Psychological Health

Evidence-Based Programs and Practices in psychological health
Introduction
Numerous years of research and studies in clinical psychology have illustrated that how individuals process received information, particularly with an attentional bias (AB) to scary information as well as bias in negatively interpreting vague information and data (interpretation bias), actually plays a huge part in the start and maintenance of depression and anxiety (Hughes at al., 2016). There is a growing interest in health psychology in the application of these experimental techniques to evaluate possible cognitive processing prejudices in health conditions like chronic pain, irritable bowel syndrome, cancer, and chronic fatigue syndrome together with health behaviors like smoking, eating, and alcohol abuse. Experimental studies in these fields could inform hypothetical development by allowing access to types and levels of information and data processing that might underpin unhelpful disease representation and manipulate health behaviors. Therefore, this paper is a study that aims to review evidence-based practices and programs within psychological health via literature review on various studies that exist on this matter.
Background
When it comes to the treatment and management of depressive disorders, psychological interventions play a key role as an alternative treatment. Several treatments have been developed mainly founded on cognitive-behavioral, psychodynamic, humanistic, or interpersonal approaches. According to one latest huge network meta-analysis involving 198 random trials conducted on patients suffering from depression, even though the amount of proof differed across the individual treatments, the health impacts appeared to be of the same magnitude (Barth et al., 2016).
The majority of the trials involved in this huge meta-analysis were conducted in specialized mental healthcare surroundings. Two questions arise about the treatment and management of depression, particularly in primary care.
One, can we infer the discoveries from trials conducted in specialized metal healthcare surroundings to primary care? Patients suffering from depression in primary care at times have more somatic or less serious symptoms compare to those patients transferred to specialty mental healthcare.
Two, the restricted figure, as well as the regional allocation of qualified experts, makes it challenging to offer personalized, face-to-face psychological therapy sessions to a broad population. Thus, there has been the development of several interventions whereby there is reduced contact time with the healthcare expert and whereby the treatment gets delivered electronically, by phone, or via printed content. It is important to understand how these less intensive psychological treatment techniques compare to the more intense (conventional) methods.
Description of intervention
CBT (cognitive behavioral therapy) refers to a focused method founded on the principle that cognitions affect behaviors and feelings, and that ensuing emotions and behaviors can affect cognitions. CBT features two different aspects: cognitive therapy and behavioral therapy. The latter is founded on the concept that behavior is acquired and can thus be altered. Some examples of behavioral methods include relaxation, activity scheduling, behavior modification, and exposure.
The former is founded on the concept that maladaptive behaviors and distressing emotions are an outcome of poor thinking patterns. Thus, therapeutic interventions like self-instructional training and cognitive restructuring are focused on substituting dysfunctional emotions and thoughts with more useful cognitions, which results in the mitigation of problem emotions, behavior, and thoughts. In this paper, meta-cognitive therapy has been added as part of cognitive-behavioral therapy. Skills training (such as anger management, stress management, and social skills training) is another vital CBT element (Hofmann et al., 2012).
Research method
A two-step procedure was utilized for this review. Firstly, a keyword search was carried out to identify any relevant studies. The used keywords were “evidence-based psychology practice,” evidence-based cognitive biases,” “evidence-based psychology health,” and “evidence-based psychological interventions.” A thorough cross-search was also carried out using different keyword combinations via the EBSCO database of research, which allowed for the simultaneous such of several databases, like Alt Healthwatch, Academic Search Premier, MEDLINE, CINAHL, PsycINFO, and PsycArticles among others. Additionally, further research was carried out via Google Scholar and the ISI Web of Knowledge. This additional search included all studies that referred or alluded to the psychological interventions mentioned in the abstract or title. Supplementary relevant studies and researches were also gotten from the reference lists of various selected articles.
In stage two, every identified reference was screened following two standards: First, the research had to be empirically founded and evaluates the impact of evidence-based practice and programs in outcomes of psychological health. Second, each study’s quality was examined in terms of research method and design, and if the journal was peer-reviewed.
