Exploring the role of CBT in the self-management of type 2 diabetes: A rapid review

Background: Type 2 diabetes has been recognised as a global health concern: one that requires intervention to lessen the incumbrance caused by the chronic illness. This rapid review was conducted to determine the scientific evidence available on how Cognitive Behaviour Therapy (CBT) interventions improved the self-management of individuals with type 2 diabetes. Aim: The aim of the review was to synthesise current scientific evidence regarding CBT-based interventions and self-management practices. Method: The rapid review served as a framework to appraise current national and international literature. The researchers used Google Scholar, Journal Storage (JSTOR), PsycINFO, APA PsycArticles, SAGE journals and EBSCO Discovery Services to search for relevant studies. This was performed by employing keywords. Nine relevant studies were identified. The studies were heterogenous in methodology. Seven of the nine studies were conducted in developing countries. Results: The study found that the context of developmental countries plays a significant role in the development of type 2 diabetes and requires tailored intervention because of socio-economic variabilities. The main themes identified in relation to improving self-management included: the characteristics of the CBT-based interventions, namely the format, duration, and outcomes, and identifying the techniques and components used in the CBT-based interventions. Conclusion: The review emphasised the need to further investigate the role of CBT in improving self-management of type 2 diabetes, especially in a South African context.

Assessment of the realisation of the right to adequate food in the Blue Crane Route (Eastern Cape, South Africa)

Objectives: To assess whether the right to adequate food (RtF) is realised by children and primary caregivers and what actions are required to fully realise this right. Design: A cross-sectional, descriptive study was undertaken using a mixed-methods approach. Setting and subjects: Rural and urban primary caregivers of children (one to five years old) were recruited if they had resided in the Blue Crane Route (Eastern Cape) for at least six months. Purposefully selected key informants (KIs) involved in nutrition and food security, health or governance participated in in-depth interviews.Outcome measures: Primary caregivers responded to interviewer-administered questionnaires (IAQ) (N = 161), which investigated various indicators supporting the realisation of the RtF. Statistical analysis of quantitative data examined relationships between urban and rural participants. Significance was considered at p < 0.05. In-depth interviews with key informants (KIs) examined the perceptions of 11 prominent community leaders. Qualitative data were coded deductively and common themes identified. Results: Based on the IAQ, half (51%) of the caregivers had experienced risk of, or food insecurity in the past month. Common themes indicative of suboptimal realisation of the RtF included insufficient employment opportunities, inadequate policies and programme implementation, and inadequate agrarian practices, while the child support grant partially supported the realisation of the RtF. Caregivers felt disempowered by a sense of inability to realise the right themselves without government assistance but KIs suggested that caregivers needed to take responsibility. Conclusion: The RtF of children and their caregivers is not fully realised in the Blue Crane Route. Concerted, multidisciplinary approaches using a rights-based approach to implement policies and programmes are needed, together with the empowerment of the community with necessary skills and resources to further the realisation of the RtF.

Research protocol: development, implementation and evaluation of a cognitive behavioural therapy-based intervention programme for the management of anxiety symptoms in South African children with visual impairments

Background: Childhood anxiety presents a serious mental health problem, and it is one of the most common forms of psychological distress reported by youth worldwide. The prevalence of anxiety symptoms amongst South African youth is reported to be significantly higher than in other parts of the world. These high prevalence rates become even more significant when viewed in terms of children with visual impairments, as it is suggested that children with physical disabilities may be more prone, than their non-disabled peers, for the development of psychological difficulties. Objectives: The main aim of this study is to develop, implement and evaluate a specifically tailored anxiety intervention programme for use with South African children with visual impairments. Method: A specifically tailored cognitive-behavioural therapy-based anxiety intervention, for 9-13 year old South African children with visual impairments, will be evaluated in two special schools. The study will employ a randomised wait-list control group design with pre- postand follow-up intervention measures, with two groups each receiving a 10 session anxiety intervention programme. The main outcome measure relates to the participants' symptoms of anxiety as indicated on the Revised Child Anxiety and Depression Scale. Conclusion: If the anxiety intervention programme is found to be effective in reducing symptoms of anxiety, this universal intervention will lay down the foundation upon which future contextually sensitive (South African) anxiety intervention programmes can be built

