagement with lower levels of engagement features of the app such as completion of routine outcome measures and weekly reflections. Despite difficulties in collection of endpoint data, there was a significant reduction in severity for both anxiety [t(53) = 5.5; P <. 001; 95% CI = 2.4-5.2] and low mood [t(53) = 2.3; P = 0.025; 95% CI=.2-3.3]. A statistically significant linear model was also fitted to GAD-7 [F(2,51) = 6.73; P <. 001] whilst the model predicting changes in the PHQ-8 did not reach significance [F(2,51) = 2.33; P = 0.11]. This indicates that reduction in these measures was affected by engagement with in-app Worry Time and Problem Solving.
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. CONCLUSIONS
. Engaged users were able to successfully interact with the LICBT specific techniques informed by an evidence-based protocol although there was poor completion of routine outcome measures and weekly reflections. Successful interaction with the specific techniques potentially contributes to promising data indicating that IMWW may be effective in the management of excessive worry. A relationship between dose and improvement justifies using log data to inform future developments. However, attention needs to be directed towards enhancing interaction with wider features of the app given that larger improvements were associated with greater engagement.
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. CLINICALTRIAL
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Abstract.
2022
Farrand P, Dawes A, Doughty M, Phull S, Saines S, Winter S, Roth A (2022). Development and application of criteria to evaluate written CBT self-help interventions adopted by Improving Access to Psychological Therapies services.
The Cognitive Behaviour Therapist,
15Abstract:
Development and application of criteria to evaluate written CBT self-help interventions adopted by Improving Access to Psychological Therapies services
Abstract
. Guided CBT self-help represents a low-intensity intervention to deliver evidence-based psychological therapy within the Improving Access to Psychological Therapies (IAPT) programme. Best practice guidance highlighting characteristics associated with CBT self-help is available to help services reach decisions regarding which interventions to adopt. However, at present a single process to evaluate written CBT self-help interventions informed by guidance is lacking. This study reports on the development of a standardised criteria-driven process that can be used to determine the extent written CBT self-help interventions are consistent with guidance regarding the fundamental characteristics of low-intensity CBT and high-quality written patient information. Following development, the process was piloted on 51 IAPT services, with 23 interventions identified as representing free-to-use written CBT self-help interventions. Overall, inter-rater reliability was acceptable. Following application of the criteria framework, 14 (61%) were considered suitable to be recommended for use within the IAPT programme. This pilot supports the development and potential utility of an independent criteria-driven process to appraise the suitability of written workbook-based CBT self-help interventions for use within the IAPT programme.
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. Key learning aims
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. (1)
. To recognise the range of written low-intensity CBT self-help interventions currently used within IAPT services.
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. (2)
. To identify separate criteria associated with high-quality written CBT self-help interventions.
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. (3)
. To use identified criteria to develop a framework to evaluate written workbook based low-intensity CBT self-help interventions for use within the IAPT programme.
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. (4)
. To evaluate inter-rater reliability of the criteria framework to evaluate the quality and appropriateness of written workbook based low-intensity CBT self-help interventions used within IAPT services.
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Abstract.
Farrand P, Dawes A, Doughty M, Phull S, Saines S, Winter S, Roth A (2022). Development and application of criteria to evaluate written CBT self-help interventions adopted by Improving Access to Psychological Therapies services – CORRIGENDUM. The Cognitive Behaviour Therapist, 15
Farrand P, Hamilton A, Strickland S (2022). Development of a competency framework for the Assistant Wellbeing Practitioner (Renal) role.
J Ren CareAbstract:
Development of a competency framework for the Assistant Wellbeing Practitioner (Renal) role.
BACKGROUND: Many people with kidney disease experience comorbid mental health difficulties that result in worse physical health outcomes alongside greater personal, treatment and societal costs. PROBLEM: Workforce expansion to treat comorbid mental health difficulties has focussed on psychological practitioners. This fails to capitalise on benefits arising from embedding roles to address biopsychosocial outcomes directly within the renal specialty. A competency framework to inform development and training for such a role has not been developed. METHODS: Five-phase process to develop a competency framework for an Assistant Wellbeing Practitioner (Renal) role. Following identification of competency frameworks for roles in psychological practice, health and social care, relevant competencies were synthesised to create a draft competency framework. This framework was revised through consultation events with professionals associated with the renal specialty and Kidney Patient Involvement Network with the framework informing a competency map. RESULTS: the competency map comprised three categories-Knowledge, Values and Principles, Core Skills and Meta-Competencies with specific competencies for an assistant practitioner role to work within the renal specialty identified. Core knowledge and skills included awareness of kidney treatments and common psychosocial difficulties, collaborative care and supporting evidence-based prevention approaches. CONCLUSIONS: Competencies associated with the Assistant Wellbeing Practitioner (Renal) role have the potential to promote mental wellbeing, better physical health and generate social and economic benefits. The competency map can inform training and role evaluation, although addressing implementation issues associated with commissioning physical and mental healthcare is required.
Abstract.
Author URL.
Dunn B (2022). How well do Cognitive Behavioural Therapy and Behavioural Activation for depression repair anhedonia? a secondary analysis of the COBRA randomised controlled trial.
Behaviour Research and TherapyAbstract:
How well do Cognitive Behavioural Therapy and Behavioural Activation for depression repair anhedonia? a secondary analysis of the COBRA randomised controlled trial
A secondary analysis of the COBRA randomized controlled trial was conducted to examine how well Cognitive Behavioural Therapy (CBT) and Behavioural Activation (BA) repair anhedonia. Patients with current major depressive disorder (N = 440) were randomized to receive BA or CBT, and anhedonia and depression outcomes were measured after acute treatment (six months) and at two further follow up intervals (12 and 18 months). Anhedonia was assessed using the Snaith Hamilton Pleasure Scale (SHAPS; a measure of consummatory pleasure). Both CBT and BA led to significant improvements in anhedonia during acute treatment, with no significant difference between treatments. Participants remained above healthy population averages of anhedonia at six months, and there was no further significant improvement in anhedonia at 12-month or 18-month follow up. Greater baseline anhedonia severity predicted reduced repair of depression symptoms and fewer depression-free days across the follow-up period following both BA and CBT. The extent of anhedonia repair was less marked than the extent of depression repair across both treatment arms. These findings demonstrate that CBT and BA are similarly and only partially effective in treating anhedonia. Therefore, both therapies should be further refined or novel treatments should be developed in order better to treat anhedonia.
Abstract.
Williams C, McClay C-A, Martinez R, Morrison J, Haig C, Jones R, Farrand P (2022). Online Cognitive Behavioral Therapy (CBT) Life Skills Program for Depression: Pilot Randomized Controlled Trial. JMIR Formative Research, 6(2).
2021
Lambert JD, Elliott LR, Taylor AH, Farrand P, Haase AM, Greaves CJ (2021). A novel method for assessing design fidelity in web-based behavioral interventions. Health Psychology, 40(3), 217-225.
Svedin F, Brantnell A, Farrand P, Blomberg O, Coumoundouros C, von Essen L, Åberg AC, Woodford J (2021). Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA): a study protocol using codesign and participatory action research.
BMJ Open,
11(7), e048097-e048097.
Abstract:
Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA): a study protocol using codesign and participatory action research
IntroductionDementia is a worldwide health concern with incident rates continuing to increase. While depression prevalence is high in people with dementia and psychological interventions such as cognitive behavioural therapy (CBT) are effective, access to psychological interventions remains limited. Reliance on traditional CBT for people with dementia and depression may present difficulties given it is a complex psychological approach, costly to deliver, and professional training time is lengthy. An alternative approach is behavioural activation (BA), a simpler psychological intervention for depression. The present study seeks to work with people with dementia, informal caregivers, community stakeholders, and healthcare professionals, to adapt a guided low-intensity BA intervention for people with dementia and depression, while maximising implementation potential within the Swedish healthcare context.Methods and analysisA mixed methods study using codesign, principles from participatory action research (PAR) and normalisation process theory to facilitate the cultural relevance, appropriateness and implementation potential of the intervention. The study will consist of four iterative PAR phases, using focus groups with healthcare professionals and community stakeholders, and semi-structured interviews with people with dementia and informal caregivers. A content analysis approach will be adopted to analyse the transcribed focus groups and semi-structured interviews recordings.Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki and data handled according to General Data Protection Regulation. Written informed consent will be obtained from all study participants. In accordance with the Swedish Health and Medical Services Act, capacity to consent will be examined by a member of the research team. Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-05542 and Dnr: 2021-00925). Findings will be published in an open access peer-reviewed journal, presented at academic conferences, and disseminated among lay and healthcare professional audiences.
Abstract.
Woodford J, Farrand P, Hagström J, Hedenmalm L, von Essen L (2021). Internet-Administered Cognitive Behavioral Therapy for Common Mental Health Difficulties in Parents of Children Treated for Cancer: Intervention Development and Description Study.
JMIR Form Res,
5(7).
Abstract:
Internet-Administered Cognitive Behavioral Therapy for Common Mental Health Difficulties in Parents of Children Treated for Cancer: Intervention Development and Description Study.
BACKGROUND: Following the end of a child's treatment for cancer, parents may report psychological distress. However, there is a lack of evidence-based interventions that are tailored to the population, and psychological support needs are commonly unmet. An internet-administered low-intensity cognitive behavioral therapy (LICBT)-based intervention (EJDeR [internetbaserad självhjälp för föräldrar till barn som avslutat en behandling mot cancer]) may provide a solution. OBJECTIVE: the first objective is to provide an overview of a multimethod approach that was used to inform the development of the EJDeR intervention. The second objective is to provide a detailed description of the EJDeR intervention in accordance with the Template for Intervention Description and Replication (TIDieR) checklist. METHODS: EJDeR was developed through a multimethod approach, which included the use of existing evidence, the conceptualization of distress, participatory action research, a cross-sectional survey, and professional and public involvement. Depending on the main presenting difficulty identified during assessment, LICBT behavioral activation or worry management treatment protocols are adopted for the treatment of depression or generalized anxiety disorder when experienced individually or when comorbid. EJDeR is delivered via the Uppsala University Psychosocial Care Programme (U-CARE) portal, a web-based platform that is designed to deliver internet-administered LICBT interventions and includes secure videoconferencing. To guide parents in the use of EJDeR, weekly written messages via the portal are provided by e-therapists comprising final year psychology program students with training in cognitive behavioral therapy. RESULTS: an overview of the development process and a description of EJDeR, which was informed by the TIDieR checklist, are presented. Adaptations that were made in response to public involvement are highlighted. CONCLUSIONS: EJDeR represents a novel, guided, internet-administered LICBT intervention for supporting parents of children treated for cancer. Adopting the TIDieR checklist offers the potential to enhance fidelity to the intervention protocol and facilitate later implementation. The intervention is currently being tested in a feasibility study (the ENGAGE study). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-023708.
Abstract.
Author URL.
Williams C, McClay C-A, Martinez R, Morrison J, Haig C, Jones R, Farrand P (2021). Online Cognitive Behavioral Therapy (CBT) Life Skills Program for Depression: Pilot Randomized Controlled Trial (Preprint).
Alharbi H, Farrand P, Laidlaw K (2021). Understanding the beliefs and attitudes towards mental health problems held by Muslim communities and acceptability of cognitive behavioural therapy as a treatment: systematic review and thematic synthesis protocol.
BMJ Open,
11(6).
Abstract:
Understanding the beliefs and attitudes towards mental health problems held by Muslim communities and acceptability of cognitive behavioural therapy as a treatment: systematic review and thematic synthesis protocol.
