Objective College counseling centers (CCCs) are increasingly being called upon to treat highly distressed students with complex clinical presentations. This study compared the effectiveness of Dialectical BehaviorTherapy (DBT) for suicidal college students to an optimized control condition, and analyzed baseline global functioning as a moderator. Method The intent-to-treat (ITT) sample included 63 college students between the ages of 18 and 25 who were suicidal at baseline, reported at least one lifetime non-suicidal self-injurious (NSSI) act or suicide attempt, and met three or more borderline personality disorder (BPD) diagnostic criteria. Participants were randomly assigned to DBT (n = 31) or an optimized Treatment as Usual (O-TAU) control condition (n = 32). Treatment was provided by trainees, supervised by experts in both treatments. Both treatments lasted 7–12 months and included both individual and group components. Assessments were conducted at pretreatment, 3-months, 6-months, 9-months, 12-months, and 18-months (follow-up). Results Mixed effects analyses (ITT sample) revealed that DBT, compared to the control condition, showed significantly greater decreases in suicidality, depression, number of NSSI events (if participant had self-injured), BPD criteria, and psychotropic medication use, and significantly greater improvements in social adjustment. Most of these treatment effects were observed at follow-up. No treatment differences were found for treatment dropout. Moderation analyses showed that DBT was particularly effective for suicidal students who were lower functioning at pretreatment. Conclusions DBT is an effective treatment for suicidal, multi-problem college students. Future research should examine the implementation of DBT in CCCs in a stepped care approach. PMID:22730955
Pistorello, Jacqueline; Fruzzetti, Alan E.; MacLane, Chelsea; Gallop, Robert; Iverson, Katherine M.
Purpose This article reports the findings of a Dialectical BehavioralTherapy- Corrections Modified (DBT-CM) intervention upon difficult to manage, impulsive and/or aggressive incarcerated male adolescents. Methods A secondary analysis of a sub-sample of 38 male adolescents who participated in the study was conducted. A one-group pretest-posttest design was used; descriptive statistics and t-tests were conducted. Results Significant changes were found in physical aggression, distancing coping methods and number of disciplinary tickets for behavior. Conclusion The study supports the value of DBT-CM for management of incarcerated male adolescents with difficult to manage aggressive behaviors. PMID:21501287
Shelton, Deborah; Kesten, Karen; Zhang, Wanli; Trestman, Robert
The current study examined two condensed adaptations of dialectical behaviortherapy (DBT) for binge eating. Women with full- or sub-threshold variants of either binge eating disorder or bulimia nervosa were randomly assigned to individually supported self-monitoring using adapted DBT diary cards (DC) or group-based DBT, each 15 sessions over 16 weeks. DC sessions focused on problem-solving diary card completion issues, praising diary card completion, and supporting nonjudgmental awareness of eating-related habits and urges, but not formally teaching DBT skills. Group-based DBT included eating mindfulness, progressing through graded exposure; mindfulness, emotion regulation, and distress tolerance skills; and coaching calls between sessions. Both treatments evidenced large and significant improvements in binge eating, bulimic symptoms, and interoceptive awareness. For group-based DBT, ineffectiveness, drive for thinness, body dissatisfaction, and perfectionism also decreased significantly, with medium to large effect sizes. For DC, results were not significant but large in effect size for body dissatisfaction and medium in effect size for ineffectiveness and drive for thinness. Retention for both treatments was higher than recent trends for eating disorder treatment in fee-for-service practice and for similar clinic settings, but favored DC, with the greater attrition of group-based DBT primarily attributed to its more intensive and time-consuming nature, and dropout overall associated with less pretreatment impairment and greater interoceptive awareness. This preliminary investigation suggests that with both abbreviated DBT-based treatments, substantial improvement in core binge eating symptoms is possible, enhancing potential avenues for implementation beyond more time-intensive DBT. PMID:24295464
Klein, Angela S; Skinner, Jeremy B; Hawley, Kristin M
Background Borderline Personality Disorder (BPD) is a serious psychiatric condition associated with substantial mortality, burden and public health costs. DBT is the treatment model with the largest number of published research articles showing effectiveness. However, some patients are not sufficiently engaged in outpatient treatment while presenting severe parasuicidal behavior, making hospitalization necessary. The Center for Personality Disorders Jelgersma developed an intensive 12-week inpatient DBT program that (i) rapidly reduces core borderline symptoms like suicidal behavior, (ii) minimizes the negative effects of an inpatient setting, and (iii) enhances compliance with outpatient treatment. We evaluate the (cost-) effectiveness of this experimental program. Methods/design Seventy patients, aged 18 to 45 years with a primary diagnosis of BPD, showing a chronic pattern of parasuicidal gestures and/or reporting high degrees of severity of other borderline symptoms, are randomly allocated to the control and intervention groups. Subjects in the control group receive standard outpatient DBT, provided in one of three regular mental health settings in GGZ Rivierduinen. Subjects in the intervention group receive 12 weeks of intensified inpatient DBT plus six months of standard DBT, provided in the Center for Personality Disorders Jelgersma. The primary outcome is the number of suicide attempts/self-harming acts. Secondary outcomes are severity of other borderline complaints, quality of life, general psychopathological symptoms and health care utilization and productivity costs. Data are gathered using a prospective, two (group: intervention and control) by five (time of measurement) repeated measures factorial design. Participants will complete three-monthly outcome assessments in the course of therapy: at baseline, and 12, 24, 36 and 52 weeks after the start of the treatment. The period of recruitment started in March 2012 and the study will end in December 2014. Discussion Highly suicidal outpatient patients can pose a dilemma for mental health care professionals. Although hospitalization seems inevitable under some circumstances, it has proven to be harmful in its own right. This paper outlines the background and methods of a randomized trial evaluating the possible surplus value of a short-term inpatient DBT program. PMID:24885551
ObjectiveTo evaluate the feasibility of dialectical behaviortherapy (DBT) implementation in a general child and adolescent psychiatric inpatient unit and to provide preliminary effectiveness data on DBT versus treatment as usual (TAU).
