Incorporating Cognitive Behavioural Therapy into a Public Health Care System: Canada and England Compared

Since the second half of the 2000s, Canada and England have instituted differing reforms to address the inadequate provision and quality of mental health services in both nations. With growing evidence demonstrating the success and cost-effectiveness of psychotherapy, the English reform sought to expand the delivery of psychological services through the Improving Access to Psychological Therapies program (IAPT) focusing on cognitive behavioural therapy (CBT). In contrast, Canadian interventions at the federal level were centred on knowledge exchange and advocacy, primarily through the Mental Health Commission of Canada. While significant improvements were made during this period to increase CBT access in England, there continues to be an insufficient availability of psychological services to meet the growing need in Canada. While a national roll-out akin to the IAPT program in England is unlikely in Canada, similar reforms could be initiated at the provincial level of government. Indeed, several provincial governments have acknowledged the need for an expansion of CBT services and, over the last decade, some have tried to make CBT techniques more widely accessible. We review the case of the Bounce Back program developed in British Columbia (BC) to illustrate this potential in the Canadian context. Best practices indicate that care is needed beyond the provision of psychiatric services and pharmacotherapy alone, and the initial results of both the IAPT program and BC’s Bounce Back program strongly suggest that it is possible to provide these cost-effective services in a public system

Incorporating Cognitive Behavioural Therapy into a Public Health Care System: Canada and England Compared

Since the second half of the 2000s, Canada and England have instituted differing reforms to address the inadequate provision and quality of mental health services in both nations. With growing evidence demonstrating the success and cost-effectiveness of psychotherapy, the English reform sought to expand the delivery of psychological services through the Improving Access to Psychological Therapies program (IAPT) focusing on cognitive behavioural therapy (CBT). In contrast, Canadian interventions at the federal level were centred on knowledge exchange and advocacy, primarily through the Mental Health Commission of Canada. While significant improvements were made during this period to increase CBT access in England, there continues to be an insufficient availability of psychological services to meet the growing need in Canada. While a national roll-out akin to the IAPT program in England is unlikely in Canada, similar reforms could be initiated at the provincial level of government. Indeed, several provincial governments have acknowledged the need for an expansion of CBT services and, over the last decade, some have tried to make CBT techniques more widely accessible. We review the case of the Bounce Back program developed in British Columbia (BC) to illustrate this potential in the Canadian context. Best practices indicate that care is needed beyond the provision of psychiatric services and pharmacotherapy alone, and the initial results of both the IAPT program and BC’s Bounce Back program strongly suggest that it is possible to provide these cost-effective services in a public system. Depuis la seconde moitié des années 2000, le Canada et l'Angleterre ont mis en place des réformes différentes pour tenter de remédier aux problèmes d’accès et de qualité des soins de santé mentale. Fondée sur des données probantes, la réforme anglaise a cherché à améliorer l’accès aux services de psychothérapie par le programme Improving Access to Psychological Therapies (IAPT) mettant l'accent sur la psychothérapie cognitivo-comportementale (PCC). En revanche, les interventions canadiennes au niveau fédéral ont été centrées sur le partage des connaissances et les programmes de sensibilisation, principalement par le biais de la Commission de la santé mentale du Canada. Ainsi, l’on observe une amélioration notable de l’accès à la PCC en Angleterre depuis la mise en œuvre de ces réformes, mais pas dans le contexte Canadien. Or, s’il est improbable d’envisager un programme fédéral du même type que l’IAPT au canada, des réformes similaires pourraient néanmoins être initiées au niveau des provinces et territoires. En effet, plusieurs gouvernements provinciaux ont reconnu la nécessité d'une expansion des services de PCC. Nous examinons le cas du programme Bounce Back développé en Colombie-Britannique pour illustrer ce potentiel dans le contexte canadien. Les meilleures pratiques indiquent que la PCC est une composante nécessaire de l’éventail des services de santé mentale, et autant les résultats du programme IAPT que ceux du programme Bounce Back de la Colombie-Britannique suggèrent fortement qu'il est possible de fournir ces services de manière efficiente dans un système public

Ultrafast dynamics in the excited hydrogen atom transfer states of ammonia clusters

Neutral ammonia clusters (NH3)m are photo-excited to the electronic $\tilde{A}$ state by a deep UV femtosecond laser pump pulse. Within a few hundred femtoseconds a significant fraction of the clusters rearrange to form an H-transfer state (NH3)$_{m-2}$NH4(3s)NH2 with the subunit NH4 in its 3s electronic ground state. This state is then electronically excited by a time-delayed infrared control pulse of variable wavelength. Finally, a third (probe) pulse in the UV ionizes the clusters for detection. The lifetime of the excited (NH3)$_{m-2}$NH4(3p )NH2 states is found to vary between 2.7 and 0.13 ps depending on cluster size and excitation energy. It increases drastically upon deuteration. The corresponding cluster size-dependent photoelectron spectra allow us to disentangle the underlying energetics of the excitation and ionization process and reveal additional processes, such as nonresonant ionization or dissociative ionization. The experimental findings suggest that the excited H-transfer ammonia complexes with m>2 are deactivated by an internal conversion process back to the electronically lowest H-transfer state followed by fast dissociation

Investigations of ultrafast dynamics in electronically excited alkylbenzenes

We investigate ultrafast dynamics in electronically excited states of some typical alkylbenzenes by time-resolved two-colour four wave mixing and velocity map imaging as complementary methods. In this context an upgraded double-sided time-resolved velocity map imaging setup is also proposed