Spirit(ed) Away: Preventing Foetal Alcohol Syndrome with Motivational Interviewing and Cognitive Behavioural Therapy

Foetal alcohol syndrome (FAS) is a growing concern in South Africa. In the Western Cape; prevalence rates for FAS are the highest in the world. Not surprisingly; the Western Cape also has some of the highest levels of alcohol consumption per capita. Although FAS is primarily caused by alcohol consumption during pregnancy; the high rate of FAS in South Africa originates from a multitude of complex factors. These factors include heritage; poverty; high levels of unemployment and low-paid menial jobs; depression; low self-esteem; low self-efficacy; increased accessibility to alcohol; lack of recreation; poor education; familial pressure; denial; cultural misconceptions and the smaller physiques of some of the women in the Western Cape. Holistic and comprehensive macro- and micro-level approaches are necessary in order to change the alcohol consumption trend that has developed over the last 300 years. No single strategy will reduce or eliminate the burden of alcohol misuse in this society. However; as the presented discussion suggests; combining the spirit of motivational interviewing (MI) with cognitive behavioural therapy (CBT) practice; borrowed from health psychological interventions for lifestyle-related chronic health conditions; holds promise for reducing the prevalence of FAS within Western Cape communities. These individual-based approaches have yet to be employed in South Africa despite the wealth of evidence that demonstrates their potential in targeting high-risk groups and reducing per capita alcohol consumption

Treating Phobias or Treating People ? Of Acronyms and the Social Context

Phobias are some of the most common disorders brought to the attention of treatment agents. Classically; the treatment of choice was SD (systematic desensitisation); sometimes combined with hypnosis. More recently; VR (virtual reality) procedures and EMDR (eye movement desensitisation reprocessing) emerged as exciting alternatives. SD and the VR procedures are operationalisations of CBT (cognitive behaviour therapy) and are based on learning theory; while EMDR is usually viewed from a psychoneurological perspective. The generally good results obtained with the methods known by these acronyms are often taken to confirm the soundness of the particular underlying theory. However; these theories under-represent the interpersonal or social aspects of phobic behaviour. Adding an inter-personal focus to the generally intra-personal view of this behaviour much more fully explains both the success of the usual treatment procedures and the relatively rare failures. Using case illustrations; this paper highlights the way in which phobic behaviour is often embedded in a matrix of interpersonal and social influences and suggests the more deliberate and effective utilisation of these in the treatment of phobic sufferers

Exercice and Depression : a Treatment Manual

Increased frequencies in unipolarmajor depression and dysthymia evolve into chronic depression (Gotlib et Hammen; 1992:ll). Depression is reportedly the most common disorder; comprising 75of all psychiatric hospitalisations (Gotlib et Hammen; 1992:17). In the South African context there are few effective manual-based therapy programmes for the treatment of unipolar major depression or dysthymia. This study aimed to develop a manual-based therapy programme for the treatment of unipolar major depression as well as dysthymia; comprising a short-term intervention strategy (a minimum of eight sessions; and a follow-up session) influenced by a cognitive behavioural model focusing on exercise therapy and medication. The control group received non-specific treatment. The research results indicated a shift in different mood constructs for the sample group; as measured by the Nowlis Mood Adjective Checklist. Furthermore; negative emotional states decreased in severity and positive states increased; during andafter the intervention. A significant decrease in depression scales was also found; as measured by the Hamilton Depression Rating Scale and the Millon Multi-Axial lnventory 11. Furthermore; the personal accounts of the clients were used to gain insight into changing cognitive structures andperspectives; which indicated an increase in concentration; motivation and sense of control