Evidence-based Low Intensity Treatments for Common Mental Health Problems
| Module title | Evidence-based Low Intensity Treatments for Common Mental Health Problems |
|---|---|
| Module code | PYC3020 |
| Academic year | 2024/5 |
| Credits | 20 |
| Module staff | Miss Megan Whitworth (Convenor) |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 14 |
| Number students taking module (anticipated) | 7 |
|---|
Module description
A range of low intensity cognitive behavioural interventions are recommended by NICE for the treatment of patients with mild-to-moderate common mental health problems, informed by the patient’s primary problem descriptor and goals. Examples of interventions include delivering a range of low-intensity guided self-help interventions (often with the use of written self-help materials) informed by cognitive-behavioural principles, such as behavioural activation, graded exposure, exposure and response prevention, worry management, cognitive restructuring (including behavioural experiments), panic management, problem solving and promoting good sleep. Other aspects of supporting patient outcomes will be covered, for example promoting physical activity and medication support. The overall delivery of these interventions is informed by the COM-B behaviour change model and strategies.
In this module you will gain competency in recognising appropriate interventions from those available and collaborating with the patient to plan a treatment programme for their individual needs. You will also develop an appreciation of what makes a good self-help resource and develop key skills in motivating and supporting the use of self-help materials with people experiencing common mental health problems. You will learn how to identify common problems arising in treatment and support patients’ use of these interventions using your skills around the COM-B model to aid this process. The module will also equip you with the knowledge and skills to deliver interventions through different modes: individually through face-to-face, telephone, video, email/text-based support or other contact methods, and also develop your skills in group facilitation. You will learn how to end treatment with relapse prevention. A significant focus upon clinical skills teaching will enhance your general and disorder-defined ‘specific factors’ competencies in support of these interventions, including ongoing review and management of risk and use of routine outcome measures.
This module builds on your knowledge and skills in engagement and assessment of common mental health problems to equip you with the expertise and skills to provide effective and patient centred evidence based low intensity treatments for common mental health problems. This module will provide the core knowledge of standard LICBT treatment protocols that will be built on in Values, Diversity and Context, with consideration of adaptations to support access, engagement and benefit from treatment.
Module aims - intentions of the module
The aim of this module is to provide you with a good understanding of the process of therapeutic support for a range of evidence-based, low intensity cognitive behavioural interventions and to support the learning and progression towards recovery of individuals and groups of patients.
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Demonstrate an awareness of the application of an adequate dose of a range of evidence-based, NICE recommended guided self-help interventions to assist patients to manage their common mental health problem (including medication support), in line with their goals.
- 2. Demonstrate competency in developing and maintaining a therapeutic alliance with patients during their treatment, including dealing with issues and events that could threaten the alliance
- 3. Competently plan, deliver and keep accurate records of a collaborative low-intensity treatment programme for step 2 appropriate common mental health problems based on NICE guidance, NHS Talking Therapies Manual, and the patient's goals, including managing the ending of contact and relapse prevention strategies.
- 4. Demonstrate competence in using the COM-B behaviour change model to facilitate the delivery of low-intensity interventions.
- 5. Evaluate the role of case management and stepped care approaches to managing common mental health problems in primary care including ongoing risk management appropriate to service protocols and NICE guidance.
- 6. Demonstrate understanding of how to effectively support patients with medication for common mental disorders, including optimising their use and minimising any adverse effects.
- 7. Demonstrate understanding of the importance of mapping core skills in the delivery of low-intensity interventions, including common factors skills, across all modes of delivery (face-to-face, telephone, video, interactive text or cCBT, and guided self-help groups).
- 8. Demonstrate competence in selecting and revising the mode of delivery of sessions, as necessary, on an ongoing basis depending on patient choice, suitability, etc.
- 9. Practice Outcome 7: Demonstrate experience and competence in the selection and delivery of treatment of a range of presenting problems using evidence-based low- intensity interventions across a range of problem descriptors, including depression and two or more anxiety disorders, and across all modes of intervention (in person, telephone, video platform).
- 10. Practice Outcome 8: Demonstrate an understanding of problems that should not be treated at Step 2, and where and how appropriate treatment should be accessed for these.
- 11. Practice Outcome 9: Demonstrate the ability to use common factor competencies to manage emotional distress and maintain therapeutic alliances to support patients using low-intensity interventions.
