Publications: 2001
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Hardy, G.E., Cahill, J., Shapiro, D.A., Barkham, M., Rees, A., & Macaskill, N. (2001). Client interpersonal and cognitive styles as predictors of response to time-limited cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 69, 841-845. This study examined the relationship between cognitive and interpersonal styles and outcome amongst 24 clients who received time-limited cognitive therapy for depression. The authors hypothesized that this relationship would be mediated by therapeutic alliance. They found that clients' interpersonal style, particularly an underinvolved style, was predictive of treatment outcome. As predicted, the impact of this style on outcome was mediated through the therapeutic alliance.
Paley, G., & Shapiro, D.A. (2001). Evidence-based psychological interventions for mental health nurses. Nursing Times, 97, 34-45. There is a wealth of research evidence to support alternative counselling methods to cognitive behaviour therapy. Mental health nurses do not need to feel intimidated or insecure if they have not received specialist training in CBT or DBT. Research suggests that any form of counselling that leads to the development of a therapeutic relationship between the nurse and client, offers some form of structure to the counselling and attends to changes or problems in the therapeutic process between nurse and client throughout the course of the counseling could justifiably be regarded as evidence-based.
Paley, G., & Shapiro, D.A. (2001). Transactional Analysis functional ego states in people with schizophrenia and their immediate relatives. International Journal of Psychiatric Nursing Research, 6, 737-745. Objective: To explore the validity of Transactional Analysis (TA) functional ego state theory. Method: The TA scales of the Adjective Checklist (ACL) were used to measure the functional ego states in 22 patients with schizophrenia and 55 of their immediate relatives. Results: There were significant differences in four out of the five ego state scores between patients and their relatives, and ego state scores correlated with measures of pathology in both patients and relatives. The results generally supported TA theory in showing that pathology is associated with higher scores on Critical Parent and Adapted Child scales, and lower scores on Nurturing Parent, Adult, and Free Child scales. Conclusion: These results offer some validity to TA theory and suggest that the TA scales of the ACL are measuring meaningful aspects of psychological functioning.
Rees, A., Stride, C.B., Shapiro, D.A., Richards, A. & Borrill, C.S. (2001). Psychometric properties of the Community Mental Health Team Effectiveness Questionnaire (CMHTEQ). Journal of Mental Health, 10, 213-222. The Community Mental Health Team Effectiveness Questionnaire (CMHTEQ) is a 27-item measure of community mental health team (CMHT) effectiveness for completion by team members. It was constructed following a stakeholder conference representing the following constituencies: clinicians, users and carers, mental health researchers, policy makers and managers. We present a psychometric analysis of the CMHTEQ, based on the responses of 1450 (response rate: 75%) CMHT staff of a sample of 113 CMHTs recruited from all Trusts providing community mental health care across four English NHS Regions. Three factors emerged from an exploratory analysis of 50% of the data, upheld by a confirmatory analysis of the remaining data: meeting external requirements; internal team processes; evidence and feedback. Factor scales exhibited acceptable internal reliabilities. The CMHTEQ meets the need for a measure of the effectiveness of CMHTs, as perceived by their members, for use in research studies of the environment and effectiveness of mental health care, and by service managers or CMHTs seeking to monitor or track performance change over time.
Stiglmayr, C.E., Shapiro, D.A., Stieglitz, R.D., Limberger, M.F., & Bohus, M. (2001). Experience of aversive tension and dissociation in female patients with Borderline Personality Disorder: A controlled study. Journal of Psychiatric Research, 35, 111-118. Assuming that the experience of strong aversive tension might be an indicator of the extent of affect dysregulation within patients with borderline personality disorder (BPD), we sought to operationalize the duration and intensity of these phenomena. In addition we studies the relationship between aversive tension and the experience of dissociative features. Seventy-two female patients with BPD, together with 55 healthy controls, completed a self-rating questionnaire covering the previous 24 h. Substantial and highly significant differences with regard to the duration and intensity of the subjectively perceived states of aversive tension were found. Amongst patients with BPD there was a strong correlation between duration and intensity of tension, and experience of dissociative features, both somatoform and psychological. The findings underline the clinical importance of states of aversive tension in BPD particularly with regard to stress-related induction of dissociative features.
Whitfield, G., Williams, C. J., & Shapiro, D.A. (2001). Assessing the take up and acceptability of a self-help room used by patients awaiting their initial outpatient appointment. Behavioural and Cognitive Psychotherapy, 29, 333-343. This open study measured the proportion of routine referrals from primary care to a psychiatric sector team with symptoms of anxiety and/or low mood who chose to take up the option of attending a self-help room to use the CBT self-help manual Mind over mood during a 6-week waiting list period. It assessed changes in psychological health, dysfunctional attitudes and degree of hopelessness during the period of use of the self-help manual, as well as patient satisfaction with it. Twenty-two of 42 consecutive referrals attended the room (mean 3.55 sessions, SD 1.71). The Beck Hopelessness Scale (BHS), the General Health Questionnaire (GHQ), and Dysfunctional Attitudes Scale (DAS), as well as measures of patient participation and satisfaction, were completed at the beginning and end of the 6-week period for those patients who attended the room. All three scale scores fell significantly over the study period, and the DAS and BHS scores at 6 weeks were negatively correlated with the number of sessions attended. The patients generally judged that the self-help intervention was acceptable and effective, and that their knowledge in a number of key areas had been improved. Conclusions regarding effectiveness are limited by the absence of control group data; nonetheless, this study does suggest that the provision of a self-help room containing Mind over mood is useful for patients with anxiety and low mood on a waiting list for a psychiatric outpatient assessment.
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