Laurence Y. Katz; Brian J. Cox; Shiny Gunasekara; Alec L. Miller
Dialectical BehaviorTherapy (DBT) is a cognitive-behavioral treatment for borderline personality disorder (BPD) that is based on the theory that emotion dysregulation is the core feature of BPD. This article focuses on aspects of DBT theory and techniques that specifically address emotion. The dialectical and biosocial theories that underlie DBT are reviewed with an emphasis on how each relates to
Melanie S. Harned; Sammy F. Banawan; Thomas R. Lynch
Dialectical BehaviorTherapy (DBT) is a comprehensive, multimodal cognitive behavioral treatment originally developed for individuals who met criteria for borderline personality disorder (BPD) who displayed suicidal tendencies. DBT is based on behavioral theory but also includes principles of acceptance, mindfulness, and validation. Since its…
Neacsiu, Andrada D.; Ward-Ciesielski, Erin F.; Linehan, Marsha M.
Dialectical-BehavioralTherapy for Borderline Personality Disorder (DBT) developed by M. Linehan is specifically designed for the outpatient treatment of chronically suicidal patients with borderline personality disorder. Research on DBTtherapy, its course and its results has focused to date on treatments in an outpatient setting.Hypothesizing that the course of therapy could be accelerated and improved by an inpatient setting at
Martin Bohus; Brigitte Haaf; Christian Stiglmayr; Ulrike Pohl; Renate Böhme; Marsha Linehan
The authors describe an intensive outpatient dialectical behaviortherapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behaviortherapy approaches that are well…
Both dialectical behaviortherapy (DBT) and mindfulness-based cognitive therapy (MBCT) include training in mindfulness skills and address the synthesis of acceptance and change. DBT is a comprehensive treatment for borderline personality disorder (BPD). MBCT was developed for prevention of relapse in individuals with a history of depressive episodes. Both have considerable empirical support for their efficacy. Many individuals with BPD
Comments on the article Payment or Repayment? The Problem of Private Practice written by O.H. Mowrer .) The current author discusses Mowrer's methods of behaviortherapy and states that he makes unsubstantiated claims regarding the effectiveness of behavioristic behaviortherapy. The author argues that until Mowrer can produce something more specific he should retire his theory.
Dialectical BehavioralTherapy (DBT) was initially developed and evaluated as an outpatient treatment program for chronically suicidal individuals meeting criteria for borderline personality disorder (BPD). Within the last few years, several adaptations to specific settings have been developed. This study aims to evaluate a three-month DBT inpatient treatment program. Clinical outcomes, including changes on measures of psychopathology and frequency of
Martin Bohus; Brigitte Haaf; Timothy Simms; Matthias F. Limberger; Christian Schmahl; Christine Unckel; Klaus Lieb; Marsha M. Linehan
Dialectical BehaviorTherapy (DBT) has recently been used to treat disorders other than Borderline Personality Disorder (BPD). Despite DBT's widespread use, no paper summarizes its use for con- ditions other than BPD; therefore, a synthesis of the literature is warranted. In this paper, we aim to (a) briefly summarize the treatment and its empirical basis for treating BPD; (b) explore
Dialectical behaviortherapy (DBT) is a comprehensive, evidence-based treatment for borderline personality disorder (BPD). The patient populations for which DBT has the most empirical support include parasuicidal women with borderline personality disorder (BPD), but there have been promising findings for patients with BPD and substance use disorders (SUDs), persons who meet criteria for binge-eating disorder, and depressed elderly patients. Although DBT has many similarities with other cognitive-behavioral approaches, several critical and unique elements must be in place for the treatment to constitute DBT. Some of these elements include (a) serving the five functions of treatment, (b) the biosocial theory and focusing on emotions in treatment, (c) a consistent dialectical philosophy, and (d) mindfulness and acceptance-oriented interventions. PMID:20975829
A mutation (K38R) which specifically eliminates kinase activity was created in the Drosophila melanogaster ckI gene (doubletime [dbt]). In vitro, DBT protein carrying the K38R mutation (DBTK/R) interacted with Period protein (PER) but lacked kinase activity. In cell culture and in flies, DBTK/R antagonized the phosphorylation and degradation of PER, and it damped the oscillation of PER in vivo. Overexpression of short-period, long-period, or wild-type DBT in flies produced the same circadian periods produced by the corresponding alleles of the endogenous gene. These mutations therefore dictate an altered “set point” for period length that is not altered by overexpression. Overexpression of the DBTK/R produced effects proportional to the titration of endogenous DBT, with long circadian periods at lower expression levels and arrhythmicity at higher levels. This first analysis of adult flies with a virtual lack of DBT activity demonstrates that DBT's kinase activity is necessary for normal circadian rhythms and that a general reduction of DBT kinase activity does not produce short periods. PMID:17893330
Muskus, Michael J.; Preuss, Fabian; Fan, Jin-Yuan; Bjes, Edward S.; Price, Jeffrey L.
Dialectical behaviortherapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have…
Rizvi, Shireen L.; Dimeff, Linda A.; Skutch, Julie; Carroll, David; Linehan, Marsha M.
A randomized clinical trial was conducted to evaluate whether Dialectical BehaviorTherapy (DBT), an effective cognitive-be- havioral treatment for suicidal individuals with borderline per- sonality disorder (BPD), would also be effective for drug-depen- dent women with BPD when compared with treatment-as-usual (TAU) in the community. Subjects were randomly assigned to ei- ther DBT or TAU for a year of treatment.
