TY - JOUR
AU - Dow, Rebecca
AB -  Abstract The last two decades have seen considerable development in our understanding of delusions, with medical perspectives broadening into more holistic bio-psychosocial models. Of particular relevance to services is the increasing evidence base for cognitive behavioural models and treatments. A number of national initiatives have aimed to ensure these developments are reflected in services. Primarily these have targeted adult services, yet delusions are no less common in older adults. Across two older adult services this study searched over 10,000 clinical notes to assess the number of individuals experiencing delusions, explored the perspectives of 27 staff members regarding their clinical approaches to working with delusions, and delivered a brief training on cognitive behavioural models and treatments of delusions. Three service users contributed to the training content. Endorsement of theoretical perspectives regarding delusions were measured pre- and post-training. Results showed over 20% of patients in the service may be experiencing paranoia or delusions, but only a handful were referred for CBT. Of 27 staff participants, less than half had received training on working with delusions, most of which was from as many as 20 years ago. Nearly all reported that a lack of knowledge prevented them from considering psychological perspectives. A quarter of staff across the two teams attended the training. No immediate changes in outcome measures were seen immediately post-training, with a striking diversity in approach reported by different members of staff. All staff qualitatively reported finding the training valuable, although engagement was dampened by high levels of stress and burnout. Key learning aims (1) To understand the developing cognitive behavioural evidence base for understanding and treating delusions in older adults. (2) To understand the need for this growing evidence base to be reflected in services, including older adult services, not only in structured interventions offered by psychological therapists, but also in patient interactions and care planning by all professions working in multi-disciplinary teams. (3) To understand some of the key challenges in assessing and improving current understanding of cognitive behavioural approaches to delusions within services. 
TI - 20 years versus 20 minutes: increasing the understanding of delusions from a cognitive behavioural perspective in two older adult community mental health teams
JF - Cognitive Behaviour Therapist
DO - 10.1017/S1754470X24000473
DA - 2025-02-24
UR - https://www.deepdyve.com/lp/cambridge-university-press/20-years-versus-20-minutes-increasing-the-understanding-of-delusions-EkCHCvPEkd
VL - 18
IS - 
DP - DeepDyve
ER -