INTRODUCTION: Many barriers prevent Muslims' accessing mental health services, the aim of this systematic review is to gain an understanding regarding these barriers and consider how they vary across different Muslim communities resident in different countries. METHODS AND ANALYSIS: Systematic review of PubMed/MEDLINE, CINAHL, PsycINFO, Ovid MEDLINE, Embase and Index Islamicus databases for studies published in English in addition to the Saudi Digital Library for studies published in Arabic. The review will include quantitative, qualitative and mixed methods studies published in peer-review journals since 1980. Methodological quality and risk of bias of included papers will be critically appraised independently according to the Mixed Methods Appraisal Tool. Thematic synthesis will be used to extract outcome and analyse data from studies included in the review. ETHICS AND DISSEMINATION: There are considered to be no ethical issues. Findings will be disseminated in both English and Arabic to clinicians and researchers via journal publication and conference presentation(s). TRIAL REGISTRATION NUMBER: CRD42020192854.
Abstract.
Author URL.
2020
Woodford J, Farrand P, Hagström J, Hedenmalm L, von Essen L (2020). Guided, internet-administered, low-intensity Cognitive Behavioral Therapy, for the treatment of Depression and/or Generalized Anxiety Disorder in parents of children treated for cancer: Development and overview of the EJDeR intervention (Preprint).
Abstract:
Guided, internet-administered, low-intensity Cognitive Behavioral Therapy, for the treatment of Depression and/or Generalized Anxiety Disorder in parents of children treated for cancer: Development and overview of the EJDeR intervention (Preprint)
. BACKGROUND
. Parents of children treated for cancer may report psychological distress following the end of treatment. However, psychological support needs are commonly unmet and there is lack of evidence-based interventions tailored to the population. An internet-administered low-intensity Cognitive Behavioral Therapy (CBT) based self-help intervention (EJDeR; intErnetbaserad sJälvhjälp för förälDrar till barn som avslutat en behandling mot canceR) may provide a solution.
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. OBJECTIVE
. To describe the development of the EJDeR intervention adopting the Template for Intervention Description and Replication (TIDieR) checklist to detail specific intervention factors.
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. METHODS
. EJDeR was developed through a multistage approach, including the use of existing evidence, conceptualization of distress, participatory action research, cross- sectional survey, and professional and public involvement. It utilizes low-intensity CBT behavioral activation and worry management treatment protocols for Depression and/or Generalized Anxiety Disorder tailored towards the population. EJDeR is delivered via the U-CARE-portal, an online platform including written, film, audio content and videoconferencing, in-portal e-mail guidance, logging of participant and therapist activity, and automatic reminders. Parents are guided to use EJDeR by e-therapists, comprising psychology program students, in at least their fourth year of study after having completed a term of advanced studies in CBT.
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. RESULTS
. An overview of the development process and a description of EJDeR informed by the TIDieR checklist are presented. Adaptations to EJDeR made in response to public involvement are highlighted. EJDeR is currently being tested in a feasibility study of an internet-administered intervention for parents of children previously treated for cancer (the ENGAGE study).
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. CONCLUSIONS
. EJDeR represents a novel approach to support parents of children treated for cancer. Adopting a low-intensity CBT approach, guided by e-therapists, and internet-administered delivery represents a unique approach to improve access to mental health support for parents of children treated for cancer. Adopting TIDieR to report EJDeR offers potential to enhance fidelity to the intervention protocol and facilitate later implementation.
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. CLINICALTRIAL
. ENGAGE study: ISRCTN 57233429
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. INTERNATIONAL REGISTERED REPORT
. RR2-10.1136/bmjopen-2018-023708
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Abstract.
Farrand P, Woodford J, Coumoundouros C, Svedin F (2020). Supported cognitive-behavioural therapy self-help versus treatment-As-usual for depressed informal caregivers of stroke survivors (CEDArS): Feasibility randomised controlled trial.
Cognitive Behaviour Therapist,
13Abstract:
Supported cognitive-behavioural therapy self-help versus treatment-As-usual for depressed informal caregivers of stroke survivors (CEDArS): Feasibility randomised controlled trial
Demands placed on informal caregivers can result in an increased likelihood of experiencing common mental health difficulties that may affect their ability to undertake the caring role. Currently, however, few evidence-based interventions have been specifically developed for informal caregivers and available interventions are difficult to access. The Improving Access to Psychological Therapies (IAPT) programme aims to improve access to evidence-based psychological therapies for all groups and may therefore present an opportunity to meet informal caregiver needs. Located within the MRC Complex Intervention Framework, a Phase II feasibility randomised controlled trial (RCT) examines key methodological, procedural and clinical uncertainties associated with running a definitive Phase III RCT of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors. Recruitment was low despite different recruitment strategies being adopted, highlighting significant challenges moving towards a Phase III RCT until resolved. Difficulties with study recruitment may reflect wider challenges engaging informal caregivers in psychological interventions and may have implications for IAPT services seeking to improve access for this group. Further attempts to develop a successful recruitment protocol to progress to a Phase III RCT examining effectiveness of the adapted CBT self-help intervention should be encouraged. Key learning aims After reading this article, readers should be able to: (1) Consider key feasibility issues with regard to recruitment and attrition when running a randomised controlled trial of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors.(2) Understand potential barriers experienced by an informal caregiving population to accessing psychological interventions.(3) Appreciate implications for clinical practice to enhance access to IAPT services and low-intensity CBT working with an informal caregiver population.
Abstract.
2019
Farrand P, Mullan E, Rayson K, Engelbrecht A, Mead K, Greenberg N (2019). Adapting CBT to treat depression in Armed Forces Veterans: qualitative study.
Behav Cogn Psychother,
47(5), 530-540.
Abstract:
Adapting CBT to treat depression in Armed Forces Veterans: qualitative study.
BACKGROUND: the principles of the Armed Forces Covenant state that Armed Forces Veterans should be at no disadvantage resulting from their service compared with a general adult population. However, despite being at increased risk of experiencing common mental health difficulties, evidence indicates that 82% of Armed Forces Veterans receive no treatment, compared with 63% of the general adult population. AIM: to gain a better appreciation of factors that inform the type of adaptations to cognitive behavioural therapy (CBT) interventions for depression and mainstream service promotion materials to enhance acceptability for Armed Forces Veterans. METHOD: This is a qualitative study employing a focus group of 12 participants to examine the main impacts of depression on Armed Forces Veterans alongside attitudes towards terminology and visual imagery. Thematic analysis was used to identify themes and sub-themes with rigour established through two researchers independently developing thematic maps to inform a final agreed thematic map. RESULTS: a behavioural activation intervention supporting re-engagement with activities to overcome depression had good levels of acceptability when adapted to reflect an Armed Forces culture. Preferences regarding terminology commonly used within CBT adapted for Armed Forces Veterans were identified. Concerns were expressed with respect to using imagery that emphasized physical rather than mental health difficulties. CONCLUSIONS: There is the need to consider the Armed Forces community as a specific institutional culture when developing CBT approaches with potential to enhance engagement, completion and recovery rates. Results have potential to inform the practice of CBT with Armed Forces Veterans and future research.
Abstract.
Author URL.
2018
Farrand P, Jeffs A, Bloomfield T, Greenberg N, Watkins E, Mullan E (2018). Mental health service acceptability for the armed forces veteran community.
Occup Med (Lond),
68(6), 391-398.
Abstract:
Mental health service acceptability for the armed forces veteran community.
BACKGROUND: Despite developments in mental health services for armed forces veterans and family members, barriers to access associated with poor levels of acceptability regarding service provision remain. Adapting a Step 2 mental health service based on low-intensity cognitive behavioural therapy (CBT) interventions to represent a familiar context and meet the needs of the armed forces veteran community may serve to enhance acceptability and reduce help-seeking barriers. AIMS: to examine acceptability of a Step 2 low-intensity CBT mental health service adapted for armed forces veterans and family members provided by a UK Armed Forces charity. METHODS: Qualitative study using individual semi-structured interviews with armed forces veterans and family members of those injured or becoming unwell while serving in the British Armed Forces. Data analysis was undertaken using thematic alongside disconfirming case analysis. RESULTS: Adapting a Step 2 mental health service for armed forces veterans and family members enhanced acceptability and promoted help-seeking. Wider delivery characteristics associated with Step 2 mental health services within the Improving Access to Psychological Therapies (IAPT) programme also contributed to service acceptability. However, limitations of Step 2 mental health service provision were also identified. CONCLUSION: a Step 2 mental health service adapted for armed forces veterans and family members enhances acceptability and may potentially overcome help-seeking barriers. However, concerns remain regarding ways to accommodate the treatment of post-traumatic stress disorder and provide support for family members.
Abstract.
Author URL.
Lambert JD, Greaves CJ, Farrand P, Price L, Haase AM, Taylor AH (2018). Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults with Depression (The eMotion Study): Pilot Randomized Controlled Trial (Preprint).
Abstract:
Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults with Depression (The eMotion Study): Pilot Randomized Controlled Trial (Preprint)
. BACKGROUND
. Physical activity is a potentially effective treatment for depression and depressive relapse. However, promoting physical activity in people with depression is challenging. Interventions informed by theory and evidence are therefore needed to support people with depression to become more physically active. eMotion is a Web-based intervention combining behavioral activation and physical activity promotion for people in the community with symptoms of depression.
.
.
. OBJECTIVE
. The objectives were to assess the feasibility and acceptability of delivering eMotion to people in the community with symptoms of depression and to explore outcomes.
.
.
. METHODS
. Participants with elevated depressive symptoms were recruited from the community through various methods (eg, social media) and randomized to eMotion or a waiting list control group for 8 weeks. eMotion is an administratively supported weekly modular program that helps people use key behavior change techniques (eg, graded tasks, action planning, and self-monitoring) to re-engage in routine, pleasurable, and necessary activities, with a focus on physical activities. Feasibility data were collected that included the following: recruitment and trial retention rates; fidelity of intervention delivery, receipt, and enactment; and acceptability of the intervention and data collection procedures. Data were collected for the primary (depression) and secondary outcomes (eg, anxiety, physical activity, fidelity, and client satisfaction) at baseline and 2 months postrandomization using self-reported Web-based questionnaires and accelerometers. Delivery fidelity (logins, modules accessed, time spent) was tracked using Web usage statistics. Exploratory analyses were conducted on the primary and secondary outcomes.
.
.
. RESULTS
. of the 183 people who contacted the research team, 62 were recruited and randomized. The mean baseline score was 14.6 (SD 3.2) on the 8-item Patient Health Questionnaire depression scale (PHQ-8). of those randomized, 52 participants provided accelerometer-recorded physical activity data at baseline that showed a median of 35.8 (interquartile range [IQR] 0.0-98.6) minutes of moderate-to-vigorous physical activity (MVPA) recorded in at least 10-minute bouts per week, with only 13% (7/52) people achieving guideline levels (150 minutes of MVPA per week). In total, 81% (50/62) of participants provided follow-up data for the primary outcome (PHQ-8), but only 39% (24/62) provided follow-up accelerometer data. Within the intervention group, the median number of logins, modules accessed, and total minutes spent on eMotion was 3 (IQR 2.0-8.0), 3 (IQR 2.0-5.0), and 41.3 (IQR 18.9-90.4), respectively. Acceptability was mixed. Exploratory data analysis showed that PHQ-8 levels were lower for the intervention group than for the control group at 2 months postrandomization (adjusted mean difference −3.6, 95% CI −6.1 to −1.1).
.
.
. CONCLUSIONS
. It was feasible to deliver eMotion in UK communities to inactive populations. eMotion has the potential to be effective and is ready for testing in a full-scale trial. Further work is needed to improve engagement with both the intervention and data collection procedures.
.
.
. CLINICALTRIAL
. ClinicalTrials.gov NCT03084055; https://clinicaltrials.gov/ct2/show/NCT03084055 (Archived by WebCite at http://www.webcitation.org/6zoyM8UXa)
.