Marsha M. Linehan; Henry Schmidt III; Linda A. Dimeff; J. Christopher Craft; Jonathan Kanter; Katherine A. Comtois
Informed by the practice of code-switching or style-switching in linguistics, “bilingual therapeutics” is proposed as the\\u000a complementary integration of two evidence-based practices in psychotherapy: motivational interviewing (MI) and dialectical\\u000a behaviortherapy (DBT). Unique features of MI and DBT are presented, current research of each practice is reviewed, and their\\u000a similarities and distinctions are discussed. It is proposed that fluency in
The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behaviortherapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…
Patients with either or both Borderline Personality Disorder (BPD) and an eating disorder face a number of intrapsychic and interpersonal difficulties that have been historically treatment resistant. Dialectical BehaviorTherapy, which combines elements of cognitive behavioraltherapy and Zen practices, has shown some promise as a potential treatment for patients with comorbid personality and eating disorders. Criticisms of DBT include
A Dialectical BehaviorTherapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment,…
Drossel, Claudia; Fisher, Jane E.; Mercer, Victoria
A central component of Dialectical BehaviorTherapy (DBT) is the teaching of specific behavioral skills with the aim of helping individuals with Borderline Personality Disorder (BPD) replace maladaptive behaviors with skillful behavior. Although existing evidence indirectly supports this proposed mechanism of action, no study to date has directly tested it. Therefore, we examined the skills use of 108 women with BPD participating in one of three randomized control trials throughout one year of treatment and four months of follow-up. Using a hierarchical linear modeling approach we found that although all participants reported using some DBT skills before treatment started, participants treated with DBT reported using three times more skills at the end of treatment than participants treated with a control treatment. Significant mediation effects also indicated that DBT skills use fully mediated the decrease in suicide attempts and depression and the increase in control of anger over time. DBT skills use also partially mediated the decrease of nonsuicidal self-injury over time. Anger suppression and expression were not mediated. This study is the first to clearly support the skills deficit model for BPD by indicating that increasing skills use is a mechanism of change for suicidal behavior, depression, and anger control. PMID:20579633
Neacsiu, Andrada D.; Rizvi, Shireen L.; Linehan, Marsha M.
Behaviortherapy approaches to the treatment of male sexual impotence, specifically premature ejaculation and erective impotence, are discussed. Included in the behavioraltherapies are systematic desensitization, active graded therapy, assertive techniques, sexual responses, operant approaches and others. Often marriage counseling is also…
Societal cost-of-illness in a German sample of patients with borderline personality disorder (BPD) was calculated for 12 months prior to an outpatient Dialectical BehaviorTherapy (DBT) program, during a year of DBT in routine outpatient care and during a follow-up year. We retrospectively assessed resource consumption and productivity loss by means of a structured interview. Direct costs were calculated as opportunity costs and indirect costs were calculated according to the Human Capital Approach. All costs were expressed in Euros for the year 2010. Total mean annual BPD-related societal cost-of-illness was €28026 (SD = €33081) during pre-treatment, €18758 (SD = €19450) during the DBT treatment year for the 47 DBT treatment completers, and €14750 (SD = €18592) during the follow-up year for the 33 patients who participated in the final assessment. Cost savings were mainly due to marked reductions in inpatient treatment costs, while indirect costs barely decreased. In conclusion, our findings provide evidence that the treatment of BPD patients with an outpatient DBT program is associated with substantial overall cost savings. Already during the DBT treatment year, these savings clearly exceed the additional treatment costs of DBT and are further extended during the follow-up year. Correspondingly, outpatient DBT has the potential to be a cost-effective treatment for BPD patients. Efforts promoting its implementation in routine care should be undertaken. PMID:25113523
Background Dialectical BehaviorTherapy (DBT) identifies emotion dysregulation as central to the dangerous impulsivity of borderline personality disorder (BPD) including substance use disorders, and DBT targets improved emotion regulation as a primary mechanism of change. However, improved emotion regulation with DBT and associations between such improvement and behavioral outcomes such as substance use has not been previously reported. Objective Thus, the goal of this study was to assess for improvement in emotion regulation and to examine the relationship between improvements in the emotion regulation and substance use problems following DBT treatment. Method Emotion regulation as assessed by the Difficulties in Emotion Regulation Scale, depressed mood as assessed by the Beck Depression Inventory, and their associations with substance use frequency were investigated in 27 women with substance dependence and BPD receiving 20 weeks of DBT in an academic community outpatient substance abuse treatment program. Results indicated improved emotion regulation, improved mood, and decreased substance use frequency. Further, emotion regulation improvement, but not improved mood, explained the variance of decreased substance use frequency. Conclusions This is the first study to demonstrate improved emotion regulation in BPD patients treated with DBT and to show that improved emotion regulation can account for increased behavioral control in BPD patients. Significance and Future Research Emotion regulation assessment is recommended for future studies to further clarify the etiology and maintenance of disorders associated with emotional dyregulation such as BPD and substance dependence, and to further explore emotion regulation as a potential mechanism of change for clinical interventions. PMID:21091162
Objective Investigate moderators of a randomized clinical trial of group Dialectical BehaviorTherapy for Binge Eating Disorder (DBT-BED) compared to an active comparison group control (ACGT) on the post-treatment outcome of binge frequency after twenty 2-hour weekly sessions. Method Moderation analyses. Results Participants were 101 adults with BED [mean (SD) age, 52.2 (10.6) years and BMI, 36.4 (8.6)]. Analyses identified two moderators of post-treatment outcome. Participants with (1) Avoidant Personality Disorder or (2) an earlier onset of overweight and dieting (< 15 years old) evidenced significantly worsened outcome when treated with ACGT versus DBT-BED. Discussion Participants with certain indicators of higher baseline pathology respond better to DBT-BED than ACGT at post-treatment. PMID:21500238
