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Title: Cognitive behavioural therapy for functional dysphonia : development of a complex intervention
Author: Deary , Vincent Aaron Vernon Adrian Hugo
ISNI:       0000 0004 2741 3796
Awarding Body: University of Newcastle Upon Tyne
Current Institution: University of Newcastle upon Tyne
Date of Award: 2011
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Functional dysphonia, loss or alteration of voice in the absence of physical pathology, is the commonest presentation to speech and language therapists (SLTs) and accounts for up to 40,000 new cases every year in the UK. Besides its impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aim of this research project was therefore to develop an improved intervention. Method A broad cognitive behavioural model of medically unexplained symptoms (MUS) was researched and identified as a suitable theoretical basis for the intervention development process. This was then applied as an assessment format in a series of patient interviews. Data from this stage were used to design a cognitive behavioural therapy (CBT) intervention for a SLT to deliver in a small consecutive cohort study. Data and clinical insights from this study were used to further develop the CBT intervention, which was then trialled in an external pilot patient randomised trial. Following up findings from the consecutive cohort phase, particular attention was paid in the randomised trial to the process issues involved in the professional behaviour change of the SLT, and a questionnaire study to investigate fatigue and perfectionism in functional dysphonia patients was conducted. Results and conclusion It was acceptable and feasible for a SLT to deliver CBT and there was some evidence of clinical effectiveness. This data is used to discuss the power and design of a future definitive study. The focus on process illuminated the work that needed to be done to embed a complex intervention in clinical practice. Functional dysphonia was shown to resemble other MUS in ways that could significantly contribute to our understanding and treatment of this condition.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis Qualification Level: Doctoral
EThOS ID:  DOI: Not available