Roger Baker - Academia.edu (original) (raw)
Papers by Roger Baker
The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designe... more The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designed to measure emotional processing styles and deficits. Scale development is an ongoing process and our aim was to (i) refine the scale by trying out items from a new item pool and (ii) shorten the scale to enhance its clinical and research utility. Fifteen new items were added to the original 38-item pool. The resulting 53-item scale was administered to four groups (N=690) (mental health, healthy controls, pain patients, and general medical practice attendees). Exploratory factor analysis was used to explore the underlying factor structure. Maximum likelihood (ML) factor analysis was used to guide the process of item selection and scale reduction. Four of the previous eight factors remained in similar form, two of the original factors were discarded, and one new factor emerged incorporating items from two previous factors. The revised version of the scale (EPS-25) has a 25-item five-factor structure. Internal reliability was moderate to high for all five factors. The psychometric properties of the revised scale appear promising, particularly in relation to the detection of differences between diagnostic groups.
Seizure, 2015
This exploratory study aimed to examine emotion-processing styles in patients with psychogenic no... more This exploratory study aimed to examine emotion-processing styles in patients with psychogenic non-epileptic seizures (PNES), compared to healthy individuals, and to explore associations of emotion processing with other psychological measures and seizure frequency, using the new Emotional Processing Scale (EPS-25), which had not previously been used in this patient group. Fifty consecutive patients with PNES referred for psychotherapy completed a set of self-report questionnaires, including the Emotional Processing Scale (EPS-25), Clinical Outcome in Routine Evaluation (CORE-10), Short Form-36 (SF-36), Patient Health Questionnaire (PHQ-15), and Brief Illness Perception Questionnaire (BIPQ). Responses on the EPS-25 were compared to data from 224 healthy controls. Patients with PNES had greater emotion processing deficits across all dimensions of the EPS-25 than healthy individuals (suppression/unprocessed emotion/unregulated emotion/avoidance/impoverished emotional experience). Impaired emotion processing was highly correlated with psychological distress, more frequent and severe somatic symptoms, and a more threatening understanding of the symptoms. Emotion processing problems were also associated with reduced health-related quality of life on the mental health (but not the physical health) component of the SF-36. The unregulated emotions sub-scale of the EPS was associated with lower seizure frequency. The results showed clear impairments of emotion processing in patients with PNES compared to healthy individuals, which were associated with greater psychological distress and reduced mental health functioning. These findings seem to support the face validity of the EPS-25 as a measure for PNES patients and its potential as a tool to assess the effectiveness of psychological interventions.
Journal of Advanced Nursing, Aug 31, 1988
Token economy in a hospital rehabilitation system A ward-based token economy programme which form... more Token economy in a hospital rehabilitation system A ward-based token economy programme which formed one part ofa larger rehabilitative serviee for long-stay psychiatric patients is described. The elinical effectiveness ofthe programme is examined by the use of various nursing, psychological and psychiatric assessments before and after the patients' treatment on the ward, and the progress of former patients is foliowed-up as they move to different parts ofthe rehabilitation service. Significant clinical gains in patients' psychiatric symptomatology and problem behaviour on the ward are reported, although there were indications that improvement was not fully maintained as the patients moved on to other parts ofthe service. Comparison ofthe present clinical programme with the earlier research programmes on the ward indicated that the present regime was superior. The advantages and problems of token economy as a rehabilitative facility are discussed, outlining the various different roles for token economy with psychiatric rehabilitation. Finally, the future of token economy for long-stay patients is considered, questioning whether it might more appropriately be replaced by other structured ward programmes.
Children Amp Society, Nov 1, 2001
Children with developmental delays often suffer feeding difŪculties. It has become common for tho... more Children with developmental delays often suffer feeding difŪculties. It has become common for those with a severe likelihood of malnutrition to be considered for alternative methods of nutritional intake, often a gastrostomy. As part of a pilot study investigating the effects of gastrostomy ...
Age and ageing, 2004
Great strides have been made in recent years in the management of falls. In care settings for old... more Great strides have been made in recent years in the management of falls. In care settings for older people it is time now to develop criteria which will allow us to move on from recording fall quantity to fall quality. It is time to work with staff and colleagues in care settings to ensure that reasonable and realistic policies, practices and expectations prevail. Healthcare professionals should also now belatedly engage with the lay public, with patients and families about falls and risk management. A risk-free life is no life at all.