Abstract.
Woodford J, Farrand P, Watkins ER, Lewellyn DJ (2018). ”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: a Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms.
Clinical Gerontologist,
41(4), 293-307.
Abstract:
”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: a Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms
Objectives: Health and social care services are increasingly reliant on informal caregivers to provide long-term support to stroke survivors. However, caregiving is associated with elevated levels of depression and anxiety in the caregiver that may also negatively impact stroke survivor recovery. This qualitative study aims to understand the specific difficulties experienced by caregivers experiencing elevated symptoms of anxiety and depression. Methods: Nineteen semi-structured interviews were conducted with caregivers experiencing elevated levels of depression and anxiety, with a thematic analysis approach adopted for analysis. Results: Analysis revealed three main themes: Difficulties adapting to the caring role; Uncertainty; and Lack of support. Conclusions: Caregivers experienced significant difficulties adapting to changes and losses associated with becoming a caregiver, such as giving up roles and goals of importance and value. Such difficulties persisted into the long-term and were coupled with feelings of hopelessness and worry. Difficulties were further exacerbated by social isolation, lack of information and poor long-term health and social care support. Clinical Implications: a greater understanding of difficulties experienced by depressed and anxious caregivers may inform the development of psychological support targeting difficulties unique to the caring role. Improving caregiver mental health may also result in health benefits for stroke survivors themselves.
Abstract.
2017
Lambert JD, Greaves CJ, Farrand P, Cross R, Haase AM, Taylor AH (2017). Assessment of fidelity in individual level behaviour change interventions promoting physical activity among adults: a systematic review.
BMC Public Health,
17(1).
Abstract:
Assessment of fidelity in individual level behaviour change interventions promoting physical activity among adults: a systematic review.
BACKGROUND: Behaviour change interventions that promote physical activity have major implications for health and well-being. Measuring intervention fidelity is crucial in determining the extent to which an intervention is delivered as intended, therefore increasing scientific confidence about effectiveness. However, we lack a clear overview of how well intervention fidelity is typically assessed in physical activity trials. METHODS: a systematic literature search was conducted to identify peer - reviewed physical activity promotion trials that explicitly measured intervention fidelity. Methods used to assess intervention fidelity were categorised, narratively synthesised and critiqued using assessment criteria from NIH Behaviour Change Consortium (BCC) Treatment Fidelity Framework (design, training, delivery, receipt and enactment). RESULTS: Twenty eight articles reporting of twenty one studies used a wide variety of approaches to measure intervention fidelity. Delivery was the most common domain of intervention fidelity measured. Approaches used to measure fidelity across all domains varied from researcher coding of observational data (using checklists or scales) to participant self-report measures. There was considerable heterogeneity of methodological approaches to data collection with respect to instruments used, attention to psychometric properties, rater-selection, observational method and sampling strategies. CONCLUSIONS: in the field of physical activity interventions, fidelity measurement is highly heterogeneous both conceptually and methodologically. Clearer articulation of the core domains of intervention fidelity, along with appropriate measurement approaches for each domain are needed to improve the methodological quality of fidelity assessment in physical activity interventions. Recommendations are provided on how this situation can be improved.
Abstract.
Author URL.
Farrand P, Woodford J, Small F, Mullan E (2017). Behavioural activation self-help to improve depression in people living with dementia: the PROMOTE treatment protocol.
New Zealand Journal of Psychology,
46(2), 51-62.
Abstract:
Behavioural activation self-help to improve depression in people living with dementia: the PROMOTE treatment protocol
There is an increasing number of people living with dementia and depression, with support for people to live well with dementia becoming a global healthcare priority and seminal to the New Zealand Framework for Dementia Care (Ministry of Health, 2013). This paper overviews the clinical protocol for the PROMOTE self-help programme to inform the delivery of a written low intensity intervention based on behavioural activation for the treatment of depression and low mood in people with dementia. The primary aim of the programme is to decrease symptoms of depression and improve quality of life in people living with dementia. Support to the person living with dementia in the use of the PROMOTE programme is provided by an informal caregiver, who themselves receive guidance over the telephone by an appropriately trained mental health professional. This model of support and guidance represents a novel feature of the intervention, and one that potentially helps to increase access within the community.
Abstract.
Richards DA, Rhodes S, Ekers D, McMillan D, Taylor RS, Byford S, Barrett B, Finning K, Ganguli P, Warren F, et al (2017). Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression.
Health Technol Assess,
21(46), 1-366.
Abstract:
Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression.
BACKGROUND: Depression is a common, debilitating and costly disorder. The best-evidenced psychological therapy - cognitive-behavioural therapy (CBT) - is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative. OBJECTIVES: to determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months' follow-up, and to investigate the processes of treatments. DESIGN: Randomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation. SETTING: Three community mental health services in England. PARTICIPANTS: Adults aged ≥ 18 years with major depressive disorder (MDD) recruited from primary care and psychological therapy services. INTERVENTIONS: BA delivered by NHS junior mental health workers (MHWs); CBT by NHS psychological therapists. OUTCOMES: Primary: depression severity (as measured via the Patient Health Questionnaire-9; PHQ-9) at 12 months. Secondary: MDD status; number of depression-free days; anxiety (as measured via the Generalised Anxiety Disorder-7); health-related quality of life (as measured via the Short Form questionnaire-36 items) at 6, 12 and 18 months; and PHQ-9 at 6 and 18 months, all collected by assessors blinded to treatment allocation. Non-inferiority margin was 1.9 PHQ-9 points. We undertook intention-to-treat (ITT) and per protocol (PP) analyses. We explored cost-effectiveness by collecting direct treatment and other health- and social-care costs and calculating quality-adjusted life-years (QALYs) using the EuroQol-5 Dimensions, three-level version, at 18 months. RESULTS: We recruited 440 participants (BA, n = 221; CBT, n = 219); 175 (79%) BA and 189 (86%) CBT participants provided ITT data and 135 (61%) BA and 151 (69%) CBT participants provided PP data. At 12 months we found that BA was non-inferior to CBT {ITT: CBT 8.4 PHQ-9 points [standard deviation (SD) 7.5 PHQ-9 points], BA 8.4 PHQ-9 points (SD 7.0 PHQ-9 points), mean difference 0.1 PHQ-9 points, 95% confidence interval (CI) -1.3 to 1.5 PHQ-9 points, p = 0.89; PP: CBT 7.9 PHQ-9 points (SD 7.3 PHQ-9 points), BA 7.8 PHQ-9 points (SD 6.5 PHQ-9 points), mean difference 0.0 PHQ-9 points, 95% CI -1.5 to 1.6 PHQ-9 points, p = 0.99}. We found no differences in secondary outcomes. We found a significant difference in mean intervention costs (BA, £975; CBT, £1235; p
Abstract.
Author URL.
Finning K, Richards DA, Moore L, Ekers D, McMillan D, Farrand PA, O'Mahen HA, Watkins ER, Wright KA, Fletcher E, et al (2017). Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation.
BMJ Open,
7(4).
Abstract:
Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation.
OBJECTIVE: to explore participant views on acceptability, mechanisms of change and impact of behavioural activation (BA) delivered by junior mental health workers (MHWs) versus cognitive behavioural therapy (CBT) delivered by professional psychotherapists. DESIGN: Semistructured qualitative interviews analysed using a framework approach. PARTICIPANTS: 36 participants with major depressive disorder purposively sampled from a randomised controlled trial of BA versus CBT (the COBRA trial). SETTING: Primary care psychological therapies services in Devon, Durham and Leeds, UK. RESULTS: Elements of therapy considered to be beneficial included its length and regularity, the opportunity to learn and not dwelling on the past. Homework was an important, although challenging aspect of treatment. Therapists were perceived as experts who played an important role in treatment. For some participants the most important element of therapy was having someone to talk to, but for others the specific factors associated with BA and CBT were crucial, with behavioural change considered important for participants in both treatments, and cognitive change unsurprisingly discussed more by those receiving CBT. Both therapies were considered to have a positive impact on symptoms of depression and other areas of life including feelings about themselves, self-care, work and relationships. Barriers to therapy included work, family life and emotional challenges. A subset (n=2) of BA participants commented that therapy felt too simple, and MHWs could be perceived as inexperienced. Many participants saw therapy as a learning experience, providing them with tools to take away, with work on relapse prevention essential. CONCLUSIONS: Despite barriers for some participants, BA and CBT were perceived to have many benefits, to have brought about cognitive and behavioural change and to produce improvements in many domains of participants' lives. To optimise the delivery of BA, inexperienced junior MHWs should be supported through good quality training and ongoing supervision. TRIAL REGISTRATION NUMBER: ISRCTN27473954, 09/12/2011.
Abstract.
Author URL.
Lambert JD, Greaves CJ, Farrand P, Haase AM, Taylor AH (2017). Development of a web-based intervention (eMotion) based on behavioural activation to promote physical activity in people with depression.
Mental Health and Physical Activity,
13, 120-136.
Abstract:
Development of a web-based intervention (eMotion) based on behavioural activation to promote physical activity in people with depression
Increasing physical activity in people with depression may have the dual benefit of targeting mental and physical health outcomes (Faulkner & Taylor, 2012). This paper describes the development and theoretical framework for a web-based behavioural activation (BA) intervention, which specifically promotes physical activity (eMotion). The Centre for eHealth Research and Disease Management (CeHReS) roadmap (van Gemert-Pijnen et al. 2011) was used to guide the process of adapting an existing face to face intervention based on BA and physical activity (BAcPAc) (Farrand et al. 2014) to be used in an online context. The CeHReS roadmap promotes active stakeholder involvement and helped to ensure that key user needs were being catered to along the developmental process. Details about the background of the intervention are provided, including the theoretical framework. A detailed description of how eMotion was operationalised (in line with TIDieR guidelines (Hoffmann et al. 2014)) is also provided. eMotion aims to offer person-centred support through optimising engagement in web-based support, building on the previous BAcPAc trial.
Abstract.
O'Shea L, Watkins E, Farrand P (2017). Psychological interventions for the treatment of depression, anxiety, alcohol misuse or anger in armed forces veterans and their families: systematic review and meta-analysis protocol.
Syst Rev,
6(1).
Abstract:
Psychological interventions for the treatment of depression, anxiety, alcohol misuse or anger in armed forces veterans and their families: systematic review and meta-analysis protocol.
BACKGROUND: Evidence highlights a high prevalence of common mental health disorders in armed forces veterans and their families, with depression, anxiety, alcohol misuse and anger being more common than PTSD. This paper presents a protocol for a systematic review and meta-analysis to identify existing randomised controlled trial (RCT) research testing the effectiveness of psychological interventions for these difficulties in armed forces veterans and their family members. METHODS: Electronic databases (CENTRAL, PsycInfo, MEDLINE, CINAHL, the Cochrane Register of Clinical Trials, EMBASE and ASSIA) will be searched to identify suitable studies for inclusion in the review supplemented by forward and backward reference checking, grey literature searches and contact with subject authors. Research including armed forces veterans and their family members will be included in the review with research including serving personnel or individuals under the age of 18 being excluded. Few RCTs examining the treatment of depression, anxiety, alcohol misuse or anger exist in armed forces veterans to date. The primary outcome will be symptomatic change following intervention for these difficulties. The secondary outcomes will include methodological aspects of interest such as discharge type and recruitment setting if data permits. In the event that the number of studies identified is too low to undertake a meta-analysis, a narrative review will be conducted. Quality assessment will be undertaken using the Cochrane Collaboration Tool and Cochran's Q statistic calculated to test for heterogeneity as suggested by the Cochrane handbook. DISCUSSION: the review will examine the findings of existing intervention research for depression, anxiety, alcohol misuse or anger in armed forces veterans and their families, along with any effect sizes that may exist. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016036676.
