Research at Sheffield has changed UK and international clinical
guidelines for the treatment of
post-traumatic stress disorder and has ensured that more appropriate
treatments target people
who have been traumatised. The Sheffield studies revealed the limitations
and ineffectiveness of a
commonly adopted clinical approach reliant on psycho-education and
self-help. These studies
concluded, on the basis of three randomised control trials of self-help
provision, that despite the
provision of information being valued by patients, it had no direct effect
on relieving symptoms or
enhancing quality of life or functioning. These research findings have
directly contributed to good
practice guidance for public health, disaster management and relief, and
responding to terrorism
Research by Anke Ehlers' group at Oxford University has had major impacts
on the treatment and outcome of post-traumatic stress disorder (PTSD). The
group developed and validated a psychological model of the key factors
that lead to PTSD. A novel form of cognitive therapy (CT) that
specifically targets these psychological processes was then developed.
Randomised controlled trials showed that CT is highly acceptable and
highly effective in recent-onset and chronic PTSD, in adults and children.
It is one of the recommended first-line interventions in the NICE PTSD
guideline. It has been made widely available in the NHS through Improving
Access to Psychological Therapies (IAPT), and is being disseminated
in other countries. Separate research by Ehlers showed that a previously
leading treatment, debriefing, was ineffective, leading to it not
being recommended by NICE.
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
There is strong evidence that Mindfulness-Based Cognitive Therapy (MBCT)
plays a major role not only in preventing the recurrence of depression,
but also in enhancing well-being more broadly. Much of this research was
carried out at Bangor University's Centre for Mindfulness Research and
Practice, with a focus on non-academic impact from the outset. Between
2008-2013, the Centre has delivered MBCT courses to over 1500 members of
the public. We have also trained over 1300 professionals to deliver MBCT
within the NHS and other contexts, leading to several successful spin-off
businesses. Finally, Centre researchers lead in the creation of UK good
The North Atlantic Treaty Organisation (NATO)/Euro-Atlantic Partnership
Council (EAPC) Guidance on "Psychosocial Care for People Affected by
Disasters and Major Incidents: a Model for Designing, Delivering and
Managing Psychosocial Services for People Involved in Major Incidents,
Conflict, Disasters and Terrorism" is a conceptual and practical
resource for: developing government policy; planning services, and
providing training for health and social care staff. It was informed by
underpinning research conducted in Aberdeen following the 1988 Piper Alpha
oil platform disaster and evidence briefings generated from a
comprehensive review of the world literature. Adopted as best practice
guidance by all 28 NATO Members and Partner Nations, it has had regional,
national and international impact by: enabling authorities to deliver
integrated psychosocial care and mental health services; enhance training;
raise awareness, and facilitate the effective utilisation of resources in
responding to psychosocial/mental health needs post- incident.
UK and international government and healthcare institutes have
incorporated Cardiff University research findings relating to the
management of intervention for individuals post-trauma into public
healthcare policy, strategy and services. Results from a randomized
controlled clinical trial of psychological debriefing (PD) following
traumatic events delivered strong evidence against the (then) standard
approach of advocating these one-off interventions post-trauma. The
Cardiff findings led to the global understanding that by not providing PD
post-trauma many tens of thousands would benefit, resulting in better
patient care and reduced healthcare costs.
Recent NHS policy has prioritised improving access to cost-effective
psychological interventions for people with mental health problems.
Research by Lucock at the Centre for Health and Social Care Research
(CHSCR) has contributed to meeting this challenge by developing and
evaluating self-help interventions which can be provided by a range of NHS
staff without professional psychotherapy or mental health training. This
work has resulted in the creation of the Self-Help Access in Routine
Primary Care (SHARP) initiative, a programme that gives practitioners
materials and training which enable them to deliver brief self-help
interventions supported by a dedicated website and a range of leaflets
that recognise service users' need for easy-to-understand material.
Feedback from practitioners on the website and training has been positive.
There is evidence of positive impacts of the training on practitioners'
confidence in their ability to deal with anxiety and depression, and in
greater use of Cognitive Behaviour Therapy (CBT) approaches with patients.
Evidence from testimony demonstrates impact on practice. Research also
provides evidence of benefit to patients in terms of reduction of anxiety
and depression and goal attainment. The research has also influenced
national guidance on best practice.
Research by the UoA has transformed trauma recovery for children in
situations of on-going violence. Hitherto, trauma recovery was provided
post-conflict. Trauma recovery programme research developed at Dundee and
led by Dr. Barron has directly improved psycho-trauma assessment and
intervention for over 6000 children in Palestine. The UoA has led the
development of a battery of screening measures and the delivery of
culture-specific programmes into counsellor practice (N=200). These
changes in psycho-trauma recovery have developed throughout Gaza (N=5000
children), across the West Bank (N=1000) and into other Middle East
countries (Jordan and Egypt; N=200). The research has led to the delivery
of trauma recovery programmes for maltreated children in 30% of Scotland's
Secure Estate (N=50).
Research at UCL developed a `screen and treat' model for dealing with
mental health problems in
the aftermath of disasters. This was successfully implemented after the
London bombings in 2005.
The strategy was shown to be very effective in detecting individuals in
severe psychological need,
and those screened and referred within the programme benefited
substantially from evidence-based
treatment. Since then, the model has been adopted in planning for major
incidents in the UK
and abroad. The screening instrument developed at UCL is in widespread use
around the world.
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.