The British journal of general practice : the journal of the Royal College of General Practitioners, 1998
Research into the effectiveness of counselling in primary care is rare. This study attempts to pr... more Research into the effectiveness of counselling in primary care is rare. This study attempts to provide a thorough evaluation of the effects of a new counselling service introduced throughout Dorset. To evaluate the impact of counselling on client symptomatology, self-esteem, and quality of life. The effect of counselling on drug prescribing, referrals to other mental health professionals, and client and general practitioner (GP) satisfaction were also assessed. All new clients referred for counselling were asked to complete and return questionnaires before and after counselling. A total of 385 clients took part in the study. The first and second assessments were compared statistically. Clients were ascribed a psychiatric diagnosis using a simplified version of DSM-IIIR (Diagnostic and Statistical Manual of the American Psychiatric Association). GPs' views of the service were determined using a specially designed questionnaire. Drug data were obtained from the Prescription Pricin...
Reviews, 1996
The unpredictable, variable nature of Multiple Sclerosis (MS), and the possibility of increasing ... more The unpredictable, variable nature of Multiple Sclerosis (MS), and the possibility of increasing disability, means that a diagnosis can have substantial psychological consequences. To assess the effectiveness of psychological interventions for people with MS. We searched 19 databases up to December 2004; Cochrane MS Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsychINFO, CINAHL and 14 others. We searched reference lists of articles, wrote to corresponding authors of the 13 papers identified by June 2004, and searched for trials in progress using 3 research registers. Randomised controlled trials of interventions described as wholly or mostly based on psychological theory and practice, in people with MS. Primary outcome measures were disease specific and general quality of life, psychiatric symptoms, psychological functioning, disability, and cognitive outcomes. Secondary outcome measures were number of relapses, pain, fatigue, health care utilisation, changes in medication, and adherence to other therapies. Pertinent studies were identified from abstracts by one author. Full papers were independently compared to selection criteria by four authors. Key details were extracted from relevant papers using a standard format, and studies scored on three dimensions of quality. The review is organised into four mini-reviews (MR) dependent on the intervention's target population; people with cognitive impairments (MR1), people with moderate to severe disability (MR2), people with MS (no other criteria) (MR3), and people with depression (MR4). Overall 16 studies were identified and included. MR1: three trials (n=145). Some evidence of effectiveness of cognitive rehabilitation on cognitive outcomes, although this was difficult to interpret because of the large number of outcome measures used. MR2: three trials (n=80). One small trial suggesting psychotherapy may help with depression. MR3: seven studies (n=688). Some evidence that cognitive behavioural therapy may help people adjust to, and cope with, having MS (three trials). The other trials were diverse in nature and some difficult to interpret because of multiple outcome measures. MR4: three trials (n=93). Two small studies of cognitive behavioural therapy showed significant improvements in depression. The diversity of psychological interventions identified indicates the many ways in which they can potentially help people with MS. No definite conclusions can be made from this review. However there is reasonable evidence that cognitive behavioural approaches are beneficial in the treatment of depression, and in helping people adjust to, and cope with, having MS.
BMC Neurology, 2014
Background: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS... more Background: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS). The aim was to evaluate the effectiveness at 1-year follow-up of a manualised group-based programme ('FACETS') for managing MS-fatigue.
Schizophrenia Bulletin, 1988
The renewed interest in the care and treatment of chronic psychiatric patients has led to an awar... more The renewed interest in the care and treatment of chronic psychiatric patients has led to an awareness of the need for improved assessment methods for this group. This article describes the development of REHAB, a behavior rating scale for use with people with chronic psychiatric disability, which has been carefully designed with respect to content, format, and ease of use. The article also draws together the various factor-analytic, reliability, validity, and sensitivity-tochange studies that provide the basic psychometric evidence for the scale's value. REHAB is presented as an integrated package of materials with special attention paid to training of raters and simplicity of interpretation. It has been used for a variety of different assessment purposes, in both research and clinical settings.