Aim: This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Material and Method: Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1?mm, resolution 85?µm pixel pitch, 8?lp/mm; 2. BioVision™ (Bioptics, Tucson, AZ, USA), CMOS technology, photodiode array, flat panel, tungsten source, focus 0.05, resolution 50?µm pixel pitch, 12?lp/mm; 3. the Trident™ specimen radiography system (SRS) (Hologic, Bedford, MA, USA), amorphous selenium, tungsten source, focus 0.05, resolution 70?µm pixel pitch, 7.1?lp/mm; 4. tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1?mm, resolution 85?µm pixel pitch, 8?lp/mm, angular range 50 degrees, 25 projections, scan time >?20?s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiographs were prospectively shown to 3 radiologists. Results: Of the 50 patients with histologically proven breast cancer (BI-RADS™ 6), 39 patients required no further surgical therapy (re-excision) after breast-conserving surgery. A retrospective analysis (n?=?11) showed a significant (p?0.05) increase of sensitivity with the BioVision™, the Trident™ and tomosynthesis compared to the Inspiration™ at a magnification of 1.0?:?2.0 or 1.0?:?1.0 (tomosynthesis) (2.6, 3.3 or 3.6?%), i.e. re-excision would not have been necessary in 2, 3 or 4 patients, respectively, compared to findings obtained with a standard magnification of 1.0?:?1.0. Conclusion: The sensitivity of the BioVision™, the Trident™ and tomosynthesis was significantly (p?0.05) higher and the rate of re-excisions was reduced compared to FFDM using a conventional detector at a magnification of 2.0 but without zooming. PMID:24771921
Schulz-Wendtland, R.; Dilbat, G.; Bani, M.; Fasching, P. A.; Heusinger, K.; Lux, M. P.; Loehberg, C. R.; Brehm, B.; Hammon, M.; Saake, M.; Dankerl, P.; Jud, S. M.; Rauh, C.; Bayer, C. M.; Beckmann, M. W.; Uder, M.; Meier-Meitinger, M.
There is a risk of experiencing clinical burnout among therapists providing treatment to clients with borderline personality disorder (BPD), a complex, costly and difficult-to-treat psychiatric disorder. Dialectical behaviortherapy (DBT) is an evidence-based treatment of BPD that has been widely disseminated. There is only one published study that has examined pre and post scores of burnout among clinicians who receive training in DBT, and none that have taken place within a public behavioral health system in the United States where resources for community-based agencies are limited and demands are high. The current study examined the rates of burnout among therapists treating clients with BPD within a large, urban public behavioral health system. The study included a sample of nine clinicians and showed significantly decreased scores of burnout after participants attended a series of DBT trainings over a period of 13 months. There were several key limitations to internal validity including the lack of a control group. Similar evaluations of training outcomes are needed to address the widespread occurrence of burnout among community-based clinicians providing treatment to clients with BPD in order to enhance the quality of patient care. PMID:24346223
This study evaluated whether dialectical behaviortherapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and\\/or self-injurious behavior (n = 101) were randomly assigned to 1 year of DBT or community treatment by experts (CTBE), plus
Melanie S. Harned; Alexander L. Chapman; Elizabeth T. Dexter-Mazza; Angela Murray; Katherine A. Comtois; Marsha M. Linehan
For longer than 40 years, the cognitive and behavioraltherapies have evolved as alternatives to more traditional nondirective\\u000a and insight-oriented modes of psychotherapy (1). The cognitive and behavioraltherapies now include a diverse group of interventions\\u000a that share several pragmatic and theoretical assumptions. First, there is an emphasis on psychoeducation: patients are assumed\\u000a to be capable of learning about their
For individuals presenting with comorbid borderline personality disorder (BPD) and substance use disorders (SUD), rates of treatment dropout from combined mental health and substance abuse treatment centers approach 80%, rendering dropout the rule rather than the exception. Several studies indicate that utilizing a more comprehensive treatment such as Dialectical BehaviorTherapy (DBT) may be useful for client retention; however, given
A Dialectical BehaviorTherapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment, particularly increased problem-focused coping, enhanced emotional well-being, and less fatigue. Caregivers tended to utilize individual therapeutic services at a higher rate during the period of group attendance, indicative of appropriate help-seeking behavior in highly demanding situations. Six of the 16 caregivers repeated the training sequence in "booster" groups. Follow-up data from the booster groups suggest that high-risk caregivers may require continuing support to maintain treatment gains. In addition to demonstrating the feasibility of DBT Skills with caregivers, the results warrant a controlled outcome evaluation. PMID:21292057
Drossel, Claudia; Fisher, Jane E; Mercer, Victoria
The goals of treatment and assessment in the behaviortherapy approach should not be confined to such specific performance-oriented objectives as increasing approach behavior to feared stimuli or overcoming a stutter. They should be as diverse and complex as the people who have them. (Author/PD)
Although one of the main aims of dialectical behaviortherapy (DBT) for borderline personality disorder (BPD) is to increase the retention rates, premature termination rates for DBT inpatient programs were found to be over 30%. The aim of the study was to identify the reasons for, and to analyze, patient characteristics that are associated with premature termination. We studied 541 inpatients with BPD, who were consecutively admitted for an open-door 3-month DBT inpatient treatment in Berlin, Germany. All participants completed several self-rating measures and participated in clinical interviews. Fourteen percent, who did not complete the full 84 days of assigned treatment, were expelled, mainly due to treatment-disturbing behaviors, or substance abuse or possession. Nearly 19% dropped out of treatment, mostly due to lack of motivation, arguments with others, and poor tolerance of emotional distress. Using non-parametric conditional inference trees, expulsion was associated with anorexia nervosa and alcohol abuse, whereas more than 9 suicide attempts, antisocial personality disorders, and more than 86 weeks in a psychiatric hospital were risk factors for dropout. We discussed measures and interventions that might lead to an adaptation of DBT inpatient programs. Future research should examine the symptom course and utilization of health-care services of non-completers. PMID:25058040
This article describes how a large residential treatment program, Spurwink Services—decentralized throughout the southern and mid-portions of Maine—adapted and implemented an Informed Dialectical BehavioralTherapy (DBT) Program as part of its evidence-based treatment interventions for adolescent youth in residential treatment. Begun as a single group 8 years ago, the program now flourishes in 5 residential treatment sites across the agency.
