Oxford Guide to Low Intensity CBT Interventions

by Bennett-Levy, James; Richards, David; Farrand, Paul; Christensen, Helen; Griffiths, Kathy; Kavanagh, David; Klein, Britt; Lau, Mark A.; Proudfoot, Judy

• ISBN13: 9780191797590
• ISBN10: 0191797596
• Format: eBook
• Copyright: 2015-01-01
• Publisher: Oxford University Press

Author Biography

James Bennett-Levy, University of Sydney and Southern Cross University, Australia,David Richards, University of Exeter, UK,Paul Farrand, University of Exeter, UK,Helen Christensen, The Australian National University, Australia,Kathy Griffiths, The Australian National University, Australia,David Kavanagh, Queensland University of Technology, Australia,Britt Klein, Swinburne University, Australia,Mark A. Lau, University of British Columbia, Canada,Judy Proudfoot, University of New South Wales, Australia,Lee Ritterband, University of Virginia, USA,Jim White, Team leader, STEPS,Chris Williams, University of Glasgow, UK

James Bennett-Levy is Associate Professor in Mental Health at Sydney University's Department of Rural Health (Northern Rivers) in northern New South Wales, Australia. As soon as he was appointed to the position, he saw the potential of low intensity CBT interventions for rural and remote communities, where access to evidence-based psychological therapies tends to be very poor. Recognising the absence of a useful low intensity CBT textbook to guide practitioners and decision makers, he initiated and co-ordinated the Oxford Guide to Low Intensity CBT Interventions. In his research work, he is one of the world's leading leading researchers on CBT training with a series of empirical and theoretical papers.

David Kavanagh holds a Research Chair in the Institute of Health & Biomedical Innovation and School of Psychology & Counselling at Queensland University of Technology in Brisbane. Much of his research has been on brief or low-intensity interventions, and improvement of mental health service delivery via training and supervision. His research has included evaluations of remotely delivered treatment by mail, and more recently using the internet and text messaging. Professor Kavanagh has an extensive record of research funding and publications, and his work is widely cited. He is currently on the Academy of the National Health and Medical Research Council, and the Science, Academia and Research Advisory Group of the Australian Psychological Society. He is co-chair of the Queensland Health Collaborative on Alcohol and Other Drugs and Mental Health, and serves on state and Commonwealth consultative committees on services for mental disorders and substance misuse.

Mark Lau is a Research Scientist and Director, BC Cognitive Behaviour Therapy Network with BC Mental Health and Addiction Services, an agency of the Provincial Health Services Authority where he is co-ordinating a series of projects to disseminate CBT across the province of BC. He is also a Clinical Associate Professor of Psychiatry at UBC and a Founding Fellow of the Academy of Cognitive Therapy. Dr. Lau's research interests include evaluating effective methods of CBT dissemination, investigating the mechanisms underlying the efficacy of Mindfulness-based Cognitive Therapy (MBCT), and the further development and validation of the Toronto Mindfulness Scale. In addition, Dr. Lau has led workshops in Cognitive Behaviour Therapy and MBCT across Canada, in the United States, United Kingdom and Australia.

David A Richards is Professor of Mental Health Services Research at Exeter University's Mood Disorders Centre in the UK. Throughout his career, he has tirelessly campaigned to improve access to evidence-based therapies such as CBT. He has been involved in the UK's Improving Access to Psychological Therapies (IAPT) programme from its inception in 2005 and developed the low-intensity CBT methods used by IAPT on behalf of the UK Department of Health. As such he can be credited with personally establishing a completely new profession of low-intensity CBT workers in the UK, now known as Psychological Wellbeing Practitioners. In his spare time he runs a multi-centre research team funded by the Medical Research Council and the National Institute for Health Research which develops and tests new models of delivering treatment in clinical trials - including stepped care, guided self-help and collaborative care.