Abstract.
Author URL.
2016
Ukoumunne OC, 1. Farrand P, Woodford J, Llewellyn D, Anderson M, Venkatasubramanian S, Adlam A, Dickens C (2016). Behavioural activation written self-help to improve mood, wellbeing and quality of life in people with dementia supported by informal carers (PROMOTE): study protocol for a single-arm feasibility study. Pilot and Feasibility Studies
Richards DA, Ekers D, McMillan D, Taylor RS, Byford S, Warren FC, Barrett B, Farrand PA, Gilbody S, Kuyken W, et al (2016). Cost and Outcome of Behavioural Activation versus
Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial. Lancet
Williams C, McClay C-A, Martinez R, Morrison J, Haig C, Jones R, Farrand P (2016). Online CBT life skills programme for low mood and anxiety: study protocol for a pilot randomized controlled trial.
Trials,
17(1).
Abstract:
Online CBT life skills programme for low mood and anxiety: study protocol for a pilot randomized controlled trial.
BACKGROUND: Low mood is a common mental health problem with significant health consequences. Studies have shown that cognitive behavioural therapy (CBT) is an effective treatment for low mood and anxiety when delivered one-to-one by an expert practitioner. However, access to this talking therapy is often limited and waiting lists can be long, although a range of low-intensity interventions that can increase access to services are available. These include guided self-help materials delivered via books, classes and online packages. This project aims to pilot a randomized controlled trial of an online CBT-based life skills course with community-based individuals experiencing low mood and anxiety. METHODS: Individuals with elevated symptoms of depression will be recruited directly from the community via online and newspaper advertisements. Participants will be remotely randomized to receive either immediate access or delayed access to the Living Life to the Full guided online CBT-based life skills package, with telephone or email support provided whilst they use the online intervention. The primary end point will be at 3 months post-randomization, at which point the delayed-access group will be offered the intervention. Levels of depression, anxiety, social functioning and satisfaction will be assessed. DISCUSSION: This pilot study will test the trial design, and ability to recruit and deliver the intervention. Drop-out rates will be assessed and the completion and acceptability of the package will be investigated. The study will also inform a sample size power calculation for a subsequent substantive randomized controlled trial. TRIAL REGISTRATION: ISRCTN ISRCTN12890709.
Abstract.
Author URL.
Farrand P, Matthews J, Dickens C, Martin A, Woodford J (2016). Psychological interventions to improve psychological well-being in people with dementia or mild cognitive impairment: Systematic review and meta-analysis protocol. BMJ Open, 6(e009713).
2015
Pentecost C, Farrand P, Greaves CJ, Taylor RS, Warren FC, Hillsdon M, Green C, Welsman JR, Rayson K, Evans PH, et al (2015). Combining behavioural activation with physical activity promotion for adults with depression: findings of a parallel-group pilot randomised controlled trial (BAcPAc).
Trials,
16(367), 1-15.
Abstract:
Combining behavioural activation with physical activity promotion for adults with depression: findings of a parallel-group pilot randomised controlled trial (BAcPAc)
Background
Depression is associated with physical inactivity, which may mediate the relationship between depression and a range of chronic physical health conditions. However, few interventions have combined a psychological intervention for depression with behaviour change techniques, such as behavioural activation (BA), to promote increased physical activity.
Methods
To determine procedural and clinical uncertainties to inform a definitive randomised controlled trial (RCT), a pilot parallel-group RCT was undertaken within two Improving Access to Psychological Therapies (IAPT) services in South West England. We aimed to recruit 80 adults with depression and randomise them to a supported, written self-help programme based on either BA or BA plus physical activity promotion (BAcPAc). Data were collected at baseline and 4 months post-randomisation to evaluate trial retention, intervention uptake and variance in outcomes to inform a sample size calculation. Qualitative data were collected from participants and psychological wellbeing practitioners (PWPs) to assess the acceptability and feasibility of the trial methods and the intervention. Routine data were collected to evaluate resource use and cost.
Results
Sixty people with depression were recruited, and a 73 % follow-up rate was achieved. Accelerometer physical activity data were collected for 64 % of those followed. Twenty participants (33 %) attended at least one treatment appointment. Interview data were analysed for 15 participants and 9 study PWPs. The study highlighted the challenges of conducting an RCT within existing IAPT services with high staff turnover and absences, participant scheduling issues, PWP and participant preferences for cognitive focussed treatment, and deviations from BA delivery protocols. The BAcPAc intervention was generally acceptable to patients and PWPs.
Conclusions
Although recruitment procedures and data collection were challenging, participants generally engaged with the BAcPAc self-help booklets and reported willingness to increase their physical activity. A number of feasibility issues were identified, in particular the under-use of BA as a treatment for depression, the difficulty that PWPs had in adapting their existing procedures for study purposes and the instability of the IAPT PWP workforce. These problems would need to be better understood and resolved before proceeding to a full-scale RCT.
Abstract.
Farrand P, Woodford J (2015). Effectiveness of cognitive behavioral self-help for the treatment of depression and anxiety in people with long-term physical health problems: a systematic review and meta-analysis of randomised controlled trials. Annals of Behavioural Medicine, 49, 579-593.
Farrand PA, Woodford J (2015). Effectiveness of cognitive behavioural (CBT) self-help for the treatment of depression and anxiety in people with long-term physical health conditions: a systematic review and meta-analysis of randomised controlled trials.
Annals of Behavioral MedicineAbstract:
Effectiveness of cognitive behavioural (CBT) self-help for the treatment of depression and anxiety in people with long-term physical health conditions: a systematic review and meta-analysis of randomised controlled trials.
Background Depression and anxiety are prevalent comorbidities in people with longterm physical health conditions. However in these groups there is limited access to evidence based treatments for the treatment of mental health difficulties.
Purpose a meta-analysis examined the effectiveness of cognitive behavioral (CBT) self-help in treating physical symptoms, depression and anxiety in people with long term conditions.
Methods Systematic search and meta-analysis of bibliographic databases, clinical trials registers, conference proceedings and expert contact.
Results 14 studies were included with a small effect size found across 11 studies reporting depressive (g=-0.20) and 8 studies anxiety symptoms (g=-0.21) as primary outcomes. 1 study examined physical health symptoms as a primary outcome, yielding a large effect size (g=-1.14). Moderator analysis revealed no significant moderators of the main effect.
Conclusions Limited evidence supports CBT self-help for depression, anxiety and physical symptoms in people with long-term conditions, with small effect sizes for depression and anxiety potentially dependent upon failure to recruit participants with clinical levels of these difficulties at baseline. Results
Abstract.
2014
Farrand P, Pentecost C, Greaves C, Taylor RS, Warren F, Green C, Hillsdon M, Evans P, Welsman J, Taylor AH, et al (2014). A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc).
Trials,
15Abstract:
A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc).
BACKGROUND: Challenges remain to find ways to support patients with depression who have low levels of physical activity (PA) to overcome perceived barriers and enhance the perceived value of PA for preventing future relapse. There is an evidence-base for behavioural activation (BA) for depression, which focuses on supporting patients to restore activities that have been avoided, but practitioners have no specific training in promoting PA. We aimed to design and evaluate an integrated BA and PA (BAcPAc) practitioner-led, written, self-help intervention to enhance both physical and mental health. METHODS/DESIGN: This study is informed by the Medical Research Council Complex Intervention Framework and describes a protocol for a pilot phase II randomised controlled trial (RCT) to test the feasibility and acceptability of the trial methods to inform a definitive phase III RCT. Following development of the augmented written self-help intervention (BAcPAc) incorporating behavioural activation with physical activity promotion, depressed adults are randomised to receive up to 12 sessions over a maximum of 4 months of either BAcPAc or behavioural activation alone within a written self-help format, which represents treatment as usual. The study is located within two 'Improving Access to Psychological Therapies' services in South West England, with both written self-help interventions supported by mental health paraprofessionals. Measures assessed at 4, 9, and 12 month follow-up include the following: CIS-R, PHQ-9, accelerometer recorded (4 months only) and self-reported PA, body mass index, blood pressure, Insomnia Severity Index, quality of life, and health and social care service use. Process evaluation will include analysis of recorded support sessions and patient and practitioner interviews. At the time of writing the study has recruited 60 patients. DISCUSSION: the feasibility outcomes will inform a definitive RCT to assess the clinical and cost-effectiveness of the augmented BAcPAc written self-help intervention to reduce depression and depressive relapse, and bring about improvements across a range of physical health outcomes. TRIAL REGISTRATION: Current Controlled Trials ISRCTN74390532, 26.03.2013.
Abstract.
Author URL.
Rhodes S, Richards DA, Ekers D, McMillan D, Byford S, Farrand PA, Gilbody S, Hollon SD, Kuyken W, Martell C, et al (2014). Cost and outcome of behavioural activation versus cognitive behaviour therapy for depression (COBRA): study protocol for a randomised controlled trial.
Trials,
15Abstract:
Cost and outcome of behavioural activation versus cognitive behaviour therapy for depression (COBRA): study protocol for a randomised controlled trial.
BACKGROUND: Cognitive behaviour therapy (CBT) is an effective treatment for depression. However, CBT is a complex therapy that requires highly trained and qualified practitioners, and its scalability is therefore limited by the costs of training and employing sufficient therapists to meet demand. Behavioural activation (BA) is a psychological treatment for depression that may be an effective alternative to CBT and, because it is simpler, might also be delivered by less highly trained and specialised mental health workers. METHODS/DESIGN: COBRA is a two-arm, non-inferiority, patient-level randomised controlled trial, including clinical, economic, and process evaluations comparing CBT delivered by highly trained professional therapists to BA delivered by junior professional or para-professional mental health workers to establish whether the clinical effectiveness of BA is non-inferior to CBT and if BA is cost effective compared to CBT. Four hundred and forty patients with major depressive disorder will be recruited through screening in primary care. We will analyse for non-inferiority in per-protocol and intention-to-treat populations. Our primary outcome will be severity of depression symptoms (Patient Health Questionnaire-9) at 12 months follow-up. Secondary outcomes will be clinically significant change and severity of depression at 18 months, and anxiety (General Anxiety Disorder-7 questionnaire) and health-related quality of life (Short-Form Health Survey-36) at 12 and 18 months. Our economic evaluation will take the United Kingdom National Health Service/Personal Social Services perspective to include costs of the interventions, health and social care services used, plus productivity losses. Cost-effectiveness will explored in terms of quality-adjusted life years using the EuroQol-5D measure of health-related quality of life. DISCUSSION: the clinical and economic outcomes of this trial will provide the evidence to help policy makers, clinicians and guideline developers decide on the merits of including BA as a first-line treatment of depression. TRIAL REGISTRATION: Current Controlled Trials ISRCTN27473954.
Abstract.
Author URL.
Parkin T, de Looy A, Farrand P (2014). Greater professional empathy leads to higher agreement about decisions made in the consultation.
Patient Education and Counseling,
96(2), 144-150.
Abstract:
Greater professional empathy leads to higher agreement about decisions made in the consultation
Objective: to examine the relationship between professional expression of empathy and agreement about decisions made in the consultation. Methods: Consultations between 86 individuals with diabetes and four dieticians were audio-recorded. Immediately following consultations patients and dieticians independently reported decisions made in a booklet. Audio-recordings were coded directly for empathy using an amended version of the empathic communication coding system (ECCS). Results: Empathy correlated significantly with patient and professional agreement about decisions made in the consultation (τ=.283, p=.0005). Multiple regression analysis indicates that for each dietician the greater the empathy the higher the level of agreement about decisions (p
Abstract.