Discusses the theoretical and practical applications of cosmetic behaviortherapy in a private practice. Enhancement of physical appearance will frequently result in an enhancement of self-concept, and the client's attainment of physical attractiveness contributes to the probability of success in current culture. (Author/JAC)
Objective The purpose of the present study was to explore the role of the therapeutic relationship and introject during the course of dialectical behaviortherapy (DBT; Linehan, 1993) for the treatment of borderline personality disorder. Method Women meeting DSM-IV criteria for borderline personality disorder (N = 101) were randomized to receive DBT or community treatment by experts. The Structural Analysis of Social Behavior (SASB; Benjamin, 1974) was used to measure both the therapeutic relationship and introject. Results Using hierarchical linear modeling, DBT patients reported the development of a more positive introject including significantly greater self-affirmation, self-love, self-protection, and less self-attack during the course of treatment and one-year follow-up relative to community treatment by experts. The therapeutic relationship did not have an independent effect on intrapsychic or symptomatic outcome but did interact with treatment. DBT patients who perceived their therapist as affirming and protecting reported less frequent occurrences of non-suicidal self-injury. Conclusions The study showed positive intrapsychic change during DBT while emphasizing the importance of affirmation and control in the therapeutic relationship. Results are discussed in the context of understanding the mechanisms of change in DBT. PMID:22061867
Bedics, Jamie D.; Atkins, David C.; Comtois, Katherine A.; Linehan, Marsha M.
Background Anorexia Nervosa (AN) is a highly life-threatening disorder that is extremely difficult to treat. There is evidence that family-based therapies are effective for adolescent AN, but no treatment has been proven to be clearly effective for adult AN. The methodological challenges associated with studying the disorder have resulted in recommendations that new treatments undergo preliminary testing prior to being evaluated in a randomized clinical trial. The aim of this study was to provide preliminary evidence on the effectiveness of a treatment program based on a novel adaptation of Dialectical BehaviorTherapy (DBT) for adult Anorexia Nervosa (Radically Open-DBT; RO-DBT) that conceptualizes AN as a disorder of overcontrol. Methods Forty-seven individuals diagnosed with Anorexia Nervosa-restrictive type (AN-R; mean admission body mass index?=?14.43) received the adapted DBT inpatient program (mean length of treatment?=?21.7 weeks). Results Seventy-two percent completed the treatment program demonstrating substantial increases in body mass index (BMI; mean change in BMI?=?3.57) corresponding to a large effect size (d?=?1.91). Thirty-five percent of treatment completers were in full remission, and an additional 55% were in partial remission resulting in an overall response rate of 90%. These same individuals demonstrated significant and large improvements in eating-disorder related psychopathology symptoms (d?=?1.17), eating disorder-related quality of life (d?=?1.03), and reductions in psychological distress (d?=?1.34). Conclusions RO-DBT was associated with significant improvements in weight gain, reductions in eating disorder symptoms, decreases in eating-disorder related psychopathology and increases in eating disorder-related quality of life in a severely underweight sample. These findings provide preliminary support for RO-DBT in treating AN-R suggesting the importance of further evaluation examining long-term outcomes using randomized controlled trial methodology. PMID:24199611
This study evaluated whether dialectical behaviortherapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were…
Harned, Melanie S.; Chapman, Alexander, L.; Dexter-Mazza, Elizabeth T.; Murray, Angela; Comtois, Katherine A.; Linehan, Marsha M.
Publication of papers related to psycho-social interventions in general and BehaviorTherapy, in particular, in Indian Journal of Psychiatry has been limited. Though the first paper related to BehaviorTherapy was published in 1952, a manual search of all available issues of the journal from 1949 showed that only 42 papers related to BehaviorTherapy have been published till 2009. Among them 10 are case reports. Methodological limitations abound even in the papers on larger groups of patients. Studies using operant conditioning have been very few. Aversion therapy and progressive muscle relaxation have been very frequently used. The published articles are reviewed under the various diagnostic categories. Publications in the recent years have been mostly on Cognitive BehaviorTherapy. Even after 57 years of co-existence, the relationship between BehaviorTherapy and Indian Psychiatry remains a tenuous one. PMID:21836708
This study focused on the development and pilot testing of a protocol based on Prolonged Exposure (PE) that can be added to Dialectical BehaviorTherapy (DBT) to treat PTSD in suicidal and self-injuring individuals with borderline personality disorder (BPD). Women with BPD, PTSD, and recent and/or imminent serious intentional self-injury (n = 13) received one year of DBT with the DBT PE Protocol, plus three months of follow-up assessment. The treatment was associated with significant reductions in PTSD, with the majority of patients no longer meeting criteria for PTSD at post-treatment (71.4% of DBT PE Protocol completers, 60.0% of the intent-to-treat sample). A minority of patients (27.3%) engaged in intentional self-injury during the study. Improvements were also found for suicidal ideation, dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and social adjustment. There was no evidence that the DBT PE Protocol led to exacerbations of intentional self-injury urges or behaviors, PTSD, treatment dropout, or crisis service use. Overall, the results indicate that this integrated BPD and PTSD treatment is feasible to implement within one year of treatment, highly acceptable to patients and therapists, safe to administer, and shows promise as an effective intervention for PTSD in this complex and high-risk patient population. PMID:22503959