Summary of findings
The findings from the study by Linde et al. (2015) illustrate that whereas several randomized trials have explored psychological treatments among primary care depression patients, it is still hard to determine whether some of the treatments are more effective and helpful than others. In complex meta-analyses, face-to-face cognitive behavioral therapy, other one-on-one treatments, guided self-help CBT, remote therapist lead CBT, and minimal/no contact CBT were found to be superior to placebo or ordinary care. One-on-one PST, one-on-one psychodynamic therapy, remote therapist-lead PST, and one-on-one interpersonal psychotherapy did not differ from placebo or ordinary care.
With only one exemption (remote therapist-lead cognitive behavioral therapy was superior to one-on-one interpersonal psychotherapy), the single treatments did not differ. For cognitive-behavioral therapy, several varying delivery methods have been examined, and the results imply that the less intensive interventions have the same impact as conventional one-on-one CBT.
Despite the depression treatment guidelines placing group CBT between high- and low-intensity evidence-based psychological interventions, the legitimacy of this placement remains unknown. Thus, the systematic review of Okumura & Ichikura (2014) sought to systematically appraise proof for the acceptability and efficacy of group cognitive-behavioral therapy among patients suffering from depression in comparison to the four psychological intervention intensity levels. The findings revealed that an average influence in favor of group cognitive-behavioral therapy compared with inactive controls. There was not enough proof to establish whether or not group CBT was indeed more effective than high- or low-intensity interventions because of the restricted amount of RCTs that compare these conditions.
Many people undergo treatment-resistant depression, which is described as limited or lack of response to the present recommended therapies. Papageorgiou & Wells (2015) assessed the efficiency of group metacognitive therapy among patents that were not responsive to both CBT and antidepressants. Sticking to a no-treatment baseline period of monitoring, ten patients got 12 2-hour weekly sessions, two post-treatment sessions, and were followed up after six months. This study’s findings illustrated that meta-cognitive therapy was linked with considerable developments across every outcome, including depression. Studies of recovery rates illustrated that 70 percent of the participants were grouped as recovered and 20 percent as improved.
Lenz, Hall & Bailey Smith (2016) carried out a study to approximate the treatment impact of mindfulness-based CT (cognitive therapy) in a group in comparison to alternative or no-treatment group interventions. A huge treatment impact size was shown to favor in comparison to a waitlist control.
Also, the four pieces of research reporting follow-up information produce huge impact size, suggesting that treatment results were sustained over time. In comparison to alternative group interventions (group CBT ad group psycho-education), MBCT was considerably more successful at minimizing depressive symptoms, with an average impact size stated. This intensity of impact was minimized to a tiny treatment impact over time, insinuating that the efficiency of MBCT in comparison to alternative treatments might lever out with time.
Kirkham, Choi, & Seitz (2016) assessed the efficacy of PST for MDD treatment among older patients in a meta-analysis and systematic review. In comparison to pooled controlled settings, there was a considerable drop in the average scores of depression for the PST patients, with an equivalent huge impact size. In the studies that included a disability outcome measure, PST considerably minimized disability in comparison to pooled controls.
Research involving up to eight PST sessions displayed heightened treatment efficiency in comparison to those having eight sessions and above, whereby no between-group disparities were noted. This review supports the present PST research literature implying that it is a successful treatment for older patients with MDD. The study, however, suggests additional research to comprehend long-term results linked to PST and its efficiency in comparison to other therapies.
Limitation of this review
There is no enough proof to illustrate that psychological interventions are indeed both cost-effective and efficient when it comes to treating mental conditions and that psychological interventions significantly contribute to the economy and community via lessening the need for access to healthcare services.
This review aims to offer the latest proof regarding a variety of psychological interventions for mental disorder treatment in order to help in the making of decisions concerning the best mental health treatments. It ought to support the works of the PHNs and mental healthcare experts offering psychological interventions through Better Access as well as other government-sponsored mental healthcare programs.
This review, however, does not contain an extensive evaluation of the undertaken research, and any reader seeking to find a thorough understanding of the study’s methodology and findings will have to access the source articles. Another limitation of this review is that provided the study’s short nature, it only mainly concentrated on cognitive-behavioral theory, and keeping in mind that there are a lot of other psychology practice programs and theories that could not all be discussed in this review, this is regarded as a considerable limitation.