Parkin T, de Looy A, Farrand P (2014). Greater professional empathy leads to higher agreement about decisions made in the consultation.
Patient Educ Couns,
96(2), 144-150.
Abstract:
Greater professional empathy leads to higher agreement about decisions made in the consultation.
OBJECTIVE: to examine the relationship between professional expression of empathy and agreement about decisions made in the consultation. METHODS: Consultations between 86 individuals with diabetes and four dieticians were audio-recorded. Immediately following consultations patients and dieticians independently reported decisions made in a booklet. Audio-recordings were coded directly for empathy using an amended version of the empathic communication coding system (ECCS). RESULTS: Empathy correlated significantly with patient and professional agreement about decisions made in the consultation (τ=.283, p=.0005). Multiple regression analysis indicates that for each dietician the greater the empathy the higher the level of agreement about decisions (p
Abstract.
Author URL.
Woodford J, Farrand P, Watkins ER, Richards DA, Llewellyn DJ (2014). Supported cognitive-behavioural self-help versus treatment-as-usual for depressed informal carers of stroke survivors (CEDArS): study protocol for a feasibility randomized controlled trial.
Trials,
157Abstract:
Supported cognitive-behavioural self-help versus treatment-as-usual for depressed informal carers of stroke survivors (CEDArS): study protocol for a feasibility randomized controlled trial
Background
Increased life expectancy has resulted in a greater provision of informal care within the community for patients with chronic physical health conditions. Informal carers are at greater risk of poor mental health, with one in three informal carers of stroke survivors experiencing depression. However, currently no psychological treatments tailored to the unique needs of depressed informal carers of stroke survivors exist. Furthermore, informal carers of stroke survivors experience a number of barriers to attending traditional face-to-face psychological services, such as lack of time and the demands of the caring role. The increased flexibility associated with supported cognitive behavioral therapy self-help (CBTsh), such as the ability for support to be provided by telephone, email, or face-to-face, alongside shorter support sessions, may help overcome such barriers to access. CBTsh, tailored to depressed informal carers of stroke survivors may represent an effective and acceptable solution.
Methods
This study is a Phase II (feasibility) randomized controlled trial (RCT) following guidance in the MRC Complex Interventions Research Methods Framework. We will randomize a sample of depressed informal carers of stroke survivors to receive CBT self-help supported by mental health paraprofessionals, or treatment-as-usual. Consistent with the objectives of assessing the feasibility of trial design and procedures for a potential larger scale trial we will measure the following outcomes: a) feasibility of patient recruitment (recruitment and refusal rates); (b) feasibility and acceptability of data collection procedures; (c) levels of attrition; (d) likely intervention effect size; (e) variability in number, length and frequency of support sessions estimated to bring about recovery; and (f) acceptability of the intervention. Additionally, we will collect data on the diagnosis of depression, symptoms of depression and anxiety, functional impairment, carer burden, quality of life, and stroke survivor mobility skill, self-care and functional ability, measured at four and six months post-randomization.
Discussion
This study will provide important information for the feasibility and design of a Phase III (effectiveness) trial in the future. If the intervention is identified to be feasible, effective, and acceptable, a written CBTsh intervention for informal carers of stroke survivors, supported by mental health paraprofessionals, could represent a cost-effective model of care.
Trial registration: Current Controlled Trials ISRCTN63590486.
Abstract.
Author URL.
2013
Gilbert T, Farrand P, Lankshear G (2013). "I Don't want to Live like This Anymore": Disrupted Habitus in Young People "At Risk" of Diagnosis of Personality Disorder.
YOUTH & SOCIETY,
45(3), 347-364.
Author URL.
Parkin T, Looy A, Farrand P (2013). An observational study exploring information exchange in consultations.
Author URL.
Harris S, Farrand P, Dickens C (2013). Behavioural activation interventions for depressed individuals with a chronic physical illness: a systematic review protocol.
Syst Rev,
2Abstract:
Behavioural activation interventions for depressed individuals with a chronic physical illness: a systematic review protocol.
BACKGROUND: Depression is common in people with chronic physical illness and is associated with worse medical outcomes. Cognitive behavioural therapy and problem-solving improve depression, although usually have small to moderate effects among people with chronic physical illness. Behavioural activation interventions for depression, which aim to increase positive reinforcement from the environment by encouraging individuals to increase pleasant/rewarding activities, have been reported to be equivalent to cognitive behavioural therapy. However, the effectiveness of behavioural activation interventions for depression in individuals with chronic physical illness is unclear. The aims of this systematic review are to identify the extent to which different forms of behavioural activation have been used as a treatment for depression in this population, examine the effectiveness of the interventions, and identify any adaptations which have been made specifically to the interventions for individuals with a range of chronic physical illnesses. METHODS/DESIGN: Electronic databases will be systematically searched using terms relevant to behavioural activation and depression, and the subset of studies in people with chronic physical illnesses will be identified by manual searching. References and citations of eligible studies will be searched and experts in this field will be contacted to identify additional papers. All study designs will be included in this review to allow for a more extensive identification of the extent of different forms of behavioural activation interventions. The different forms of behavioural activation and the specific chronic physical health conditions for which this intervention has been used will be reviewed narratively. For the effectiveness of the interventions, if sufficient randomised controlled trials have been undertaken the results will be meta-analysed. Non-randomised studies will be narratively synthesised and adaptations to the interventions will also be narratively reviewed. DISCUSSION: the findings will inform the design, development and subsequent evaluation of a behavioural activation intervention for depression in people with a chronic physical illness. PROSPERO registration number: CRD42013004500.
Abstract.
Author URL.
Farrand P, Woodford J (2013). Impact of support on the effectiveness of written cognitive behavioural self-help: a systematic review and meta-analysis of randomised controlled trials.
Clinical Psychology Review,
33(1), 182-195.
Abstract:
Impact of support on the effectiveness of written cognitive behavioural self-help: a systematic review and meta-analysis of randomised controlled trials.
Cognitive behavioural therapy self-help is an effective intervention for a range of common mental health difficulties. However the extent to which effectiveness may vary by type of support--guided, minimal contact, self-administered--has not been extensively considered. This review identifies the impact of support on the effectiveness of written cognitive behavioural self-help and further explores the extent to which effectiveness varies across mental health condition by type of support provided. Randomised controlled trials were identified by searching relevant bibliographic databases, clinical trials registers, conference proceedings and expert contact. 38 studies were included in the meta-analysis yielding a statistically significant overall mean effect size (Hedges' g=-0.49). Overall effect size did not significantly differ by type of support (Q=0.85, df=2, p=0.65) (guided: Hedges' g=-0.53; minimal contact: Hedges' g=-0.55; self-administered: Hedges' g=-0.42). For guided and self-administered types of support, planned comparisons revealed a trend for effect size to vary by mental health condition and for guided CBT self-help the modality of support was significant (Q=6.32, df=2, p=0.04), with the largest effect size associated with telephone delivery (Hedges' g=-0.91). Additional moderator analysis was undertaken for depression given the number of available studies. Regardless of higher baseline levels of severity the effect size for minimal contact was greater than for guided support. Greater consideration should be given to the potential that type of support may be related to the effectiveness of written cognitive behavioural self-help and that this may vary across mental health condition. Findings from this systematic review make several recommendations to inform future research.
Abstract.
Author URL.
Osborne R, Dunne E, Farrand P (2013). Integrating technologies into "authentic" assessment design: an affordances approach.
Research in Learning Technology,
21Abstract:
Integrating technologies into "authentic" assessment design: an affordances approach
Current pressures in higher education around student employability are driving new initiatives for change. Assessment is also a topic of debate, as it is a key driver of student behaviour, yet often falls behind other metrics in national surveys. In addition, increasing focus on digital literacies is catalysing new appreciations of what emerging digital culture might mean for both students and staff. These three highly topical challenges were jointly explored by the University of Exeter's Collaborate project, which aimed to create employability-focused assessments enhanced by technology. By combining existing research on assessment with grounded data derived from local stakeholders, the project has developed a model for assessment design which embeds employability directly into the curriculum. Digital technologies have been aligned with this model using a "top trump" metaphor, where key affordances of technologies are highlighted in the context of the model. This paper explores the design-based research approach taken to develop this model and associated "top trumps", along with results from the first practical iteration. Results suggest that the model is effective in supporting the design of an "authentic" assessment and that a targeted affordances approach can support the alignment of specific technologies with a particular pedagogic design. © 2013 R. Osborne et al.
Abstract.
Farrand P, Woodford, J (2013). Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW.
Quality of Life Research,
22(4), 829-838.
Abstract:
Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW
PURPOSE:
To examine both the feasibility of applying the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting procedure (SEIQoL-DW) as a routine outcome measure within an early intervention service for young people with indicated personality disorder and the overall quality of life (QoL) in this population.
METHODS:
SEIQoL-DW was administered alongside the Standardised Assessment of Personality-Abbreviated Scale-Self-Report (SAPAS-SR), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and the Post-Traumatic Stress Disorder-Primary Care (PTSD-PC) as part of routine service evaluation over a 16-month period. Descriptive statistics were calculated for data reflecting use of the SEIQoL-DW alongside demographic and outcome variables.
RESULTS:
The SEIQoL-DW was administered to 52 young adults with indicated personality disorder, with 47 completing the measure, taking an average time of 27 min. Individual QoL was poor with a mean global index score of 55.07 (SD = 22.34). Individual QoL areas formed five main domains-'Aspects of Daily Living', 'Relationships', 'Social Life and Leisure', 'Family' and 'Emotional and Physical Wellbeing'.
CONCLUSION:
This study further extends the application of the SEIQoL-DW for use as a routine outcome measure within a busy service setting, although ways to accommodate administration time need to be considered. Poor QoL highlights the need for continued development of services to meet the needs of young adults with indicated personality disorder.
Abstract.
Woodford J, Farrand P, Richards D, Llewellyn DJ (2013). Psychological treatments for common mental health problems experienced by informal carers of adults with chronic physical health conditions (Protocol).
Syst Rev,
2Abstract:
Psychological treatments for common mental health problems experienced by informal carers of adults with chronic physical health conditions (Protocol).
BACKGROUND: Improved life expectancy is resulting in increased outpatient treatment of people with chronic physical health conditions and reliance on the provision of informal care in the community. However, informal care is also associated with increased risk of experiencing common mental health difficulties such as depression and anxiety. Currently there is a lack of evidence-based treatments for such difficulties, resulting in poor health outcomes for both the informal carer and care recipient. METHODS/DESIGN: Electronic databases will be systemically searched for randomised controlled trials examining the effectiveness of psychological interventions targeted at treating depression or anxiety experienced by informal carers of patients with chronic physical health conditions. Database searches will be supplemented by contact with experts, reference and citation checking and grey literature. Both published and unpublished research in English language will be reviewed with no limitations on year or source. Individual, group and patient-carer dyad focused interventions will be eligible. Primary outcomes of interest will be validated self-report or clinician administered measures of depression or anxiety. If data allows a meta-analysis will examine: (1) the overall effectiveness of psychological interventions in relation to outcomes of depression or anxiety; (2) intervention components associated with effectiveness. DISCUSSION: This review will provide evidence on the effectiveness of psychological interventions for depression and anxiety experienced by informal carers of patients with chronic physical health conditions. In addition, it will examine intervention components associated with effectiveness. Results will inform the design and development of a psychological intervention for carers of people with chronic physical health conditions experiencing depression and anxiety. PROSPERO registration number: CRD42012003114.
Abstract.
Author URL.
2012
Farmer C, Farrand P, O'Mahen H (2012). 'I am not a depressed person': how identity conflict affects help-seeking rates for major depressive disorder.