This study focused on the development and pilot testing of a protocol based on Prolonged Exposure (PE) that can be added to Dialectical BehaviorTherapy (DBT) to treat PTSD in suicidal and self-injuring individuals with borderline personality disorder (BPD). Women with BPD, PTSD, and recent and/or imminent serious intentional self-injury (n=13) received one year of DBT with the DBT PE Protocol, plus three months of follow up assessment. The treatment was associated with significant reductions in PTSD, with the majority of patients no longer meeting criteria for PTSD at post-treatment (71.4% of DBT PE Protocol completers, 60.0% of the intent-to-treat sample). A minority of patients (27.3%) engaged in intentional self-injury during the study. Improvements were also found for suicidal ideation, dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and social adjustment. There was no evidence that the DBT PE Protocol led to exacerbations of intentional self-injury urges or behaviors, PTSD, treatment dropout, or crisis service use. Overall, the results indicate that this integrated BPD and PTSD treatment is feasible to implement within one year of treatment, highly acceptable to patients and therapists, safe to administer, and shows promise as an effective intervention for PTSD in this complex and high-risk patient population. PMID:22503959
The movement within behaviortherapy to introduce cognitive terms, constructs, and techniques reflects and involves an extension of the pervasive cognitive movement within the experimental field and the long-standing cognitive approach of many clinicians. Modern day attacks on behaviorism by cognitivists have been almost exclusively geared to the…
We assessed the effect of DBT skills utilization on features of borderline personality disorder as measured by the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). Participants were outpatients (N = 27) enrolled in a dialectical behaviortherapy (DBT) program in a university-affiliated community mental health clinic. Diary cards were collected each week to track self-reported skills use. At the beginning of each new skills training module, patients completed another PAI-BOR. Univariate and multilevel analyses indicated significant improvement on the total PAI-BOR score and on several PAI-BOR subscale scores. Results also revealed that overall DBT skills use increased significantly over time, as did individual skills related to mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Multilevel modeling results indicated that overall skills use showed a significant effect on PAI-BOR total scores, Affective Instability scores, Identity Problems scores, and Negative Relationships scores, even after controlling for initial levels of distress and diary card compliance. PMID:19072676
\\u000a This chapter is intended to help practicing cognitive behavior therapists make their treatment more intense, interpersonal\\u000a , and impactful for both therapists and clients by incorporating the methods of functional analytic psychotherapy (FAP; Kohlenberg & Tsai,\\u000a 1991; Tsai\\u000a et al., 2008). Our approach is user friendly in that it builds on existing cognitive behaviortherapy\\u000a (CBT\\u000a ) methods and skills
Robert J. Kohlenberg; Jonathan W. Kanter; Mavis Tsai
Cognitive behavioraltherapy (CBT) techniques offer short-term, goal-oriented psychotherapy. In this respect, it differs from classical psychoanalysis in emphasizing changes in thought patterns and behaviors rather than providing 'deep insight'. Importantly, the beneficial effects of CBT can be achieved in 10–20 sessions, compared with the many years required for classical psychoanalysis. Although CBT is often done on a one-to-one basis,
Increasingly, attention is turning to the significance of children's mental health. This attention results from a confluence\\u000a of information sources col lectively emphasizing the prevalence of childhood problems. Epidemiologi-cal estimates for the\\u000a prevalence rates of childhood emotional and behavioral disorders range between 15 and 22% (e.g., McCracken, 1992; Roberts,\\u000a Att-kisson,&Rosenblatt, 1998; Rutter, 1989; Kazdin&Weisz, 2003a; WHO, 2001). These rates may
The cognitive-behavioral family therapy (CBFT) approach is introduced, described and illustrated in this paper. The approach maintains that the family-related cognitions held by individuals play an important role in shaping what they expect from family life and how they experience, functton in, and react to it. The paper describes how, during the five steps of CBFT, a therapist can help
Replies to A. A. Lazarus's responses to the author's (1982) critique of Lazarus's (1971) review of 100 cases that yielded a 36% relapse rate after behaviortherapy (BT). It is argued that Lazarus should have clarified that he confined himself to BT in light of indications (i.e., Lazarus's assertions of the limited role he has given to BT and his
Burkholderia fungorum DBT1, first isolated from settling particulate matter of an oil refinery wastewater, is a bacterial strain which has been shown capable of utilizing several polycyclic aromatic hydrocarbons (PAHs) including dibenzothiophene (DBT). In particular, this microbe is able to efficiently degrade DBT through the Kodama pathway. Previous investigations have lead to the identification of six genes, on a total of eight, required for DBT degradation. In the present study, a combined experimental/computational approach was adopted to identify and in silico characterize the two missing genes, namely a ferredoxin reductase and a hydratase-aldolase. Thus, the finding of all enzymatic components of the Kodama pathway in B. fungorum DBT1 makes this bacterial strain amenable for possible exploitation in soil bioremediation protocols. PMID:23686744
Behavioral techniques reported to improve ambulation skills among physically handicapped persons include both reward and desensitization procedures. This report describes the application of other behavior modification principles to two patients who resisted physical therapy (PT) designed to educate them in the use of orthopedic assistive devices. Peer modeling was used with case 1, a 2 1/2-year-old girl with complete L4 spina bifida who cried frequently when wearing her brace, and refused to walk except with much assistance. Case 2 was a 21-year-old hemiplegic man seen two years after a severe head injury. Initially, severe tantrum behavior accompanied all demands placed on him. Treatment involved a combination of contingent music for being quiet and contingent aversive auditory feedback for yelling. In both cases clinically significant behavioral changes were observed. Results are discussed with respect to the cost effectiveness of behavioral interventions and the interdisciplinary coordination of rehabilitation team members. PMID:3882077
