title: Improving access to psychological therapies in voice disorders: a cognitive behavioural therapy model.
abstract: OBJECTIVE
  The improving access to psychological therapies initiative has highlighted the importance of managing mental health problems effectively, and research has shown excellent outcomes from cognitive behavioural therapy (CBT) interventions. Patients presenting with functional dysphonia will often also describe psychological distress including anxiety, depression and reduced general well-being, and it is felt that effective voice therapy needs to include the management of psychological well-being. The evidence for the use of CBT enhanced voice therapy is limited to date. Recent research has only started to identify the benefits of this approach and questions regarding how to achieve and maintain competence are essential.
  
  
  RESULTS
  Voice therapy outcomes are positive and patients receiving CBT with voice therapy have shown more improvement in their general well-being and distress.
  
  
  CONCLUSIONS
  CBT is a very well evidenced therapy and recommended by The National Institute for Health and Care Excellence (NICE) as the treatment of choice for mental health difficulties and medically unexplained symptoms. Allied health professionals are increasingly being trained to use CBT skills in the management of a number of symptoms/illnesses, and this should be considered for the management of functional dysphonia. However, there is a need for more research and detailed consideration of how therapists should be trained and supervised and how cost-effective this approach may be.
authors.affiliation: aThe Freeman Hospital, Newcastle Upon Tyne bNorthumbria University, Newcastle Upon Tyne cSunderland Royal Hospital, Sunderland, UK.
authors.forename: Tracy
authors.initials: T
authors.lastname: Miller
authors.forename: Vincent
authors.initials: V
authors.lastname: Deary
authors.forename: Jo
authors.initials: J
authors.lastname: Patterson
mesh_terms: D015928:Cognitive Behavioral Therapy; D006801:Humans; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D014832:Voice Disorders / Q000523:psychology* / Q000628:therapy*