Lee Ritterband is an Associate Professor at the University of Virginia Health System Department of Psychiatry and Neurobehavioral Sciences and Director of the Behavioral Health and Technology program area. With degrees in clinical psychology and computer science/technology, Dr. Ritterband specializes in the development and testing of behaviorally-based treatment programs delivered via the Web. Over the past decade, Dr. Ritterband has established himself as one of the leading researchers in Internet health interventions. He has been a Principal or Co-Investigator on many large research projects funded by the National Institutes of Health. In 2003, Dr. Ritterband was honored with the award, Best eHealth Research Paper of the Year, sponsored by the Health e-Technologies Initiative, National Program Office of the Robert Wood Johnson Foundation for eHealth.

Chris Williams is Professor of Psychosocial Psychiatry at the University of Glasgow, UK. He became interested in low intensity working in the mid-1990's when he completed a postgraduate CBT course, but found he struggled to offer one hour CBT appointments in his everyday work. He sees low intensity working as bringing together two themes he is particularly interested in - CBT and education/teaching - and views CBT as a self-help form of psychotherapy.
He researches CBT self-help in psychiatric and community settings and has developed a range of book-based, DVD, class-based and computer-delivered self-help resources including the free access www.livinglifetothefull.com website which receives around 2 million hits a month. His work developing the five areas model of CBT is focused on making CBT accessible to practitioners and the general public alike. Together his CBT self-help books are amongst the most used in the UK. He is Patron of the charities Anxiety UK and Triumph over Phobia.

Jim White is a consultant clinical psychologist and currently leads the STEPS primary care mental health team in south-east Glasgow. He has mainly worked in primary care settings and has a reputation for innovation in his approach to common mental health problems. In particular, he is interested in getting to much larger numbers of people a lot sooner, empowering them to make real choices about how they want to tackle their problems and to work with them in ensuring they are able to act on their choices. The STEPS approach is possibly one of the most radical approaches in primary care mental health in Britain. We are a Scottish Executive Exemplar Project.

STEPS offers a 6 level stepped-care approach:
SC Individual therapy
SC Group work
SC Single contacts
SC Non-face-to-face interventions
SC Working with others
SC Awareness raising / community involvement / early intervention and prevention


Britt Klein is the Co-Director of the National eTherapy Centre; the Co-Director of the Swin-PsyCHE e-Therapy Unit; and an Associate Professor in the Faculty of Life and Social Sciences at Swinburne University, Melbourne, Australia. Since 1998 she has been developing and evaluating internet-based mental and physical health interventions as a means to increase access to health services by utilising low intensity CBT intervention modalities. Her biggest achievement to date is the co-creation of Anxiety Online (www.anxietyonline.org.au): a full service education and training, online psychological assessment and treatment clinic for the anxiety disorders open to the general public. She has been awarded numerous grants to develop and evaluate internet-based wellbeing, prevention and treatment programs, has published widely, teaches and supervises students in the field of internet interventions and she is the Co-Editor of the e-Journal of Applied Psychology.

Table of Contents

Foreword, Isaac Marks
Section 1 Low Intensity CBT Models and Conceptual Underpinnings

Overview, James Bennett-Levy & Paul Farrand
1. Low Intensity CBT Interventions: A Revolution in Mental Health Services, 1. James Bennett-Levy, Dave Richards & Paul Farrand
2. Access and Organisation: Putting Low Intensity Interventions to Work in Clinical Services, Dave Richards
3. The STEPS Model: a High Volume, Multi-level, Multi-purpose approach to address Common Mental Health Problems, Jim White
4. Increasing Access and Effectiveness: Using the Internet to deliver Low Intensity Cognitive Behaviour Therapy, Helen Christensen
5. A New Language for CBT: New ways of Working Require New Thinking as well as New Words, Chris Williams & Jill Morrison
Section 2A: Introducing and Supporting Guided CBT