Palliative Medicine, 2003
This paper is a development on recent research that proved the value of non-pharmacological techn... more This paper is a development on recent research that proved the value of non-pharmacological techniques and strategies in the management of breathlessness in lung cancer. It evaluates the intervention in a specialist palliative care setting using an outpatient clinic at Lewis-Manning House. Referrals were made by the patients' physician or specialist nurse. Patients (n = 30) were assessed and treated by the senior physiotherapist in charge of the clinic over three sessions. A number of outcomes were measured at various stages of the patients' treatment. The results have confirmed and strengthened the previous published results. Highly significant improvements in patients' breathlessness, functional capacity, activity levels and distress levels have been shown. For example, the percentage of patients experiencing breathlessness several times or more per day was reduced from 73% to 27% four weeks later. In addition, this project has been able to demonstrate significant improvements in quality of life and high levels of satisfaction with the interventions. Qualitative data enhanced the findings of objective measurements.
Journal of Psychosomatic Research, 2007
Objective: The objective of this study was to report on the development and preliminary psychomet... more Objective: The objective of this study was to report on the development and preliminary psychometric evaluation of an emotional processing scale, a 38-item self-report questionnaire designed to identify emotional processing styles and deficits. Methods: An initial item pool derived from a conceptual model and clinical observations was piloted on clinical and community samples (n=150). The resulting 45-item scale was administered to patients with psychological problems, psychosomatic disorders, and physical disease, and to healthy individuals (n=460). Exploratory factor analysis was used to explore the underlying factor structure. Results: Maximum likelihood factor analysis yielded an eight-factor solution relating to styles of emotional experience (Lack of Attunement, Discordant, and Externalized), mechanisms controlling the experience and expression of emotions (Suppression, Dissociation, Avoidance, and Uncontrolled), and signs of inadequate processing (Intrusion). Internal reliability was moderate to high for six of eight factors. Preliminary findings suggested satisfactory convergent validity. Discussion: Overall, the psychometric properties of this scale appear promising. Work is in progress to refine the scale by incorporating additional items and by conducting further psychometric evaluations on new samples. D
Journal of Psychosomatic Research, 2010
The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designe... more The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designed to measure emotional processing styles and deficits. Scale development is an ongoing process and our aim was to (i) refine the scale by trying out items from a new item pool and (ii) shorten the scale to enhance its clinical and research utility. Fifteen new items were added to the original 38-item pool. The resulting 53-item scale was administered to four groups (N=690) (mental health, healthy controls, pain patients, and general medical practice attendees). Exploratory factor analysis was used to explore the underlying factor structure. Maximum likelihood (ML) factor analysis was used to guide the process of item selection and scale reduction. Four of the previous eight factors remained in similar form, two of the original factors were discarded, and one new factor emerged incorporating items from two previous factors. The revised version of the scale (EPS-25) has a 25-item five-factor structure. Internal reliability was moderate to high for all five factors. The psychometric properties of the revised scale appear promising, particularly in relation to the detection of differences between diagnostic groups.
Journal of Neurology, Neurosurgery & Psychiatry, 2013
Journal of Interprofessional Care, 2003
Considerable efforts have been made to describe and evaluate general practitioner (GP) referral o... more Considerable efforts have been made to describe and evaluate general practitioner (GP) referral of patients to counsellors, although the literature describing contributory factors in the referral process is inconclusive. The aim of this study was to conduct a comprehensive literature review and present the information in a cohesive and practical model that might be of interest to both doctors and counsellors. An English language computerised literature search was conducted. The title or abstract contained any, or a combination of the following keywords: 'patient characteristics', 'counselling', 'primary care', and 'referral'. A further search was conducted based on relevant articles referenced in the above selection. A model was developed that showed an array of factors related to the patient, the GP, the GP-counsellor relationship, and external variables. Their interaction resulted in a complex collaborative process between the patient, GP and counsellor. These and their consequences were discussed, along with future research needs.
Journal of Advanced Nursing, 2003
Effects of multi-sensory stimulation for people with dementia Background. Over recent years multi... more Effects of multi-sensory stimulation for people with dementia Background. Over recent years multi-sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to Ó 2003 Blackwell Publishing Ltd 465 staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS. Aim. To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.). Methods. A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30-minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre-, mid-, post-trial and follow-up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital.