- 12. Practice Outcome 10: Demonstrate competence in delivering low-intensity interventions using a range of methods including one-to-one treatment (in person, via video consultation, via telephone, interactive text or computerised cognitive behavioural therapy (cCBT)) and where possible guided self - help groups (in person and via video).
- 13. Practice Outcome 11: Demonstrate competence in selecting and revising mode of delivery, as necessary on an ongoing basis depending on patient choice, suitability, etc.
- 14. Practice Outcome 12: Demonstrate knowledge and understanding to map core skills into text-based interventions.
- 15. Practice Outcome 13: Demonstrate high quality clinical note keeping and effective use of clinical outcome measures to shape and adapt low intensity interventions.
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 16. Summarise basic and essential factual and conceptual knowledge of the subject, and demonstrate a critical understanding of this knowledge, to a level appropriate to Level 6
- 17. Review and evaluate established work and identify some of the strengths and weaknesses of this work, to a level appropriate to Level 6
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 18. Record accurately interviews and questionnaire assessments using paper and electronic record-keeping systems
- 19. Evaluate your strengths and weaknesses, challenge received opinion and develop your own criteria and judgement, and to seek and make use of feedback
Syllabus plan
The module content, module-specific learning objectives, style of delivery and assessment for this module are as informed by the NHS-England 4th Edition (Version 3) (2023) revised curriculum for the training of Psychological Wellbeing Practitioners to support the delivery of low intensity CBT associated with NHS Talking Therapies services. Teaching content will include:
Evidence-based interventions and strategies
- Developing and maintaining a therapeutic alliance
- Dealing with issues and events that disrupt the alliance – engaging patients
- Use of the COM-B model
- Competence in selecting appropriate low intensity CBT treatment for the patient’s primary problem descriptor and effectively planning and supporting a course of Low intensity CBT treatment
- Competence in introducing low intensity interventions (intervention specific and problem specific)
- Recognising common problems encountered by patients when using interventions and supporting patients to collaboratively problem solve thes
- Knowledge of the theory and delivery of various interventions:
- Behavioural Activation
- Problem Solving
- Exposure (including Graded Exposure and Exposure and Response Prevention)
- Promoting good sleep and physical activity
- Cognitive Restructuring/Behavioural Experiments
- Panic Management
- Dealing with Worry
- Medication Support
Context of delivery
- Case management
- Stepped care
- Risk management
- Supporting low intensity interventions through various modes of support including face-to-face, telephone, video, electronic communication (cCBT, email and text-based support) and group work
Learning activities and teaching methods (given in hours of study time)
| Scheduled Learning and Teaching Activities | Guided independent study | Placement / study abroad |
|---|---|---|
| 75 | 125 | 0 |
Details of learning activities and teaching methods
| Category | Hours of study time | Description |
|---|---|---|
| Scheduled Learning and Teaching | 24 | Practical classes these will be used to develop clinical competencies in the delivery and support of treatment interventions through demonstrations, tutor supervised small group role-play and reflection |
| Scheduled Learning and Teaching | 24 | Lectures |
| Scheduled Learning and Teaching | 27 | Seminars and tutorials these will be led by the tutor and address a range of important topics covered in the module |
| Guided independent study | 75 | Reading, practice-related activities and preparation for seminars in flipped classroom delivery model |
| Guided independent study | 45 | Self-practice and self-reflection on role plays of interventions with fellow students undertaken outside of teaching sessions |
| Guided independent study | 5 | Develop an understanding of service- related clinical protocols, policies and procedures to inform practice, and develop knowledge of role |
Formative assessment
| Form of assessment | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|
| In class clinical skills competency assessment (treatment session roleplay) | 35 minutes | 2-4, 6, 8, 18, 19 | Oral and written |
| Clinical skills competency assessment of live patient recording/roleplay recording of a treatment session | 35 minutes | 2-4, 6, 8, 18, 19 | Oral and written |
| Written reflections on clinical skills competency assessment | 300 words | 18,19 | Oral and written |
Summative assessment (% of credit)
