Implementing a hybrid cognitive-behavioural therapy for pain-related insomnia in primary care : lessons learnt from a mixed-methods feasibility study

Objectives: To test the feasibility of implementing a brief but intensive hybrid cognitive behavioural therapy (Hybrid CBT) for pain-related insomnia. Design: Mixed-methods, with qualitative process evaluation on a two-arm randomised controlled feasibility trial. Setting: Primary care. Participants: Twenty-five adult patients with chronic pain and insomnia. Intervention: Hybrid CBT or self-help control intervention. Primary and secondary outcome measures: Primary outcomes measures were the Insomnia Severity Index and interference scale of the Brief Pain Inventory (BPI). Secondary outcomes measures were the present pain intensity rating from the BPI, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale and EQ-5D-5L. Results: Fourteen participants were randomised to receive Hybrid CBT, 11 to receive the self-help control treatment. Of the 14 in the Hybrid CBT group, 9 (64%) completed all four treatment sessions (4 discontinued due to poor health; 1 due to time constraints). Adherence to the self-help control treatment was not monitored. The total number of participants completing the 12-week and 24-week follow-ups were 12 (6 in each group; Hybrid CBT: 43%; self-help: 55%) and 10 (5 in each group; Hybrid CBT: 36%; self-help: 45%). Based on the data available, candidate outcome measures appeared to be sensitive to changes associated with interventions. Thematic analysis of pre-postintervention interview data revealed satisfaction with treatment content among those who completed the Hybrid CBT, whereas those in the self-help control treatment wanted more contact hours and therapist guidance. Other practical suggestions for improvement included shortening the duration of each treatment session, reducing the amount of assessment paperwork, and minimising the burden of sleep and pain monitoring. Conclusion: Important lessons were learnt with regard to the infrastructure required to achieve better patient adherence and retention. Based on the qualitative feedback provided by a subset of treatment completers, future trials should also consider lowering the intensity of treatment and streamlining the data collection procedure. Trial registration number: ISRCTN17294365

Support for Resettling Refugees: The Role of Fixed-Growth Mindsets

In six studies (N = 2,340), we identified one source of people’s differential support for resettling refugees in their country—their beliefs about whether the kind of person someone is can be changed (i.e., a growth mind-set) or is fixed (i.e., a fixed mind-set). U.S. and UK citizens who believed that the kind of person someone is can be changed were more likely to support resettling refugees in their country (Studies 1 and 2). Study 3 identified a causal relationship between the type of mind-set people hold and their support for resettling refugees. Importantly, people with a growth mind-set were more likely to believe that refugees can assimilate in the host society but not that they should assimilate, and the belief that refugees can assimilate mediated the relationship between people’s mind-sets and their support for resettling refugees (Studies 4–6). The findings identify an important antecedent of people’s support for resettling refugees and provide novel insights into the science of mind-sets

To have or to do : it's all in the mind(set)

The pursuit of happiness in our consumerist society is all about getting the biggest hedonic bang for the (limited) buck. In the domain of consumer behavior, extant research over the last decade suggests that people generally derive more happiness from experiences rather than material possessions. But is this experiences-over-goods effect universal? I propose that an individual’s beliefs about the malleability (vs. fixedness) of human characteristics, influence the preference for experiences over goods. Ten studies provide converging evidence that incremental theorists (growth mindset) value experiences (over material possessions) more than entity theorists (fixed mindset). I replicate the effect across multiple contexts, both for anticipatory consumption choices and preferences and retrospective post-consumption evaluations (Pilot Study, Studies 1 & 2a-2c). Further, I find that incremental theorists’ preference for experiences is driven by the belief that experiences contribute to self-growth and learning (Studies 3 & 4). In a stricter test of the hypothesis, I demonstrate that incremental theorists’ preference for experiences holds even when a product (experience) is framed as an experience (vs. a material possession) (Studies 5 & 6). Finally, I also propose a ‘material’ reward to nudge entity theorists into opting for experiences that are beneficial for them (Study 7). This research contributes to literature on experiential vs. material consumption by investigating a meaningful individual difference that influences the happiness people derive from experiences. I also contribute to implicit theory literature by examining the underlying reason that drives incremental theorists’ preference for experiences. Lastly, it has interesting implications for marketers to design compelling communication campaigns by leveraging either the material or experiential attributes to appeal to specific target audiences.Doctor of Philosophy (NBS