Gerontology, 2005
Fall prevention measures in hospital are often considered to be restraint and unsuitable for clin... more Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: 'restraint should always be an option in patients if the patient is at risk of falling' (82 vs. 45%; p < 0.0001), 'restraining methods are acceptable at the discretion of care professionals' (91 vs. 43%; p < 0.0001), 'restraint is an infringement of personal freedom' (35 vs. 66%; p < 0.0001) and 'restraint is necessary if it frees staff to do more clinical work' (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society's values. Such information is important to formulate informed fall prevention policies.
Familial Cancer, 2007
Focussing on the primary care aspects of the Kenilworth model, the Poole Primary Care Trust (PCT)... more Focussing on the primary care aspects of the Kenilworth model, the Poole Primary Care Trust (PCT) cancer genetics service has aimed to develop a high quality primary care-led service for the assessment and counselling of people concerned about their genetic risk of cancer. The service has been available through General Practitioner (GP) surgeries within the PCT since early 2006, and is delivered by Community Cancer Nurses as part of their role to provide proactive care and support to cancer patients, their families and the local population. Acting as a point of reference for cancer genetics at each practice, the nurses have supplied basic education to both health professionals and lay staff about the aims of the service and the genetic risk of cancer. Feedback from service users is one of the key elements of the Poole evaluation. This article is based on the views of some of the first patients referred. The patients consulted one of the cancer nurses between June and December 2006, and were interviewed by a researcher about their experience. The interviews focussed on the psychosocial aspects of the patients' experiences, which are less accessible through quantitative methods. The patients were encouraged to talk specifically and generally about their experiences, and described some of the feelings and emotions from the time of their referral onwards.
Counselling Psychology Quarterly, 2013
ABSTRACT While prolonged exposure is considered one of the “gold standard” and recommended treatm... more ABSTRACT While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Therapy is intuitive and makes sense to those affected by PTSD. It is framed in an emotional context and is presented as part of a lifestyle change that may reduce the likelihood of psychological problems developing in the future.
Counselling Psychology Quarterly, 2002
... care ROGER BAKER 1,2 , EMMA BAKER 2 , HELEN ALLEN 2 , ... However, there have been some contr... more ... care ROGER BAKER 1,2 , EMMA BAKER 2 , HELEN ALLEN 2 , ... However, there have been some controlled studies that have shown positive effects of counselling (eg, Blakey et al., 1994) and more recent evidence has emerged from a review of controlled studies that suggested ...
Clinical Rehabilitation, 2003
To investigate whether behavioural, motor and physiological responses of individuals with Hunting... more To investigate whether behavioural, motor and physiological responses of individuals with Huntington's disease (HD) to a controlled multisensory environment (MSE) are effective as a therapeutic (sustained effects) or leisure (immediate effects) activity. Pilot study--a randomized, controlled, two-group design. Specialist residential unit for people with mid-late stage HD. Twelve patients with HD (one subject from each group dropped out during the study after week 8 due to medical complications). Patients attended eight, 30-minute sessions over a four-week period, of multisensory stimulation (MSE, treatment group) or relaxation activities (control group). Between-group comparisons for changes between assessment sessions for two behavioural assessments: Rehabilitation Evaluation--Hall and Baker (REHAB), Behaviour and Mood Disturbance Scale (BMD); a motor assessment: the dyskinesia section of the St Hans Rating Scale (SHRS); physiological measures: blood pressure, heart rate and respiratory rate. Secondary measures during intervention sessions included behavioural assessment using the Interact. There were no significant differences found between the groups for any main outcome measures made between sessions. The MSE group showed some positive effects within-sessions, with the Interact showing significant between-group differences in immediate effects on mood (p = 0.028). There was also a significantly different change over time for within-session changes in stimulation levels (p = 0.0002) and mood (p = 0.0001) between the groups. No physiological effects were observed in relation to sessions in either group. Two MSE subjects underwent changes in medication during the study period. There was no therapeutic effect of MSEs over the four-week study period. MSEs appear to be more effective thanconventional relaxation techniques as a leisure activity.