| Coursework | Written exams | Practical exams |
|---|---|---|
| 0 | 30 | 70 |
Details of summative assessment
| Form of assessment | % of credit | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|---|
| Examination (this assessment must be passed; failure in this assessment will lead to failure in the module) | 30 | 1 hour | 1, 5, 7, 16, 17 | Written and oral |
| Clinical skills competency assessment of a treatment session with a patient in service, comprising seven sections (this assessment must be passed with a mark of 21/42 overall and with marks of 3/6 in sections 2, 3, 4, 5 and 7; failure in this assessment will result in a maximum fail mark of 49 and lead to failure in the module) | 70 | 35 minutes | 2-4, 6, 8, 18, 19 | Written and oral |
| Clinical practice outcome assessment of competency in clinical practice and is pass/fail only (this assessment must be passed; failure in this assessment will lead to failure in the module) | 0 | n/a | 9-15, 18, 19 | Written and oral |
Details of re-assessment (where required by referral or deferral)
| Original form of assessment | Form of re-assessment | ILOs re-assessed | Timescale for re-assessment |
|---|---|---|---|
| Examination | Examination | 1, 5, 7, 16, 17 | For students on the standard route: Four weeks from the results release. For students on the adapted route for part-time trainees: 6 weeks from the results release |
| Clinical skills competency assessment | Clinical skills competency assessment | 2-4, 6, 8, 18, 19 | For students on the standard route: Six weeks from the voluntary additional top up skills date. For students on the adapted route for part-time trainees: Twelve weeks from the voluntary additional top up skills date. |
| Clinical practice outcome | Clinical practice outcome | 9-15, 18, 19 | Four weeks from the date feedback was provided, or a date determined in partnership with you and your service on basis of agreed action plan. |
Re-assessment notes
Three assessments are required for this module. In all cases re-assessment will be the same as the original assessment. Where you have been referred/deferred for any form of assessment detailed above you will have the opportunity to retake within the time scales above (or a date determined in partnership with you and your service on the basis of agreed action plan for Clinical Practice Outcomes).
If you pass re-assessments taken as a result of deferral, your re-assessment will be treated as it would be if it were your first attempt at the assessment and the overall module mark will not be capped.
If you pass re-assessments taken as a result of referral (i.e. following initial failure in the assessment), the individual assessment is capped at the pass mark and the overall module mark will be capped at 40%.
If you fail re-assessments taken as a result of referral (i.e. following initial failure in the assessment), you will be failed in the module and as a consequence you will be failed in the programme and your registration as a student of the University will be terminated.
Indicative learning resources - Basic reading
Core reading:
- Bennett-Levy, J. et al. (2010). Oxford guide to low intensity CBT interventions. OUP Oxford.
- Bennett-Levy, J., Thwaites, R., Haarhoff, B., & Perry, H. (2014). Experiencing CBT from the inside out: A self-practice/self-reflection workbook for therapists. Guilford Publications.
- Farrand, P. (Ed.). (2020). Low-intensity CBT skills and interventions: a practitioner′ s manual. Sage.
- Papworth, M., & Marrinan, T. (Eds.). (2018). Low intensity cognitive behaviour therapy: A practitioner′ s guide. Sage.
- Richards, D., & Whyte, M. (2011). Reach Out: National programme student materials to support the delivery of training for Psychological Wellbeing Practitioners delivering low intensity interventions, 3rd edition. Available at: https://cedar.exeter.ac.uk/v8media/facultysites/hls/cedar/resources/Reach_Out_3rd_edition.pdf
- Silverman, J., Kurtz, S., & Draper, J. (2016). Skills for communicating with patients. CRC Press.
Wider reading:
- 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.
- National Institute for Health Care Excellence. (2011). Common mental health problems: identification and pathways to care. [NICE Guideline No. CCB123]. Retrieved from: https://www.nice.org.uk/guidance/cg123
- Richards, D. A. et al. (2017). Cost and Outcome of Behavioural Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression. Health Technology Assessment (Winchester, England), 21(46), 1-366.
| Credit value | 20 |
|---|---|
| Module ECTS | 10 |
| Module pre-requisites | None |
| Module co-requisites | PYC3019 Engagement and Assessment of Patients with Common Mental Health Problems and PYC3021 Values, Diversity and Context |
| NQF level (module) | 6 |
| Available as distance learning? | No |
| Origin date | 05/02/2018 |
| Last revision date | 13/06/2024 |