BMC Psychiatry,
12Abstract:
'I am not a depressed person': how identity conflict affects help-seeking rates for major depressive disorder.
BACKGROUND: There is a significant treatment gap for patients with depression. A third of sufferers never seek help, and the vast majority of those who do only do so after considerable delay. Little is understood regarding poor help-seeking rates amongst people with depression, with existing research mainly focussed on the impact of barriers to treatment. The current study explored psychological factors affecting help-seeking behaviour in clinically depressed individuals. METHODS: Semi-structured interviews were conducted with 20 current or previously clinically depressed participants who either had or had not sought professional help. Thematic analysis was used to analyse results. RESULTS: the onset of depressive symptoms created conflict with participants' identity and personal goals. Delays in seeking help were primarily attributed to the desire to protect identity and goals from the threat of depressive symptoms. Participants used avoidance strategies to reduce the perceived threat of depressive symptoms on identity. These strategies interfered with help-seeking. Help-seeking was only undertaken once participants reached a point of acceptance and began to make concessions in their identity and goals, at which time they reduced their use of avoidance. CONCLUSIONS: Difficulties resolving conflict between identity and depressive symptoms may account for significant delays in seeking help for depression. The results have implications for predicting health behaviour and improving treatment uptake for depression, and may inform existing help-seeking models.
Abstract.
Author URL.
Woodford J, Farrand P, Richards DA, Llewellyn D (2012). Coping in informal carers of stroke survivors: a comparison of coping strategies used by depressed and non-depressed informal carers.
Author URL.
Gilbert A, Farrand P, Lankshear G (2012). Crisis and loss in the social experiences of young adults with undiagnosed personality disorder.
Illness Crisis and Loss,
20(2), 119-140.
Abstract:
Crisis and loss in the social experiences of young adults with undiagnosed personality disorder
This qualitative study focuses on the social experiences of a group of young women and men who engaged with a street level organization providing an early intervention service for young people "at risk" of diagnosis of personality disorder. Semi-structured interviews provided a range of insights into their lives which are characterized by difficult relationships and a range of risky and self-harming behaviors. Analysis produced three themes that highlight the onset of difficulties and dysfunctional relationships, the triggers for the current episode of difficulties, and the quality of family and other forms of support. This provided an overarching view of social circumstances that are embedded with crisis embodied by self-harm and a sense of loss for an "imagined" or "idealized" family that is symbolized by dysfunctional and abusive relationships. © 2012, Baywood Publishing Co. Inc.
Abstract.
Farrand P, Woodford J (2012). Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW.
Quality of Life Research,
22(4), 829-838.
Abstract:
Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW
Purpose: to examine both the feasibility of applying the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting procedure (SEIQoL-DW) as a routine outcome measure within an early intervention service for young people with indicated personality disorder and the overall quality of life (QoL) in this population.
Methods: SEIQoL-DW was administered alongside the Standardised Assessment of Personality Abbreviated Scale - Self-Report (SAPAS-SR); Patient Health Questionnaire (PHQ-9); Generalised Anxiety Disorder Scale (GAD-7) and the Post-Traumatic Stress Disorder-Primary Care (PTSD-PC) as part of routine service evaluation over a 16 month period. Descriptive statistics were calculated for data reflecting use of the SEIQoL-DW alongside demographic and outcome variables.
Results: the SEIQoL-DW was administered to 52 young adults with indicated personality disorder, with 47 completing the measure, taking an average time of 27 minutes. Individual QoL was poor with a mean global index score of 55.07 (sd = 22.34). Individual QoL areas formed five main domains - ‘Aspects of Daily Living’, ‘Relationships’, ‘Social Life and Leisure’, ‘Family’, ‘Emotional and Physical Wellbeing’.
Conclusion: This study further extends the application of the SEIQoL-DW for use as a routine outcome measure within a busy service setting, although ways to accommodate administration time need to be considered. Poor QoL highlights the need for continued development of services to meet the needs of young adults with indicated personality disorder.
Abstract.
Gilbert T, Farrand P, Lankshear G (2012). Troubled lives: Chaos and trauma in the accounts of young people considered 'at risk' of diagnosis of personality disorder.
Scandinavian Journal of Caring Sciences,
26(4), 747-754.
Abstract:
Troubled lives: Chaos and trauma in the accounts of young people considered 'at risk' of diagnosis of personality disorder
This study explores accounts provided by 27 young people who had contact with an early intervention service for young people considered to be 'at risk' of diagnosis of personality disorder. These accounts, developed from semi-structured interviews, focussed on their experiences prior to and since referral, which normally followed an episode of extremely risky behaviour such as self-harm or a suicide attempt. Analysis provided three themes. These focussed on the chaotic lifestyles of the young people, which were punctuated by episodes of self-harm and other risky behaviours; the unsupportive or traumatic relationships with parents and partners, which culminated in a toxic mix of isolation and self-blame and the role of case coordinators. The lack of stable adult relationships is evident. Findings suggest the establishment of stable, supportive adult relationships with a view to providing a problem-solving approach with the aim of guiding young people away from risky acts and their traumatic consequences may be fruitful. The challenge is to find a sustainable way of establishing such a model outside of paid relationships. The other challenge is to develop research approaches with similarly placed young people, which enable ongoing contact. © 2012 Nordic College of Caring Science.
Abstract.
Gilbert T, Farrand P, Lankshear G (2012). Troubled lives: chaos and trauma in the accounts of young people considered at risk' of diagnosis of personality disorder.
SCANDINAVIAN JOURNAL OF CARING SCIENCES,
26(4), 747-754.
Author URL.
2011
Woodford J, Farrand P, Bessant M, Williams C (2011). Recruitment into a guided internet based CBT (iCBT) intervention for depression: Lesson learnt from the failure of a prevalence recruitment strategy.
CONTEMPORARY CLINICAL TRIALS,
32(5), 641-648.
Author URL.
2010
Farrand P, Williams C (2010). Assessment in low intensity psychological therapy. In Bennett-Levy J, Richards D, Farrand P (Eds.) The Oxford Guide to Low Intensity CBT Interventions, Oxford: Oxford University Press.
Farrand P, Woodford J (2010). Developing guided books on prescription schemes. In Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh D, Klein B, Lau MA, Proudfoot J, Ritterband L (Eds.)
Oxford Guide to Low Intensity CBT Interventions, Oxford: Oxford University Press.
Abstract:
Developing guided books on prescription schemes
Abstract.
Farrand P, Perry J, Linsley S (2010). Enhancing Self-Practice/Self-Reflection (SP/SR) approach to cognitive behaviour training through the use of reflective blogs.
Behav Cogn Psychother,
38(4), 473-477.
Abstract:
Enhancing Self-Practice/Self-Reflection (SP/SR) approach to cognitive behaviour training through the use of reflective blogs.
BACKGROUND: Self-Practice/Self-Reflection (SP/SR) is increasingly beginning to feature as a central component of CBT training programmes (Bennett-Levy et al. 2001). Programmes including a reflective element, however, are not unproblematic and it has been documented that simply setting time aside for reflection does not necessarily result in trainees using such time to reflect. Such limitations may be overcome by including a requirement to post reflections on reflective blogs. AIM: to examine the effect that a requirement to contribute to a reflective blog had upon a SP/SR approach to CBT training. METHOD: a focus group methodology was adopted with data analyzed using a general inductive qualitative approach. RESULTS: the requirement to use blogs to reflect upon the self-practice of CBT techniques enhanced SP/SR, established a learning community, and improved course supervision, although some technical difficulties arose. CONCLUSIONS: Consideration should be given towards using reflective blogs to support a SP/SR approach to CBT training. Benefits afforded by the use of reflective blogs further establish SP/SR as a valid and flexible training approach.
Abstract.
Author URL.
Owens C, Farrand P, Emmens T, Darvill R, Hewis E, Aitken P (2010). Involving service users in intervention design: a participatory approach to developing a text-messaging intervention to reduce repetition of self-harm. Health Expectations, 14, 285-295.
Bennett-Levy J, Richards DA, Farrand P (2010). Low Intensity CBT Interventions: a Revolution in Mental Health Services. In Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh D, Klein B, Lau MA, Proudfoot J, Ritterband L (Eds.)
Oxford Guide to Low Intensity CBT Interventions, Oxford: Oxford University Press.
Abstract:
Low Intensity CBT Interventions: a Revolution in Mental Health Services.
Abstract.
Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh D, Klein B, Lau MA, Proudfoot J, Ritterband L, et al (2010).
Oxford Guide to Low Intensity CBT Interventions.Abstract:
Oxford Guide to Low Intensity CBT Interventions
Abstract.
Darvill R, Skirton H, Farrand P (2010). Psychological factors that impact on women's experiences of first-time motherhood: a qualitative study of the transition.
Midwifery,
26(3), 357-366.
Abstract:
Psychological factors that impact on women's experiences of first-time motherhood: a qualitative study of the transition.
OBJECTIVE: childbearing is a significant transition, especially for first-time mothers. The objectives of this study were to explore the maternal transition from womens' perspectives and to identify any unmet needs for support. DESIGN: grounded theory was chosen as the most appropriate method of analysis due to its ability to identify social processes in an inductive way. Semi-structured interviews were used to collect data from the participants, and the interview transcripts were analysed using the constant comparative method. SETTING: communities within one region of the UK. PARTICIPANTS: 13 women (aged 16 years) who had delivered their first child six to 15 weeks prior to the interview were recruited to the study. FINDINGS: three main themes (control, support and forming a family) all contributed to the core category: 'changes in the woman's self-concept'. Women felt that they had lost some control over their lives in the early stages of pregnancy and after the birth. The early changes in their self-image and the shift in focus from themselves to the needs of the fetus indicate that the transition may begin at a very early stage in the first trimester. The unfamiliar territory of pregnancy and early motherhood created a need for a mentor or mentors to help guide them through the transition, and to 'normalise' their feelings and experiences. Finally, the women recognised that the act of childbearing fundamentally transformed them and their partners from individuals or a couple into founding members of a new family. KEY CONCLUSIONS: first-time mothers start to undergo a transition at an early stage in their pregnancy. They face difficult periods both early in the pregnancy and after the birth, and have unmet needs for support in those periods, particularly the support of other new mothers. IMPLICATIONS FOR PRACTICE: providing more information about early pregnancy before conception may enable women to form more accurate expectations of this period. Facilitating contact between pregnant mothers would help them to establish a more appropriate support network prior to the birth.
Abstract.
Author URL.
Woodford J, Farrand P, Williams C (2010). Recruitment into a guided internet based CBT intervention for depression: Lessons learnt from the failure of a prevalence recruitment strategy. Conference of the British Association of Behavioural and Cognitive Psychotherapies. 20th - 23rd Jul 2010.
Abstract:
Recruitment into a guided internet based CBT intervention for depression: Lessons learnt from the failure of a prevalence recruitment strategy.
Abstract.
Richards DA, Farrand P (2010). Sorting the wheat from the chaff: Selecting written self-help materials. In Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh D, Klein B, Lau MA, Proudfoot J, Ritterband L (Eds.)
Oxford Guide to Low Intensity CBT Interventions, Oxford: Oxford University Press.
Abstract:
Sorting the wheat from the chaff: Selecting written self-help materials.
Abstract.
Farrand P, Perry J, Linsley S (2010). The use of reflective blogs to support self-practice, self reflection in the training of cognitive behavioural therapists. BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPY, 38, 473-477.
2009
Farrand P, Booth N, Gilbert T, Lankshear G (2009). Engagement and early termination of contact with a community-based early intervention service for personality disorder in young adults.
Early Intervention in Psychiatry: the development, onset and treatment of emerging mental disorders,
3(3), 204-212.
Abstract:
Engagement and early termination of contact with a community-based early intervention service for personality disorder in young adults.