The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designe... more The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designed to measure emotional processing styles and deficits. Scale development is an ongoing process and our aim was to (i) refine the scale by trying out items from a new item pool and (ii) shorten the scale to enhance its clinical and research utility. Fifteen new items were added to the original 38-item pool. The resulting 53-item scale was administered to four groups (N=690) (mental health, healthy controls, pain patients, and general medical practice attendees). Exploratory factor analysis was used to explore the underlying factor structure. Maximum likelihood (ML) factor analysis was used to guide the process of item selection and scale reduction. Four of the previous eight factors remained in similar form, two of the original factors were discarded, and one new factor emerged incorporating items from two previous factors. The revised version of the scale (EPS-25) has a 25-item five-factor structure. Internal reliability was moderate to high for all five factors. The psychometric properties of the revised scale appear promising, particularly in relation to the detection of differences between diagnostic groups.
Seizure, 2015
This exploratory study aimed to examine emotion-processing styles in patients with psychogenic no... more This exploratory study aimed to examine emotion-processing styles in patients with psychogenic non-epileptic seizures (PNES), compared to healthy individuals, and to explore associations of emotion processing with other psychological measures and seizure frequency, using the new Emotional Processing Scale (EPS-25), which had not previously been used in this patient group. Fifty consecutive patients with PNES referred for psychotherapy completed a set of self-report questionnaires, including the Emotional Processing Scale (EPS-25), Clinical Outcome in Routine Evaluation (CORE-10), Short Form-36 (SF-36), Patient Health Questionnaire (PHQ-15), and Brief Illness Perception Questionnaire (BIPQ). Responses on the EPS-25 were compared to data from 224 healthy controls. Patients with PNES had greater emotion processing deficits across all dimensions of the EPS-25 than healthy individuals (suppression/unprocessed emotion/unregulated emotion/avoidance/impoverished emotional experience). Impaired emotion processing was highly correlated with psychological distress, more frequent and severe somatic symptoms, and a more threatening understanding of the symptoms. Emotion processing problems were also associated with reduced health-related quality of life on the mental health (but not the physical health) component of the SF-36. The unregulated emotions sub-scale of the EPS was associated with lower seizure frequency. The results showed clear impairments of emotion processing in patients with PNES compared to healthy individuals, which were associated with greater psychological distress and reduced mental health functioning. These findings seem to support the face validity of the EPS-25 as a measure for PNES patients and its potential as a tool to assess the effectiveness of psychological interventions.
Journal of Advanced Nursing, Aug 31, 1988
Token economy in a hospital rehabilitation system A ward-based token economy programme which form... more Token economy in a hospital rehabilitation system A ward-based token economy programme which formed one part ofa larger rehabilitative serviee for long-stay psychiatric patients is described. The elinical effectiveness ofthe programme is examined by the use of various nursing, psychological and psychiatric assessments before and after the patients' treatment on the ward, and the progress of former patients is foliowed-up as they move to different parts ofthe rehabilitation service. Significant clinical gains in patients' psychiatric symptomatology and problem behaviour on the ward are reported, although there were indications that improvement was not fully maintained as the patients moved on to other parts ofthe service. Comparison ofthe present clinical programme with the earlier research programmes on the ward indicated that the present regime was superior. The advantages and problems of token economy as a rehabilitative facility are discussed, outlining the various different roles for token economy with psychiatric rehabilitation. Finally, the future of token economy for long-stay patients is considered, questioning whether it might more appropriately be replaced by other structured ward programmes.
Children Amp Society, Nov 1, 2001
Children with developmental delays often suffer feeding difŪculties. It has become common for tho... more Children with developmental delays often suffer feeding difŪculties. It has become common for those with a severe likelihood of malnutrition to be considered for alternative methods of nutritional intake, often a gastrostomy. As part of a pilot study investigating the effects of gastrostomy ...
Age and ageing, 2004
Great strides have been made in recent years in the management of falls. In care settings for old... more Great strides have been made in recent years in the management of falls. In care settings for older people it is time now to develop criteria which will allow us to move on from recording fall quantity to fall quality. It is time to work with staff and colleagues in care settings to ensure that reasonable and realistic policies, practices and expectations prevail. Healthcare professionals should also now belatedly engage with the lay public, with patients and families about falls and risk management. A risk-free life is no life at all.