Overview, Paul Farrand, Lee Ritterband & James Bennett-Levy
6. Low Intensity CBT Assessment: In Person or by Phone, Paul Farrand & Chris Williams
7. Monitoring & Evaluation in Low Intensity CBT Interventions, Judy Proudfoot & Jennifer Nicholas
8. Introducing and Supporting Written and Internet-Based Guided CBT, Mark Kenwright
9. Matching clients to CBT self-help resources, Rebecca Martinez & Chris Williams
10. Collaborative Care: The Effective Organization of Treatment for Depression, Dave Richards
11. Supervising low intensity workers, Dave Richards
Section 2B Key Low Intensity CBT Interventions in Depression and Anxiety

Overview, Mark Lau
12. Behavioural Activation for Depression, Dave Richards
13. Problem Solving Therapy for Depression, Laurence Mynors-Wallis & Mark Lau
14. Increasing Physical activity as a Low Intensity Treatment for Depression, Adrian Taylor
15. Key Components of Low Intensity Interventions for Anxiety, Nick Titov, Gavin Andrews & Peter McEvoy
16. Brief Motivational Interviewing for Depression and Anxiety, Leanne Hides, Steve Carroll, Dan I Lubman & Amanda Baker
17. Low Intensity Interventions for Chronic Insomnia, Norah Vincent & Maxine Holmqvist
Section 2C: Guided CBT Interventions using Written Materials
Overview, Chris Williams, Paul Farrand & James Bennett-Levy
18. Choosing self-help books wisely: Sorting the wheat from the chaff, Dave Richards & Paul Farrand
19. Using Guided Self-Help Book Prescription Schemes, Paul Farrand & Joanne Woodford
20. Delivering book based CBT Self-Help Classes in health service, further education and voluntary sector services, Marie Chellingsworth, Chris Williams, Ann McCreath, Paul Tanto & Kirsten Thomlinson
Section 2D: Guided CBT Interventions using the Internet

Overview, Judy Proudfoot & Britt Klein
21. Turn On, Tune In and (Don't) Drop Out: Engagement, Adherence, Attrition and Alliance with Internet-based CBT Interventions, Kate Cavanagh
22. Treatment Credibility and Satisfaction with Internet Interventions, Lee Ritterband, Frances Thorndike, Drew Saylor & Desi Vasquez
23. Internet-based Mental Health Screening, Tara Donker, Annemieke Van Straten & Pim Cuijpers
24. Standards and Operating Guidelines for Internet Interventions, Lisa Whitehead & Judy Proudfoot
25. Guided CBT Internet Interventions: Specific Issues in Supporting Clients with Depression, Anxiety and Co-Morbid Conditions, Proudfoot, Andersson, Carlbring, Klein, Kyrios, Lauder, Munro, Palermo, Riper, Blankers
Section 2E Novel Uses of Communication Technologies: Supporting Low Intensity CBT in New Environments

Overview, Judy Proudfoot & Britt Klein
26. Using different communication channels to support internet interventions, Gerhard Andersson & Per Carlbring
27. Supporting Low Intensity Interventions using the Telephone, Karina Lovell
28. Use of Short-Messaging Service (SMS) To Enhance Low Intensity CBT, Jennifer Shapiro & Stephanie Bauer
29. Email in Low Intensity CBT Interventions, Nick Titov
30. Online Mutual Support Bulletin Boards, Kathy Griffiths & Julia Reynolds
31. Low Intensity Cognitive Behavioural Therapies by Mail (M-CBT), David Kavanagh, Jennifer Connolly, Amy Kelly, Angela White & Jan Parry
Section 2F Stepping Further Outside the Box: Extending the Environments for Low Intensity CBT

