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Preliminary evaluation of a “formulation-driven cognitive behavioral guided self-help (fCBT-GSH)” for crisis and transitional case management clients

Authors Naeem F, Johal RK, Mckenna C, Calancie O, Munshi T, Hassan T, Nasar A, Ayub M

Received 13 November 2016

Accepted for publication 16 December 2016

Published 10 March 2017 Volume 2017:13 Pages 769—774


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder

Farooq Naeem,1,2 Rupinder K Johal,1 Claire Mckenna,1 Olivia Calancie,1 Tariq Munshi,1,2 Tariq Hassan,1 Amina Nasar,3 Muhammad Ayub1

1Department of Psychiatry, Queen’s University, Kingston, ON, Canada; 2Addiction and Mental Health Services – Kingston, Frontenac, Lennox & Addington (AMHS-KFLA), Kingston, ON, Canada; 3Services Institute of Medical Sciences, Lahore, Pakistan

Background: Cognitive behavioral therapy (CBT) is found to be effective for common mental disorders and has been delivered in self-help and guided self-help formats. Crisis and transitional case management (TCM) services play a vital role in managing clients in acute mental health crises. It is, therefore, an appropriate setting to try CBT in guided self-help format.
Methods: This was a preliminary evaluation of a formulation-driven cognitive behavioral guided self-help. Thirty-six (36) consenting participants with a diagnosis of nonpsychotic illness, attending crisis and the TCM services in Kingston, Canada, were recruited in this study. They were randomly assigned to the guided self-help plus treatment as usual (TAU) (treatment group) or to TAU alone (control group). The intervention was delivered over 8–12 weeks. Assessments were completed at baseline and 3 months after baseline. The primary outcome was a reduction in general psychopathology, and this was done using Clinical Outcomes in Routine Evaluation – Outcome Measure. The secondary outcomes included a reduction in depression, measured using the Hospital Anxiety and Depression Scale, and reduction in disability, measured using the World Health Organization Disability Assessment Schedule 2.0.
Findings: Participants in the treatment group showed statistically significant improvement in overall psychopathology (P<0.005), anxiety and depression (P<0.005), and disability (P<0.005) at the end of the trial compared with TAU group.
Conclusion: A formulation-driven cognitive behavioral guided self-help was feasible for the crisis and TCM clients and can be effective in improving mental health, when compared with TAU. This is the first report of a trial of guided self-help for clients attending crisis and TCM services.

Keywords: mental health crisis, transitional case management, cognitive behavior therapy, guided, self help

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