The British journal of general practice : the journal of the Royal College of General Practitioners, 1998
Research into the effectiveness of counselling in primary care is rare. This study attempts to pr... more Research into the effectiveness of counselling in primary care is rare. This study attempts to provide a thorough evaluation of the effects of a new counselling service introduced throughout Dorset. To evaluate the impact of counselling on client symptomatology, self-esteem, and quality of life. The effect of counselling on drug prescribing, referrals to other mental health professionals, and client and general practitioner (GP) satisfaction were also assessed. All new clients referred for counselling were asked to complete and return questionnaires before and after counselling. A total of 385 clients took part in the study. The first and second assessments were compared statistically. Clients were ascribed a psychiatric diagnosis using a simplified version of DSM-IIIR (Diagnostic and Statistical Manual of the American Psychiatric Association). GPs' views of the service were determined using a specially designed questionnaire. Drug data were obtained from the Prescription Pricin...
Reviews, 1996
The unpredictable, variable nature of Multiple Sclerosis (MS), and the possibility of increasing ... more The unpredictable, variable nature of Multiple Sclerosis (MS), and the possibility of increasing disability, means that a diagnosis can have substantial psychological consequences. To assess the effectiveness of psychological interventions for people with MS. We searched 19 databases up to December 2004; Cochrane MS Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsychINFO, CINAHL and 14 others. We searched reference lists of articles, wrote to corresponding authors of the 13 papers identified by June 2004, and searched for trials in progress using 3 research registers. Randomised controlled trials of interventions described as wholly or mostly based on psychological theory and practice, in people with MS. Primary outcome measures were disease specific and general quality of life, psychiatric symptoms, psychological functioning, disability, and cognitive outcomes. Secondary outcome measures were number of relapses, pain, fatigue, health care utilisation, changes in medication, and adherence to other therapies. Pertinent studies were identified from abstracts by one author. Full papers were independently compared to selection criteria by four authors. Key details were extracted from relevant papers using a standard format, and studies scored on three dimensions of quality. The review is organised into four mini-reviews (MR) dependent on the intervention's target population; people with cognitive impairments (MR1), people with moderate to severe disability (MR2), people with MS (no other criteria) (MR3), and people with depression (MR4). Overall 16 studies were identified and included. MR1: three trials (n=145). Some evidence of effectiveness of cognitive rehabilitation on cognitive outcomes, although this was difficult to interpret because of the large number of outcome measures used. MR2: three trials (n=80). One small trial suggesting psychotherapy may help with depression. MR3: seven studies (n=688). Some evidence that cognitive behavioural therapy may help people adjust to, and cope with, having MS (three trials). The other trials were diverse in nature and some difficult to interpret because of multiple outcome measures. MR4: three trials (n=93). Two small studies of cognitive behavioural therapy showed significant improvements in depression. The diversity of psychological interventions identified indicates the many ways in which they can potentially help people with MS. No definite conclusions can be made from this review. However there is reasonable evidence that cognitive behavioural approaches are beneficial in the treatment of depression, and in helping people adjust to, and cope with, having MS.
BMC Neurology, 2014
Background: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS... more Background: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS). The aim was to evaluate the effectiveness at 1-year follow-up of a manualised group-based programme ('FACETS') for managing MS-fatigue.
Schizophrenia Bulletin, 1988
The renewed interest in the care and treatment of chronic psychiatric patients has led to an awar... more The renewed interest in the care and treatment of chronic psychiatric patients has led to an awareness of the need for improved assessment methods for this group. This article describes the development of REHAB, a behavior rating scale for use with people with chronic psychiatric disability, which has been carefully designed with respect to content, format, and ease of use. The article also draws together the various factor-analytic, reliability, validity, and sensitivity-tochange studies that provide the basic psychometric evidence for the scale's value. REHAB is presented as an integrated package of materials with special attention paid to training of raters and simplicity of interpretation. It has been used for a variety of different assessment purposes, in both research and clinical settings.