Few studies have examined factors associated with continuity of care in a community-based early intervention service for personality disorder in patients aged 16-25.
Abstract.
Author URL.
Farrand P, Confue P, Byng R, Shaw S (2009). Guided self-help supported by paraprofessional mental health workers: an uncontrolled before--after cohort study.
Health Soc Care Community,
17(1), 9-17.
Abstract:
Guided self-help supported by paraprofessional mental health workers: an uncontrolled before--after cohort study.
There has been considerable development of guided self-help clinics within primary care. This uncontrolled before-after cohort study examines efficiency and effectiveness of these clinics when supported by paraprofessional mental health workers having little mental health training and experience. Data were collected by seven Graduate Mental Health Workers (GMHW) located in South-west England. Alongside an analysis of clinic attendance and dropout, efficiency was measured with respect to the number and length of sessions to support patients with the effectiveness of the interventions examined with respect to problem severity. Over a 15-month period, 1162 patients were referred to the GMHW clinics with 658 adopting guided self-help. Patients using guided self-help received an average input per patient, excluding assessment, of four sessions of 40 minutes. Dropout rate was comparable to other primary-care-based mental health clinics supported by experienced mental health professionals with 458 patients completing all support sessions. However, only 233 patients went on to attend the 3 months of follow-up session. Effectiveness of guided self-help clinics supported by paraprofessional mental health workers was comparable to that supported by an experienced mental health nurse. Improvements in problem severity were statistically significant, with 55% and 58% (final support session) and 63% and 62% (3 months of follow-up) of patients experiencing clinically significant and reliable change for anxiety and depression, respectively. However, concerns exist over the efficiency of the GMHW clinic especially with respect to the use of longer support sessions and high dropout rate at the 3 months of follow-up session. The paper concludes by highlighting the effectiveness of guided self-help when supported by paraprofessional mental health workers, but questions the utility of the two-plus-one model of service delivery proposing a collaborative care approach as an alternative.
Abstract.
Author URL.
Mitchell A, Farrand P, James H, Luke R, Purtell R, Wyatt K (2009). Patients' experience of transition onto haemodialysis: a qualitative study.
J Ren Care,
35(2), 99-107.
Abstract:
Patients' experience of transition onto haemodialysis: a qualitative study.
Transition onto haemodialysis is a time of increased psychosocial difficulty, yet, many renal patients exhibit personal resilience in continuing to lead productive lives. Using a positive psychological methodology, this qualitative study aims to identify factors identified by patients as helpful in the transition onto haemodialysis. Semi-structured interviews were undertaken with 10 patients within six months of starting haemodialysis. Interpretive content analysis identified three main themes (each with subthemes) in patients' accounts-preparation, cognitive style and social support. Limited differences arose between patients who underwent a gradual versus acute transition onto haemodialysis. Themes are discussed with reference to implications for practice development.
Abstract.
Author URL.
Farrand P, Endacott R (2009). Speech and Quality of Life following Total Laryngectomy: a Case of the Emperors New Voice?. In Preedy VR, Watson RR (Eds.)
Handbook of Disease Burdens and Quality of Life Measures, Springer Verlag.
Abstract:
Speech and Quality of Life following Total Laryngectomy: a Case of the Emperors New Voice?
Abstract.
2008
Jones RB, Martinez R, Maramba I, Prestwich J, McCauley M, Farrand P, Williams C (2008). Exploratory study of chat room motivational support for users of an Internet-based cognitive behavioural therapy for the treatment of depression. In Kay S (Ed) Healthcare Computing, Weybridge:.
2007
Farrand P, Duncan F (2007). Generic health-related quality of life amongst patients employing different voice restoration methods following total laryngectomy.
Psychol Health Med,
12(3), 255-265.
Abstract:
Generic health-related quality of life amongst patients employing different voice restoration methods following total laryngectomy.
Three methods of voice restoration--tracheosophageal speech (TEP), oesophageal speech, electrolarynx--are available following total laryngectomy. TEP produces better voice quality compared with other methods and is assumed to result in better quality of life. Little evidence exists to support the relationship between voice quality and quality of life, however. Advertising this study through several leading laryngectomy charities resulted in the completion of 226 questionnaires (TEP = 147; oesophageal speech = 42; electrolarynx = 37) comprising the Short Form 36 (SF-36) quality of life measure and questions examining perceived voice intelligibility. Additionally, 89 questionnaires comprising only the SF-36 were completed by participants who reported having no serious medical problems, to form a healthy control group. Results indicate that improved voice quality does not result in widespread benefits to quality of life. On only a few dimensions were there differences between voice restoration method: electrolarynx and TEP better than oesophageal speech with respect to pain, TEP better than oesophageal speech with respect to role limitation: physical problems. Additionally whilst widespread differences between voice restoration methods did not occur, all three groups had a worse quality of life compared with the healthy control group. Implications of the results for the selection of voice restoration method to maximize quality of life are discussed.
Abstract.
Author URL.
Farrand P, Duncan F, Byng R (2007). Impact of graduate mental health workers upon primary care mental health: a qualitative study.
Health Soc Care Community,
15(5), 486-493.
Abstract:
Impact of graduate mental health workers upon primary care mental health: a qualitative study.
The role of the primary care graduate mental health worker (GMHW) was developed to improve the availability of mental health services within primary care. However, little is known concerning the impact of the role upon primary care mental health. Semistructured interviews were undertaken with 27 key stakeholders (12 clients, 10 managers/supervisors, 5 general practitioners) who had experience of the GMHW role and activities provided. Thematic analysis of interview transcripts highlighted four main themes: Access to primary care mental health, Inappropriate referrals, GMHW characteristics, and Role developments. All participant groups highlighted a range of ways in which the GMHW role was making significant contributions to primary care mental health. Many of these were associated with increasing access to mental health services afforded by the range of interventions provided. Benefits, however, may exclude working clients who expressed concerns about a lack of flexibility in the appointment times offered. Concerns arise as a consequence of inappropriate referrals made by some general practitioners. Such referrals were, in part, motivated by a belief that developments in primary care mental health should have been directed towards clients with more severe difficulties. In conclusion, this study suggests that the GMHW role is having a significant impact upon primary care mental health. Attempts to improve primary care mental health through the incorporation of the GMHW role within stepped care models of mental health service delivery should be encouraged.
Abstract.
Author URL.
Farrand P, Parker M, Lee C (2007). Intention of adolescents to seek professional help for emotional and behavioural difficulties.
Health Soc Care Community,
15(5), 464-473.
Abstract:
Intention of adolescents to seek professional help for emotional and behavioural difficulties.
Much is known about adolescent help seeking for severe mental health problems. Little is currently understood about the professionals that adolescents would seek help from for milder emotional and behavioural difficulties. A self-report questionnaire was completed by 968 adolescents (53% male), aged 13-14 years in school year 9, and 15-16 years in school year 11 (64% male), attending a purposive sample of four medium to large secondary schools in Devon, UK, during February 2005. Questionnaires were completed by adolescents during whole class teaching sessions with all in attendance being willing to participate. However, 39 (4%) responses were uncompleted or incorrectly completed and removed from subsequent analysis. Questionnaires contained a series of commonly experienced difficulties and asked adolescents to indicate who they would seek help from first, if anyone, from a list of professionals identified as common providers of support. Logistic regression analyses indicated that intention to seek help varied between a low of 30% for adolescents in Year 11 on the difficulty 'were arguing all the time with your parents' to a high of 95% for females on the difficulty 'had been unfairly treated or spoken to by a teacher' with Year and Sex influencing each difficulty separately. With the exception of the difficulty 'were feeling "down" for a long time' there was a high degree of discrimination regarding the professional group (School vs. Health) that would be approached for help. With respect to specific professionals, the Form tutor featured prominently across several difficulties involving school, friends and family (range 53-65%), but also significantly across several difficulties suggestive of emotional problems (range 49-61%). General practitioners were commonly identified as providing help with difficulties sleeping (76%), and along with the school nurse with problems concerning health advice (range 38-49%). Findings highlight the influence of Year and Sex, and importance of the Form tutor in adolescent help seeking across the range of difficulties. A need is identified for further training of Form tutors in recognition of their role in supporting the interface between adolescents and services aimed at engaging young people and a recognition by health and social care professionals regarding the importance of this role.
Abstract.
Author URL.
2006
Farrand P, Perry J, Lee C, Parker M (2006). Adolescents' preference towards self-help: Implications for service development.
Primary Care and Community Psychiatry,
11(2), 73-79.
Abstract:
Adolescents' preference towards self-help: Implications for service development
Objectives: Self-help interventions for mental health problems experienced by adults have undergone development with significant benefits reported. Similar benefits resulting from such interventions may potentially also arise for adolescents. However, little is known concerning the attitudes held by adolescents towards using self-help in the event that they experienced mental health or personal difficulties. Such understanding would be useful with respect to informing service development and hence influencing the extent to which such interventions would be adopted. Method: a survey method was employed. A single-sided questionnaire was administered to 1001 adolescents within four secondary schools, with 968 (97%) returned completed. The questionnaire initially provided examples of a range of mental health and personal difficulties alongside a brief description of self-help. Questions then examined whether adolescents would use self-help in the event that they experienced the difficulties presented and if so preferences for use with respect to format, location and professional preferred for support. Results: the majority of adolescents (681; 73%) suggested that they would intend to adopt self-help were they to experience a mild to moderate mental health difficulty. Either format was selected by 302 (44%) adolescents, whilst 267 (39%) and 112 (17%) were only willing to adopt a computer or book based format, respectively. There was a strong preference to use self-help at home with support provided by the form tutor, a school based professional, when requested. Conclusions: Results indicate that self-help may be acceptable to the majority of adolescents. Implications for the development of school based self-help schemes for adolescents are discussed. © 2006 LIBRAPHARM LIMITED.
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Farrand P, Rowe R (2006). Areca nut use amongst South Asian schoolchildren in Tower Hamlets, London: the extent to which the habit is engaged in within the family and used to suppress hunger.
Community Dent Health,
23(1), 58-60.
Abstract:
Areca nut use amongst South Asian schoolchildren in Tower Hamlets, London: the extent to which the habit is engaged in within the family and used to suppress hunger.
OBJECTIVES: to examine the extent to which an areca nut habit is engaged in within the family and degree to which the habit may be used to suppress hunger amongst South Asian schoolchildren with a view to informing health promotion campaigns. RESEARCH DESIGN: Self-administered questionnaire. SETTING: Two comprehensive schools (one mixed, one all girls) in the Tower Hamlets district of East London, UK. PARTICIPANTS: 341 (285 girls; 56 boys) children of self-reported South Asian origin (Bangladeshi 286, Pakistani 4, Asian, 51) who reported currently engaging in an areca nut habit. RESULTS: Areca nut habits were mainly used in a family context. Smaller proportions of children reported predominant use alone or with peers. A substantial minority reported using their habit to suppress hunger. CONCLUSION: the family plays a crucial role in maintaining areca nut use. This implies effective health promotion campaigns must operate at the family and even community levels rather than being targeted at the children directly.
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Farrand P, McMullan M, Jowett R, Humphreys A (2006). Implementing competency recommendations into pre-registration nursing curricula: effects upon levels of confidence in clinical skills.
Nurse Educ Today,
26(2), 97-103.
Abstract:
Implementing competency recommendations into pre-registration nursing curricula: effects upon levels of confidence in clinical skills.