Conclusion
Clinical Health Psychology is a promising and growing area in psychological science. The past 40 years have experienced massive developments in evidence-based psychological treatments, psychology practice studies, and field-reported fielding, particularly from CBT. The utilization of psychological treatment has brought about mixed data and information, for instance, in individuals suffering from chronic anxiety or depression, recovery rates of about 50 percent have been realized, with many others considerably improving.
Also, the possibility of relapse has reduced by approximately 50 percent as well, and in this respect, cognitive behavioral therapy appears to be more successful in comparison to medicines. Furthermore, many patients prefer cognitive behavioral therapy to medicines. The main focus in medical and psychological studies had shifted from a vague illustration of the efficiency of psychotherapy to particular assessment, identification, as well as the classification of particular treatments that are successful in trial settings for largely acknowledged psychopathologies.
An important question in establishing the efficiency of evidence-based practice is, what sort of treatment, prescribed by who, and under which scenarios, is most efficient for an individual with this particular issue?
It is also recognized that there might be several variables in play in a particular patient’s treatment that might not have been captured in the conventional research methods utilizing an RCT (randomized controlled trial). Even though RCT has always been regarded as the main standard for assessing the efficiency of interventions, more and more study questions and designs might not be investigated using RCT.
For instance, there might be certain elements of the treatment conditions or patient’s presentation that make it virtually impossible to carry out randomization or eradicate prejudice even with the use of the most thorough research technique (Australian Publication Society, 2010). A lot has been documented regarding the value of the clinician’s experience and training, therapeutic relationship, as well as the patient’s preferences and attitude. Health experts should utilize their professional view in establishing the most suitable intervention method founded on the best existing proof accompanied by relevant contextual and client factors.
Implications
From the above conclusion, it is proposed that in the coming years, this particular specialty section might become a useful platform for both researchers and clinicians to discuss experimental findings, theories, opinions, hypotheses, and approaches in medical health psychology (Castelnuovo, 2017).
Medical decisions need to be made in collaboration with the individual based on the most appropriate medically relevant proof and also with consideration of the likely costs, befits, as well as available options and resources. It is a psychologist administering treatment who makes the final decision concerning a particular treatment plan or intervention. The engagement of an informed patient is important to the success of the treatment. Decisions involving treatment should not be made by unprofessional individuals that are not familiar with the details of a particular case.
The psychologist administering treatment decides the suitability of study findings to a particular individual. Different patients might require interventions ad decisions not focused on by the existing research. The utilization of study evidence on a given individual always entails probabilistic implications. Thus, constant observation of patient improvement and treatment adjustment as required are important to EBPP.
Also, psychologists should attend to a variety of outcomes that might, at times, propose one approach and, at times, another, and they should also deal with the strengths and weaknesses of present studies. Psychological outcomes might include not just symptom alleviation and prevention of any imminent symptomatic events, but also the quality of life, capacity to make good life choices, adaptive functioning in both relationships and work, change in personality, as well as other goals set during the cooperation between clinician and patient.
Suggestions for future research
Additional research should be inspired by the recognized gaps in evidence. In this meta-analysis, the primary framework of the evidence base is a star-shaped intervention network with placebo or normal care as the “golden shared comparator” through which every single intervention is contrasted. Making a comparison of active interventions within such a network depends not only on the debatable transitivity presumption but also impedes reliable analysis of inconsistency.
Rather than conducting experiments that compare adequately examined interventions (such as one-on-one cognitive behavioral therapy) with a developed reference (for instance ordinary care), head to head random comparisons of medically diverse treatments would be preferable than those that methodically vary. This includes not just the hypothetical background but also the magnitude of contact with the medical expert and the mode of delivery (one-on-one versus remote, comprising different kinds of the methodical realization).
This allows for comparison among the broad selection if psychological interventions involved in primary care without the confusion of probable self-selection procedures in the population seeking treatment. Therefore, primary care researchers of psychological treatments and interventions are greatly encouraged to beat the “legitimation” method of comparing certain specific interventions to non-specific interventions and instead adopt the comparative efficacy research viewpoint, seeking answers that truly do inform the making of decisions under routine settings.