Palliative Medicine, 2003
This paper is a development on recent research that proved the value of non-pharmacological techn... more This paper is a development on recent research that proved the value of non-pharmacological techniques and strategies in the management of breathlessness in lung cancer. It evaluates the intervention in a specialist palliative care setting using an outpatient clinic at Lewis-Manning House. Referrals were made by the patients' physician or specialist nurse. Patients (n = 30) were assessed and treated by the senior physiotherapist in charge of the clinic over three sessions. A number of outcomes were measured at various stages of the patients' treatment. The results have confirmed and strengthened the previous published results. Highly significant improvements in patients' breathlessness, functional capacity, activity levels and distress levels have been shown. For example, the percentage of patients experiencing breathlessness several times or more per day was reduced from 73% to 27% four weeks later. In addition, this project has been able to demonstrate significant improvements in quality of life and high levels of satisfaction with the interventions. Qualitative data enhanced the findings of objective measurements.
Journal of Psychosomatic Research, 2007
Objective: The objective of this study was to report on the development and preliminary psychomet... more Objective: The objective of this study was to report on the development and preliminary psychometric evaluation of an emotional processing scale, a 38-item self-report questionnaire designed to identify emotional processing styles and deficits. Methods: An initial item pool derived from a conceptual model and clinical observations was piloted on clinical and community samples (n=150). The resulting 45-item scale was administered to patients with psychological problems, psychosomatic disorders, and physical disease, and to healthy individuals (n=460). Exploratory factor analysis was used to explore the underlying factor structure. Results: Maximum likelihood factor analysis yielded an eight-factor solution relating to styles of emotional experience (Lack of Attunement, Discordant, and Externalized), mechanisms controlling the experience and expression of emotions (Suppression, Dissociation, Avoidance, and Uncontrolled), and signs of inadequate processing (Intrusion). Internal reliability was moderate to high for six of eight factors. Preliminary findings suggested satisfactory convergent validity. Discussion: Overall, the psychometric properties of this scale appear promising. Work is in progress to refine the scale by incorporating additional items and by conducting further psychometric evaluations on new samples. D
Journal of Psychosomatic Research, 2010
The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designe... more The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designed to measure emotional processing styles and deficits. Scale development is an ongoing process and our aim was to (i) refine the scale by trying out items from a new item pool and (ii) shorten the scale to enhance its clinical and research utility. Fifteen new items were added to the original 38-item pool. The resulting 53-item scale was administered to four groups (N=690) (mental health, healthy controls, pain patients, and general medical practice attendees). Exploratory factor analysis was used to explore the underlying factor structure. Maximum likelihood (ML) factor analysis was used to guide the process of item selection and scale reduction. Four of the previous eight factors remained in similar form, two of the original factors were discarded, and one new factor emerged incorporating items from two previous factors. The revised version of the scale (EPS-25) has a 25-item five-factor structure. Internal reliability was moderate to high for all five factors. The psychometric properties of the revised scale appear promising, particularly in relation to the detection of differences between diagnostic groups.
Journal of Neurology, Neurosurgery & Psychiatry, 2013
Journal of Interprofessional Care, 2003
Considerable efforts have been made to describe and evaluate general practitioner (GP) referral o... more Considerable efforts have been made to describe and evaluate general practitioner (GP) referral of patients to counsellors, although the literature describing contributory factors in the referral process is inconclusive. The aim of this study was to conduct a comprehensive literature review and present the information in a cohesive and practical model that might be of interest to both doctors and counsellors. An English language computerised literature search was conducted. The title or abstract contained any, or a combination of the following keywords: 'patient characteristics', 'counselling', 'primary care', and 'referral'. A further search was conducted based on relevant articles referenced in the above selection. A model was developed that showed an array of factors related to the patient, the GP, the GP-counsellor relationship, and external variables. Their interaction resulted in a complex collaborative process between the patient, GP and counsellor. These and their consequences were discussed, along with future research needs.
Journal of Advanced Nursing, 2003
Effects of multi-sensory stimulation for people with dementia Background. Over recent years multi... more Effects of multi-sensory stimulation for people with dementia Background. Over recent years multi-sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to Ó 2003 Blackwell Publishing Ltd 465 staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS. Aim. To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.). Methods. A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30-minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre-, mid-, post-trial and follow-up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital.
