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Psychosis is a serious mental illness for which treatment can be aided by psychological therapies. Researchers at King's College London (KCL) demonstrated that family environment is key to recovery and developed and validated a family intervention for psychosis. Family intervention for psychosis is a recommended treatment in NICE guidelines (2009), as well as by the Patient Outcomes Research Team in the USA. The NICE guideline committee was chaired and advised by KCL researchers. Family intervention for psychosis is part of training programs for clinical staff and has changed NHS practice. The KCL-led website mentalhealthcare.org.uk disseminates this research to families of those with psychosis.
Professor Alex Copello took a leading role in conducting research on the consequences of drug and alcohol addiction for the families of the substance users as well as the users themselves, leading to the Stress-Strain-Coping-Support (SSCS) model of understanding addictions and the impact of these problems on families. The model was used to develop and evaluate family treatment interventions. Compared with other psychosocial treatments for substance users, family treatment interventions have the key advantage of addressing the difficulties also experienced by families of substance users, in addition to the users themselves. This work has increased national and international recognition of the importance of families in treating substance addiction in policy, and has resulted in the needs of the family being recognised for the first time in the 10-year Drug Strategy for England in 2008. It has led to family-based interventions being recommended in national clinical guidance from NICE and from the National Treatment Agency for substance misusers. Copello and his team have been actively involved in training large numbers of clinical services and practitioners in the use of these therapeutic methods, and the methods are being adopted in many other countries.
Lancaster research has changed the understanding and treatment of bipolar disorder (BD) from biological models and pharmacological treatments to integrated psychosocial interventions complementary to routine medication and matched to user needs. We have developed novel psychological interventions (individual, family and group approaches), and reliable and valid ways to assess valued outcomes and underlying mechanisms of change. This research has delivered 3 major impacts. It has: fundamentally changed understanding of the condition in professional and lay audiences; changed treatment in terms of policy and practice, including NICE clinical guidelines; changed professional training delivered both nationally and internationally.
Anorexia nervosa affects 1-4% of people over their lifetime with approximately half of all adolescents with anorexia requiring inpatient treatment. A specific form of family therapy, developed at the Maudsley Hospital and evaluated by researchers at King's College London through a series of randomised controlled trials, has been widely acknowledged as the principal evidence-based treatment for adolescent anorexia nervosa. The treatment is recommended by NICE in the UK and clinical guidelines in other countries and is strongly supported by advocacy and carer groups. It has influenced service commissioning with a growing number of specialist family-oriented outpatient services being developed in the UK and abroad. The Maudsley service model has been adopted by the Department of Health's Increased Access to Psychological Treatments programme as a specialist component of Systemic Family Therapy training.
There are very few evidence-based psychological interventions for people with Alzheimer's disease and other dementias. Of these, cognitive stimulation has the strongest evidence-base. Developed by Bob Woods (Bangor University) and Martin Orrell (UCL) in the late 1990s, the approach has proven effective in maintaining both cognitive function and quality of life. Recommended in guidelines around the world for use with people with mild to moderate dementia as the major evidence-based non-pharmacological intervention, it has assisted literally thousands of people with dementia and their carers globally to have a better quality of life both before and since 2008.
The benefits of office-based psychotherapies such as cognitive-behaviour therapy (CBT) are well-established in the treatment of common psychiatric disorders but their effectiveness with more severe conditions and when administered in circumstances beyond the reach of conventional services have not been known. Researchers at the University of Liverpool (UoL) have developed, adapted and evaluated CBT as a treatment for patients with schizophrenia, bipolar disorder and eating disorders and are now pioneering the delivery of CBT in rural areas in the developing world. This work has led to changes in treatment guidelines and improved treatment in the UK and in other countries.
Depression is a major public health problem producing substantial decrements in health and well-being, with 15% lifetime prevalence, affecting 350 million people worldwide. The Mood Disorders Centre (MDC) has improved treatment for depression by (i) understanding psychological mechanisms underpinning depression; (ii) translating this into innovative treatments and prevention interventions, evaluated in clinical trials; (iii) improving dissemination, delivery, and access to treatments. This research has improved patient care and quality of life, influenced national policy (NICE Depression Guidelines), informed national service and training provision (Improving Access to Psychological Therapies IAPT programme, with 680,000 people completing treatment 2008-2011) and achieved international impact on clinical practice.
Studies conducted at Imperial College, over the last 20 years, have improved the rational, evidence-based treatment of schizophrenia. Our research has covered symptomatology, neurocognitive function, medication side effects, and comorbid substance use, and involved clinical trials of pharmacological and psychosocial treatments. We lead national quality improvement programmes supporting the implementation of psychopharmacological practice standards. Our work has impacted upon the understanding, clinical assessment and treatment of this condition in both first-episode patients and established schizophrenia, and has improved prescribing practice and the identification and assessment of side-effects.
While in Oxford, David M. Clark and colleagues developed psychological models of panic disorder and social anxiety disorder, tested the models in experiments, and devised novel psychological treatments (forms of cognitive therapy [CT]) that target the processes in the models. Randomised controlled trials (RCTs) showed that CT was more effective than existing psychological and drug treatments, with 70-80% of people recovering. The therapies are recommended first-line interventions in current NICE guidelines, and are widely available in the NHS through the Improving Access to Psychological Therapies (IAPT) programme, which Clark helped establish and is now evaluating. The treatments are also being used and recommended in many other countries.
Work by Fonagy and Roth at UCL to establish a firm evidence base for psychological therapies has had a profound impact on the delivery of services across the UK. This evidence was used to establish the Improving Access to Psychological Therapies programme. Building on the original research, Roth and Pilling developed a series of competence frameworks which have been used to train thousands of additional therapists to deliver the programme. More than a million patients have now benefitted from the programme, which, along with the clear impacts on individual wellbeing, has also been recognised as having significant economic gains, in terms of NHS savings, reduced welfare spending, and increased return to the workforce.