To inspire investigators in this field, this paper suggests ten important subjects that could be promising and interesting research drivers on the topic.
(1) Integration between pharmacology and psychological treatments psychotherapy
Future studies have to shift from the old type of reasoning that stresses on the difference between psychological treatment and pharmacological ones to a more integrated approach mainly because of the huge amount of proof regarding the efficiency of combination therapy over psychotherapy or pharmacotherapy alone, with depression as an example to take into consideration. Additional research should be carried out to find the best possible sequential approach or combination to pharmacology and psychotherapy for every psychopathology and all patients while taking into account the preferences of the patient (Castelnuovo, 2017).
(2) Integration between neuroscience and psychological treatments psychotherapy
Pieces of evidence of neuroimaging can assist us in understanding psychopathological and psychological phenomena better to improve our understanding of treatment procedures and models.
(3) Integration of psychological data with bio-physical ones
The psychosomatic area that concentrates on direct psycho-biological impacts of emotions and cognitions on medical illnesses pathophysiology is a growing and promising area of research.
(4) Development of fresh connection areas between medicine and clinical health psychology not yet discovered
Next to conventional collaboration areas between psychology and medicine like psycho-oncology, pain management, or psycho-cardiology, collaboration areas including psycho-pneumology, psycho-endocrinology, and psycho-geriatric, as well as latest topics like health behavior, psychological elements of medical diseases, and impact of organic conditions on an individual’s functioning have to be more developed.
(5) Focus on positive psychology
Positive psychotherapy and positive psychology are both new interesting approaches in the field of mental healthcare, and more investigation should be conducted.
(6) Integration of medical, psychological protocols with some of the latest monitoring strategies, virtual reality, technologies, and mHealth
The utilization of latest technologies and mHealth platforms could assist clinicians in various critical scenarios such as offering the continuity of medical help following a conventional duration of inpatient care and also opportunities to motivate and observe patients, particularly in the treatment’s follow-up phase (Castelnuovo, 2017) or even with the rural population that have only limited access to medical services. mHealth should illustrate its usefulness, and further research is required, especially in the cost-effectiveness area, whereby the latest technologies could play an important part in a stepped-care method of care.
(7) Adapting medical, psychological protocols to particular special contexts and populations (active aging and elderly, chronic care management, immigrants, among others)
Medical health psychology should come up with fresh protocols and adjust the old ones to suit the new emergent context and populations, such as elderly citizens, chronic patients, as well as immigrants that need personalized care approaches.
(8) Study of moderators and mediators of change in psychotherapy and medical psychology
The effectiveness of the ESTs (empirically supported treatments) from the EBM (evidence-based medicine) point of view has already been illustrated, and the common aspects approach normally regards every psychological intervention to positive because of the presence of fruitful shared core components. Further investigations should be conducted on the moderators and mediators that would enable and improve change in medical psychotherapy and psychology.
(9) Development of evaluation methods in medical health psychology
New endorsed questionnaires, semi-structured interviews, and scales should be developed in order to provide healthcare experts with valid and reliable psychometric tools, which would have a medical impact. Future studies in this area should cover the clinometric model (Castelnuovo, 2017).
(10) Conveying recommendations and guidelines for applications having a medical impact
To realize the real impact and changes in the medical community, studies have to fill in the gap that exists between practice and theory, offering toolkits for clinicians like recommendations and guidelines. A good example of this that needs to be followed is the Italian Consensus Conference on Pain in Neuro-rehabilitation.
References
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Castelnuovo, G. (2017). New and old adventures of clinical health psychology in the twenty-first century: standing on the shoulders of giants. Frontiers in psychology, 8, 1214.
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Linde, K., Rücker, G., Sigterman, K., Jamil, S., Meissner, K., Schneider, A., & Kriston, L. (2015). Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis. BMC family practice, 16(1), 103.
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Papageorgiou, C., & Wells, A. (2015). Group metacognitive therapy for severe antidepressant and CBT resistant depression: a baseline-controlled trial. Cognitive therapy and research, 39(1), 14-22.