Gerontology, 2005
Fall prevention measures in hospital are often considered to be restraint and unsuitable for clin... more Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: 'restraint should always be an option in patients if the patient is at risk of falling' (82 vs. 45%; p < 0.0001), 'restraining methods are acceptable at the discretion of care professionals' (91 vs. 43%; p < 0.0001), 'restraint is an infringement of personal freedom' (35 vs. 66%; p < 0.0001) and 'restraint is necessary if it frees staff to do more clinical work' (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society's values. Such information is important to formulate informed fall prevention policies.
Familial Cancer, 2007
Focussing on the primary care aspects of the Kenilworth model, the Poole Primary Care Trust (PCT)... more Focussing on the primary care aspects of the Kenilworth model, the Poole Primary Care Trust (PCT) cancer genetics service has aimed to develop a high quality primary care-led service for the assessment and counselling of people concerned about their genetic risk of cancer. The service has been available through General Practitioner (GP) surgeries within the PCT since early 2006, and is delivered by Community Cancer Nurses as part of their role to provide proactive care and support to cancer patients, their families and the local population. Acting as a point of reference for cancer genetics at each practice, the nurses have supplied basic education to both health professionals and lay staff about the aims of the service and the genetic risk of cancer. Feedback from service users is one of the key elements of the Poole evaluation. This article is based on the views of some of the first patients referred. The patients consulted one of the cancer nurses between June and December 2006, and were interviewed by a researcher about their experience. The interviews focussed on the psychosocial aspects of the patients' experiences, which are less accessible through quantitative methods. The patients were encouraged to talk specifically and generally about their experiences, and described some of the feelings and emotions from the time of their referral onwards.
Counselling Psychology Quarterly, 2013
ABSTRACT While prolonged exposure is considered one of the “gold standard” and recommended treatm... more ABSTRACT While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Therapy is intuitive and makes sense to those affected by PTSD. It is framed in an emotional context and is presented as part of a lifestyle change that may reduce the likelihood of psychological problems developing in the future.
Counselling Psychology Quarterly, 2002
... care ROGER BAKER 1,2 , EMMA BAKER 2 , HELEN ALLEN 2 , ... However, there have been some contr... more ... care ROGER BAKER 1,2 , EMMA BAKER 2 , HELEN ALLEN 2 , ... However, there have been some controlled studies that have shown positive effects of counselling (eg, Blakey et al., 1994) and more recent evidence has emerged from a review of controlled studies that suggested ...
Clinical Rehabilitation, 2003
To investigate whether behavioural, motor and physiological responses of individuals with Hunting... more To investigate whether behavioural, motor and physiological responses of individuals with Huntington's disease (HD) to a controlled multisensory environment (MSE) are effective as a therapeutic (sustained effects) or leisure (immediate effects) activity. Pilot study--a randomized, controlled, two-group design. Specialist residential unit for people with mid-late stage HD. Twelve patients with HD (one subject from each group dropped out during the study after week 8 due to medical complications). Patients attended eight, 30-minute sessions over a four-week period, of multisensory stimulation (MSE, treatment group) or relaxation activities (control group). Between-group comparisons for changes between assessment sessions for two behavioural assessments: Rehabilitation Evaluation--Hall and Baker (REHAB), Behaviour and Mood Disturbance Scale (BMD); a motor assessment: the dyskinesia section of the St Hans Rating Scale (SHRS); physiological measures: blood pressure, heart rate and respiratory rate. Secondary measures during intervention sessions included behavioural assessment using the Interact. There were no significant differences found between the groups for any main outcome measures made between sessions. The MSE group showed some positive effects within-sessions, with the Interact showing significant between-group differences in immediate effects on mood (p = 0.028). There was also a significantly different change over time for within-session changes in stimulation levels (p = 0.0002) and mood (p = 0.0001) between the groups. No physiological effects were observed in relation to sessions in either group. Two MSE subjects underwent changes in medication during the study period. There was no therapeutic effect of MSEs over the four-week study period. MSEs appear to be more effective thanconventional relaxation techniques as a leisure activity.