The competency based pre-registration nursing curriculum was introduced to address concerns about levels of confidence and competence in skills of newly qualified Project 2000 educated nurses [Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Healthcare. The Stationary Office, London]. This study sought to examine whether the implementation of the competency recommendations has led to improvements in the confidence of nursing students in their clinical skills. A self-administered questionnaire examining ratings of confidence in areas of nursing practice and core competencies as specified by the Nursing and Midwifery Council (NMC) [UKCC, 2001. Requirements for Pre-registration Nursing Programmes. UKCC, London] was administered to 139 final year adult nursing students who were studying with the Project 2000 or competency curriculum. The response rate was 53%, results indicating that the students studying the competency curriculum have higher levels of confidence in all areas of their practice targeted by the competency recommendations than students studying in the Project 2000 curriculum. The positive effect that the competency recommendations had upon levels of confidence in nursing practice, and the implications of such changes to curricula are discussed.
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Farrand P, Duncan F, Byng R (2006). Roles undertaken by graduate mental health workers across South West England.
PRIMARY CARE & COMMUNITY PSYCHIATRY,
11(1), 21-27.
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2005
Farrand P (2005). Development of a supported self-help book prescription scheme in primary care.
Primary Care Mental Health,
3(1), 61-66.
Abstract:
Development of a supported self-help book prescription scheme in primary care
The treatment of mild to moderate mental health problems places extreme pressures upon primary care. To help ease these pressures, a number of self-help book schemes have been developed across the UK. This paper describes the development of a variant to these schemes. In addition to a prescription for a self-help book, clients also receive support in its use via specially developed self-help clinics. It is hoped that the supported self-help book scheme will not only help to increase access to a viable form of psychological treatment within primary care, but through support will also help to make the self-help approach acceptable to a greater number of users. © 2005 Radcliffe Publishing.
Abstract.
2004
Dewhurst SA, Farrand P (2004). Investigating the phenomenological characteristics of false recognition for categorised words.
European Journal of Cognitive Psychology,
16(3), 403-416.
Abstract:
Investigating the phenomenological characteristics of false recognition for categorised words
Previous research (Dewhurst & Anderson, 1999) has shown that the presentation of multiple items from the same semantic category leads to the false recognition of previously unstudied category members. The present study explored the characteristics of these illusory memories by asking participants to assign each recognised item to either "remember", "know", or "guess" response categories and to give verbal descriptions explaining each response. Descriptions of both correct and false remember responses consisted of detailed accounts of images, thoughts, and memories that participants claimed to have experienced at encoding. These findings illustrate the ease with which detailed illusory memories can be created in the laboratory and the difficulty of differentiating between true recollections of actual events and false recollections of events that did not occur.
Abstract.
Farrand P (2004). Social psychological foundations of health and illness. Journal of Advanced Nursing, 46(3), 342-342.
2003
Arthur SK, Evans DF, Farrand P, Yazaki E (2003). Altered bowel habit due to time zone shifts: a pilot study.
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Farrand P, Clover H, Hutchison IL (2003). GDPs' self-perceived confidence and anxiety in their clinical and communication skills used when screening for oral cancer: UK variations.
Prim Dent Care,
10(3), 81-86.
Abstract:
GDPs' self-perceived confidence and anxiety in their clinical and communication skills used when screening for oral cancer: UK variations.
OBJECTIVE: to compare anxieties of general dental practitioners (GDPs) across the UK in communicating with patients about oral cancer and confidence in clinical skills required to perform soft tissue screening for oral cancer. DESIGN: a questionnaire was sent to 2200 randomly selected GDPs from across the UK. Responses to the questionnaires were analysed using 95% confidence intervals. SETTING: Dental practitioners in general practice within England, Northern Ireland, Scotland and Wales. RESULTS: the response rate varied between 57% in England and 65% in Northern Ireland. A high percentage of dental practitioners across all UK regions reported performing soft tissue examinations (range 78% to 88%). The number of soft tissue examinations per month varied between 129 (95% CI 109, 148) and 162 (95% CI 154, 170) indicating criteria when selecting patients for screening. Using a nine-point rating scale (1 = not at all, 9 = extremely), confidence in the clinical skills required during oral cancer screening was generally good (ratings varying between 5.4 and 6.7). With the exception of reporting positive findings to patients (rating 4.5 to 5.2), anxiety in communication skills used during oral cancer screening was generally low (ratings varying between 1.8 and 3.9). CONCLUSION: While concerns over generalizing the results exist, the situation with respect to the clinical and communication skills required by GDPs during oral cancer screening is generally encouraging. An area of concern is discussing positive findings with patients. This may be overcome by developing specialist courses on breaking bad news within undergraduate dental curricula and programmes of continuing professional development.
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2002
Farrand P (2002). Psychology of medicine and surgery: a guide for psychologists, counsellors, nurses and doctors.
Psychology and Psychotherapy: theory, research and practice,
75, 115-116.
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Farrand P, Hussain F, Hennessy E (2002). The efficacy of the 'mind map' study technique.
Med Educ,
36(5), 426-431.
Abstract:
The efficacy of the 'mind map' study technique.
OBJECTIVES: to examine the effectiveness of using the 'mind map' study technique to improve factual recall from written information. DESIGN: to obtain baseline data, subjects completed a short test based on a 600-word passage of text prior to being randomly allocated to form two groups: 'self-selected study technique' and 'mind map'. After a 30-minute interval the self-selected study technique group were exposed to the same passage of text previously seen and told to apply existing study techniques. Subjects in the mind map group were trained in the mind map technique and told to apply it to the passage of text. Recall was measured after an interfering task and a week later. Measures of motivation were taken. SETTING: Barts and the London School of Medicine and Dentistry, University of London. SUBJECTS: 50 second- and third-year medical students. RESULTS: Recall of factual material improved for both the mind map and self-selected study technique groups at immediate test compared with baseline. However this improvement was only robust after a week for those in the mind map group. At 1 week, the factual knowledge in the mind map group was greater by 10% (adjusting for baseline) (95% CI -1% to 22%). However motivation for the technique used was lower in the mind map group; if motivation could have been made equal in the groups, the improvement with mind mapping would have been 15% (95% CI 3% to 27%). CONCLUSION: Mind maps provide an effective study technique when applied to written material. However before mind maps are generally adopted as a study technique, consideration has to be given towards ways of improving motivation amongst users.
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2001
Farrand P, Rowe RM, Johnston A, Murdoch H (2001). Prevalence, age of onset and demographic relationships of different areca nut habits amongst children in Tower Hamlets, London.
Br Dent J,
190(3), 150-154.
Abstract:
Prevalence, age of onset and demographic relationships of different areca nut habits amongst children in Tower Hamlets, London.
OBJECTIVE: to examine prevalence and demographic relationships of different areca nut habits amongst children. DESIGN: Self-administered questionnaire. SUBJECTS: Children aged between 11 and 15. of 800 questionnaires distributed, 704 were fully completed (88%). SETTING: Two secondary schools in the London district of Tower Hamlets. MEASURES: Demographic, areca nut habits used, age first used, still using, frequency of use. RESULTS: Users of any areca nut habit were exclusively from the South Asian population. of this population, 77% had engaged in a habit, and dependent upon habit between 54 and 92% of these still remained current users. The highest prevalence of current use for boys and girls respectively was for areca nut alone (36%, 43%), followed by mistee pan (35%, 29%), betel-quid (27%, 26%) and pan masala (14%, 16%). of the current users, 44% engaged in one habit only, 24% two, 20% three and 13% all four. The highest period of risk for starting to use areca nut alone, betel-quid and mistee pan was between ages 5 and 12, whilst for pan masala it was after 10. Boys had a significantly higher risk of beginning use before 10 (P <. 001) and a higher frequency of use for pan masala (P<. 01), areca nut alone (P<. 05) and betel-quid (P =. 06) than girls. The frequency of using each habit was between 3 and 5 episodes per week, however boys use pan masala approximately 10 times per week. CONCLUSION: South Asian children may already be experienced users of areca nut. Greater attention should be directed towards identifying signs of oral submucous fibrosis, oral cancer and other potentially malignant lesions within the South Asian population.
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Farrand P, McKenna FP (2001). Risk perception in novice drivers: the relationship between questionnaire measures and response latency.
Transportation Research Part F: Traffic Psychology and Behaviour,
4(3), 201-212.
Abstract:
Risk perception in novice drivers: the relationship between questionnaire measures and response latency
The extent to which questionnaire based measures of driving risk, driving ability and accident likelihood are associated with response latency based measures obtained on a hazard perception test was examined. In Experiment 1 questionnaire evaluations of driving in general were obtained and correlated with hazard perception performance. In Experiment 2 questionnaire evaluations and hazard perception performance were obtained when drivers viewed the same driving scenes. In neither experiment did questionnaire responses correlate significantly with hazard perception performance. Additionally while in both experiments no difference in hazard perception performance arose between males and females, females rated driving as more risky and their ability to be lower than males. The results indicate independence between questionnaire and response latency measures of hazard perception. However the possibility that both approaches should be adopted within a single framework is raised. © 2001 Elsevier Science Ltd.
Abstract.
Farrand P, Parmentier FB, Jones DM (2001). Temporal-spatial memory: retrieval of spatial information does not reduce recency.
Acta Psychol (Amst),
106(3), 285-301.
Abstract:
Temporal-spatial memory: retrieval of spatial information does not reduce recency.
Factors influencing the shape of serial position curves in non-verbal serial short-term memory were examined, using a task testing memory for the position of dots. Similar recency slopes were found when both position and order were recalled (Experiment 1A) and when order only was required (Experiment 1B). This observation was confirmed and tested further in conditions requiring the same encoding but different amounts of spatial information at retrieval (Experiment 2). However, Experiment 2 also revealed an effect of spatial information retrieval on the overall level of memory for recency items. Overall, the results indicate that spatial items produce bow-shaped serial positions curves in tasks requiring the maintenance of order information and that recency is affected by the demand on spatial information retrieval in terms of the overall level of performance but not in terms of the recency slope. These findings are contrary to what is found in the literature on serial verbal recall when both item and order information are required.
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Ali N, Farrand P (2001). The Human Face. BMJ, 322(7286).
2000
Farrand P (2000). Psychological approaches to dermatology. BRIT J MED PSYCHOL, 73, 429-429.
1996
Farrand P, Jones D (1996). Direction of report in spatial and verbal serial short-term memory.
Q J Exp Psychol A,
49(1), 140-158.
Abstract:
Direction of report in spatial and verbal serial short-term memory.
Four experiments examined the role played by item and order information in determining the effects of order of report of a sequence from short-term memory. Experiments in which list items were re-presented prior to recall so that only their order had to be reported showed no differences in performance between the forward and backward direction of report. This result was found with lists of auditory-verbal, visual-verbal, and spatial stimuli. When the list items were not re-presented, so that recall of both items and order was required, recall in the backward direction of report was significantly worse than in the forward direction of report, both in spatial and verbal tasks. The results point to the symmetry of inter-item associations, though only equivocally so, but they suggest strongly that the processes of spatial and verbal serial recall share many functional characteristics.
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1995
Jones D, Farrand P, Stuart G, Morris N (1995). Functional equivalence of verbal and spatial information in serial short-term memory.
J Exp Psychol Learn Mem Cogn,
21(4), 1008-1018.
Abstract:
Functional equivalence of verbal and spatial information in serial short-term memory.
Performance on a test of serial memory for the spatial position of a sequence of dots showed similarities to typical results from the serial recall of verbal material: a marked increase in error with increasing list length, a modest rise in error as retention interval increased, and bow-shaped serial position curves. This task was susceptible to interference from both a spatial task (rote tapping) and a verbal task (mouthed articulatory suppression) and also from the presence of irrelevant speech. Effects were comparable to those found with a serial verbal task that was generally similar in demand characteristics to the spatial task. As a generalization, disruption of the serial recall of visuospatial material was more marked if the interference conditions involved a changing sequence of actions or materials, but not if a single event (tap, mouthed utterance, or sound) was repeated.
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