Gouvier, W D; Richards, J S; Blanton, P D; Janert, K; Rosen, L A; Drabman, R S
Behavioral couples' therapy has a long history of success with couples and is an empirically validated treatment for marital discord (Task Force on Promotion and Dissemination of Psychological Procedures, 1995). However, only about 50% of all couples in treatment experience long-term change (2 years). One of the founders of behavioral couples' therapy called for the therapy to return to its
James Cordova; Joseph Cautilli; Corrina Simon; Robin Axelrod Sabag
Objective This study describes naturalistic 3-month follow-up after discharge from a 5-day partial hospitalization dialectical behaviortherapy (DBT) program for women diagnosed with borderline personality disorder (BPD). We also examined individual BPD criteria as predictors of treatment response. Methods Fifty women diagnosed with BPD were consecutively recruited from a partial hospital DBT program, 47 of whom (94%) completed all assessments including baseline (prior to discharge) and 3-months post-discharge assessments. Most continued with some combination of individual psychotherapy and pharmacotherapy, and all had the option of continuing with weekly DBT skills classes. Baseline scores were compared to 3-month scores using paired two-tailed non-parametric (sign) tests. Regression analyses were conducted to identify predictors of outcome. Results Depression, hopelessness, anger expression, dissociation, and general psychopathology scores significantly decreased over the 3-month follow-up interval, although scores on several measures remained in the clinical range. Those who endorsed emptiness, impulsivity, and relationship disturbance demonstrated improvement on a number of outcomes, while those who endorsed identity disturbance and fear of abandonment had less improvement on some outcomes. Conclusion These findings illustrate 1) that improvement occurred over a 3-month interval on a number of measures in patients receiving treatment as usual following discharge from a partial hospitalization program, and 2) that BPD is a complex, heterogeneous disorder for which there is no single pathognomonic criterion, so that each criterion should be considered individually in determining its potential effect on treatment outcomes. PMID:19461390
YEN, SHIRLEY; JOHNSON, JENNIFER; COSTELLO, ELLEN; SIMPSON, ELIZABETH B.
... found. But cognitive behavioraltherapy showed even bigger "effect sizes" across studies that tested it, the researchers ... of social anxiety, they can also have side effects, including sleep problems and sexual dysfunction, said Evan ...
... Issues Listen BehaviorTherapy: The Specifics of Parent Training Article Body Once you and your child have ... the stage for the successful use of parent training tools and techniques. One of the first principles ...
Objective: Confirm previously reported cure rate of 88% with standard protocol using multiple behavioraltherapies (BT) in a larger patient population.Methods: Consecutive patients referred to a single physician for urinary incontinence (UI) who met protocol criteria for BT were prospectively followed through their course of therapy and for up to 24 months after completion. Descriptive analysis of outcomes and comparison
Forty years ago it was shown that neuroses are persistent unadaptive anxiety response habits that can be systematically overcome by deconditioning procedures collectively known as behaviortherapy. Indispensable to behaviortherapy is behavior analysis—detailed and accurate specification of the antecedents of the individual's neurotic patterns. In recent years, the behaviortherapy movement has been infiltrated by two alien orientations—“exposure therapy”
There has been a recent acceleration in the development and testing of programs for computer-assisted cognitive-behavioral\\u000a therapy (CCBT). Programs are now available for treatment of depression, anxiety disorders, and other psychiatric conditions.\\u000a Technology for delivery of CCBT includes multimedia programs, virtual reality, and handheld devices. Research on CCBT generally\\u000a has supported the efficacy of computer-assisted therapy and has shown patient
Jealousy is a multidimensional cognitive, emotional, behavioral and interpersonal phe- nomenon. Jealousy can be a destructive and often dangerous emotional and interper- sonal response to threats to a valued relationship. Despite the importance of jealousy as an issue for couples, there has been relatively little attention to this problem. Jealousy is af orm ofangry, agitated worry, whose goal is to
Attention deficit/hyperactivity disorder (ADHD) often persists into adolescence and has the same functional impairments as were present during childhood. Medications lessen ADHD symptoms yet do not reliably affect functioning. Thus, there exists a great need for psychosocial treatments in adolescents with ADHD. Nonetheless, relative to the vast literature that has been reported on children with ADHD, much less data have been reported about psychosocial interventions for adolescents with ADHD. Cognitive behavioraltherapy interventions that are being used with adolescents rely more on traditional behavioral principles than cognitive therapy tenets. PMID:25220089
We are studying the interactions of isolated bacteria with dibenzothiophene (DBT), a sulfur-containing model compound, and with a solubilized coal product derived from a high-organic-sulfur lignite. The sensitivity of the tetrazolium assay used to identify and study these strains was improved by substituting tetrazolium violet for triphenyltetrazolium. DBT metabolism by thirteen strains was investigated using qualitative and quantitative GC and GC-MS analyses. Growth medium and incubation time affect the extent of DBT degradation and the production of DBT metabolites. Under specific conditions, seven of the strains produce metabolites which elute close to the position of one or another of the biphenyl standards. However, when these samples are spiked with the standard compounds, the bacterial metabolites do not co-elute with the standards. The modification of solubilized high-organic-sulfur coal by six of these strains was also studied. No selective removal of sulfur relative to carbon was observed. 13 refs., 1 fig., 2 tabs.
