While we now have a strong evidence base for cognitive behaviour therapy in managing mental health problems, the challenge is to disseminate it into real-world settings. Two dissemination approaches exist: the dominant ‘research to practice’ model, a linear sequence, taking interventions from the research laboratory and overcoming barriers so as to apply them in the real world and a more collaborative approach, in which researchers work together with clinicians and patients to adapt existing treatments for real-world settings. This article provides a detailed example of a collaborative approach to adapting cognitive behaviour therapy, by developing a very brief mental health intervention for patients in a primary-care (family doctor) setting.

Background: Very few studies have compared the efficacy of individual and group cognitive behaviour therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) by taking into consideration the change in OCD severity in both the short and long term. Aims: To conduct an open trial of individual versus group CBT for OCD, comparing the clinical and statistically significant changes in severity both at post-treatment and one year later. Method: Forty-two OCD subjects were assigned to individual (n = 18) or group CBT (n = 24, in four groups). Sixteen and 22 subjects completed the treatment in the individual and group conditions, respectively. The Yale-Brown Obsessive Compulsive Scale was recorded at pre-treatment, post-treatment and at the one-year follow-up. Results: At the end of treatment, the clinically significant change was comparable for the two treatment conditions and remained stable at the one-year follow-up. Of the 16 participants who completed the individual CBT treatment, 68.75% were classified as recovered at post-treatment, compared to 40.9% of those receiving group CBT. At follow-up the rate of recovery decreased to 62.5% in individual CBT and to 31.8% in group CBT. Conclusions: Group CBT is effective in decreasing OCD severity. The post-treatment changes were maintained one year later. Nevertheless, these changes were higher in the individual delivery of CBT.

Over the past two decades, substantial research has been conducted to investigate the idea that alterations in short-term nutritional intake play a role in influencing cognitive behaviour and mood. A portion of this research has examined specifically the effect of meal intake on the performance of mental tasks and subjective feelings of mood. Results of this research indicate that a number of variables including the timing and nutritional composition of the meal, nutritional status, habitual patterns of feeding behaviour, beliefs about food, and the nature of the mental tasks, can influence the effects of meals on cognitive behaviour. For example, studies have demonstrated that breakfast intake generally is associated with an improvement in cognitive performance later in the morning, while lunch intake is associated with an impairment in mid-afternoon performance on mental tasks and more negative reports of mood. Intake of nutrients late in the afternoon appears to have a positive effect on subsequent performance on tasks involving sustained attention or memory. Although research has provided insights into the role of meal intake on cognitive behaviour and mood, there are a number of factors which remain to be studied. These include the interaction of age, gender, activity level, meal composition, personality factors, stress with the effects of meals on cognitive behaviour. Additionally, more work is needed on the time-course of short-term nutrient effects, and the effects of chronic changes in meal intake on behaviour.