Overview, Mark Lau
32. Large group didactic CBT classes for common mental health problems, Jim White
33. Cognitive Behaviour Group Therapy (CBGT): Capitalizing on efficiency and humanity, Ingrid Sochting, Christopher Wilson & Theo DeGagne
34. Will you follow while they lead? Introducing a patient-led approach to low intensity CBT interventions, Tim Carey
35. The Advice Clinic or What I did in my thirty minutes, Jim White
36. Low intensity CBT Interventions by General Practitioners, Lee David
37. Adapting low intensity CBT for clients with severe mental disorder, Frank Deane & David Kavanagh
Section 2G: Going Upstream: Using Low Intensity CBT Interventions to Prevent Mental Health Problems

Overview, Kathy Griffiths
38. Group CBT for prevention of depression in adults, Pim Cuijpers
39. Internet-delivered prevention for anxiety and depression disorders in adults, Tahlee Marian & Justin Kenardy
40. Low intensity targeted group prevention of depression in adolescents and children, Greg Clarke
41. Internet-based anxiety and depression prevention programs for children and adolescents, Alison Calear, Helen Christensen, Kathy Griffiths
42. Parental programs for preventing behavioural and emotional problems in children, Matthew Sanders and James Kirby
43. Mindfulness-based cognitive therapy: a low intensity group program to prevent depressive relapse, Mark Lau
Section 3 Training Low Intensity CBT Practitioners

Overview, James Bennett-Levy & Dave Richards
44. Training low intensity workers, Dave Richards
45. Training Depression Care Managers, Dave Ekers
46. Training Peers to Provide Low Intensity CBT Support: The Value of Personal Experience, Sharon Lawn, Ann Smith, Kelly Hunter, Jim Smith, Nicki Hurst, Michael Nanai, & Kylie Neate
47. Training the Wider Workforce in the Use of Cognitive Behaviour Therapy Written Self-help Resources, Chris Williams, Catriona Kent & Anne Joice
48. Training GPs to prescribe depression self-management, Dan Bilsker & Elliot Goldner
49. Training Clinicians Online to be Etherapists: The 'Anxiety Online' model, David Austin, Britt Klein, Kerrie Shandley & Lisa Ciechomski
50. From Classroom to 'Shop Floor': Challenges Faced As A Low Intensity Practitioner, Jillian Telford & Rea Wilson
Section 4A: Facilitating the Uptake of Low Intensity CBT Interventions: Changing Systems and Routine Practice

Overview, David Kavanagh & James Bennett-Levy
51. Establishing the Improved Access to Psychological Therapies (IAPT) Program: Lessons from large-scale change in England, James Seward, Michael Clark
52. Implementing Low Intensity Interventions: What Governments want and why, Alex McMahon
53. Challenges and Potential Solutions in Integrating Internet-based CBT Interventions into Specialist Services, Gehard Andersson, Per Carlbring, Viktor Kaldo, Pim Cuijpers
54. Achieving widespread dissemination of low intensity evidence-based practices: The experience of the Triple P-Positive Parenting Program, Matthew Sanders & Majella Murphy Brennan
55. Practical Service Redesign: Helping GPs to Enhance Depression Care, Michael Smith
56. Implementing low-intensity CBT (LI CBT) in case management of clients with severe mental illness, David Kavanagh & Frank Deane
57. Effective Partnerships with Community Groups, Kevin Khayat
Section 4B: Facilitating the Uptake of Low Intensity CBT Interventions: Adapting Interventions to Different Community Contexts

Overview, David Kavanagh & James Bennett-Levy
58. Bringing the public on board: Health promotion and social marketing in deprived communities, Jim White
59. Enhancing Community Awareness of Depression and Access to Treatment: Experiences with beyondblue, Nicole Highet, Clare Shann & Leonie Young
60. Problems and Potentials in Rolling out Low Intensity CBT in Rural Communities, Mark Lau
61. Improving Access to Low intensity Interventions for Ethnic Minority Communities, Judy Leibowitz
62. Low intensity CBT with Indigenous consumers: Creative solutions for culturally appropriate mental health care, Arlene Laliberte, Tricia Nagel, & Melissa Haswell-Elkins