Protein phosphorylation plays an essential role in the generation of circadian rhythms, regulating the stability, activity, and subcellular localization of certain proteins that constitute the biological clock. This study examines the role of the protein kinase Doubletime (DBT), a Drosophila ortholog of human casein kinase I (CKI)?/?. An enzymatically active DBT protein is shown to directly phosphorylate the Drosophila clock protein Period (PER). DBT-dependent phosphorylation sites are identified within PER, and their functional significance is assessed in a cultured cell system and in vivo. The perS mutation, which is associated with short-period (19-h) circadian rhythms, alters a key phosphorylation target within PER. Inspection of this and neighboring sequence variants indicates that several DBT-directed phosphorylations regulate PER activity in an integrated fashion: Alternative phosphorylations of two adjoining sequence motifs appear to be associated with switch-like changes in PER stability and repressor function. PMID:18666831
Forty-five adults with primary insomnia received cognitive-behavioraltherapy (CBT) implemented in a group therapy format, in individual face-to-face therapy or through brief individual telephone consultations. The results indicate that CBT was effective in improving sleep parameters with all 3 methods of treatment implementation, and there was no…
Bastien, Celyne H.; Morin, Charles M.; Ouellet, Marie-Christine; Blais, France C.; Bouchard, Sebastien
Primary insomnia (PI) is a prevalent form of sleep difficulty that impairs diurnal functioning, reduces quality of life and enhances health care utilization\\/costs for millions worldwide. Whereas the underlying pathophysiology of PI remains poorly understood, it is widely accepted that a host of cognitive and behavioral factors play important roles in perpetuating this condition. As such, a multi-factorial, cognitive–behavioraltherapy
Studies have reported conflicting findings regarding the impact on treatment for eating disorder patients comorbidly diagnosed with borderline personality disorder. The current investigation sought to investigate whether individuals diagnosed with an eating disorder vs. those comorbidly diagnosed with an eating disorder and borderline personality disorder differ on measures of eating disorders symptoms and\\/or general distress over the course of treatment.
Denise D. Ben-Porath; Lucene Wisniewski; Mark Warren
This article provides information on how Rational Emotive BehaviorTherapy (REBT) can be adapted for use in rehabilitation counseling. It states that although clients with an average range of intelligence have responded well to REBT, clients with borderline intellectual functioning are not suitable candidates for cognitive disputing but can be…
Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive-behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed…
Cognitive behavioral psychology is a new theoretical orientation. When applied in treatment, it is known as cognitive behaviortherapy (CBT). CBT, although based primarily on an information processing model, rests firmly on the twin pillars of both behaviorism and cognitive psychology. Today cognitive therapy and behavioraltherapy are terms which…
Recent innovations in the treatment and prevention of depression that build on the foundation of cognitivebehavioral therapy\\u000a represent promising directions for clinical practice and research. Specifically, behavioral activation and mindfulness-based\\u000a cognitive therapy have been a recent focus of attention. Behavioral activation is a brief, structured approach to treating\\u000a acute depression that seeks to alleviate depression by promoting an individual’s contact
Art therapy in conjunction with cognitive behavioraltherapy reduces symptoms and enhances the potential for positive outcomes for sexually abused children in trauma-focused treatment. This article presents a treatment model that utilizes specific art therapy interventions to facilitate treatment, based on research on the effectiveness of combined art therapy and cognitive behaviortherapy (Pifalo, 2001, 2006).
The field of behaviortherapy is not in touch with itself in terms of its overarching behaviorism. Many erroneously consider its basic behaviorism to have been radical behaviorism and continue to look to develop behaviortherapy (including behavior analysis and behavioral assessment) within that framework. But that approach turns out to be much less than maximal because there is a
For more than twenty-four hundred years, people were seen to behave in given ways because of what they were feeling or thinking, and feelings and thoughts were therefore the things to study. However, it has always been difficult to do very much with feelings and thoughts because of their inaccessibility to outside observers. Further, important distinctions are obscured when behavior is attributed to a state of mind. As more and more of the variables of which behavior is a function are identified and their role analysed, less remains to be explained in mentalistic ways. The operant side of behaviortherapy is illustrated by considering a few characteristic problems. Discussion includes the analysis of contingencies outside and inside the clinic, and the relationship between behavioral health and medical health. PMID:3069874
What Can Design Thinking Learn from Behavior Group Therapy? Julia von Thienen, Christine Noweski in Behavior Group Therapy bear a striking resemblance to Design Thinking. They invoke almost identical process Design Thinking may profit from taking a look at Behavior Group Therapy. We will discuss (a) new
Forty-five adults with primary insomnia received cognitive-behavioraltherapy (CBT) implemented in a group therapy format, in individual face-to-face therapy or through brief individual telephone consultations. The results indicate that CBT was effective in improving sleep parameters with all 3 methods of treatment implementation, and there was no significant difference across methods of implementation. All 3 treatment modalities produced improvements in
Célyne H. Bastien; Charles M. Morin; Marie-Christine Ouellet; France C. Blais; Sébastien Bouchard
To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioraltherapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing. PMID:16460670
Mitchell, James E; Burgard, Melissa; Faber, Ron; Crosby, Ross D; de Zwaan, Martina
Manualized therapy has been criticized as being incompatible with behaviortherapy. However, the majority of empirically supported, manual-based therapies utilize basic behavioral principles, such as positive reinforcement, to achieve positive change in the target behavior. Parent-Child Interaction Therapy (PCIT), for example, is a manualized treatment that makes extensive use of the empirically-derived behavioral principles of this paradigm. Understanding how and
Laurie A. Greco; John T. Sorrell; Cheryl B. McNeil
In the U.S., helping the noncompliant child and parent child interaction therapy represent behavioral family therapy programs that are empirically supported for treating the conduct problems of 2- to 7-year\\u000a old children. This study examined how caregivers in China would view behavioral family therapy. Caregivers in Hangzhou, China\\u000a reported the perceived age of deviance for behavioral family therapy targets (e.g.,
There has long been interest in combining pharmacotherapy with psychotherapy, including cognitive behavioraltherapy (CBT). More recently, basic research on fear extinction has led to interest in augmentation of CBT with the N-methyl Daspartate (NMDA) glutamate receptor partial agonist D-cycloserine (DCS) for anxiety disorders. In this article, the literature on clinical trials that have combined pharmacotherapy and CBT is briefly reviewed, focusing particularly on the anxiety disorders. The literature on CBT and DCS is then systematically reviewed. A series of randomized placebo-controlled trials on panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia suggest that low dose DCS before therapy sessions may be more effective compared with CBT alone in certain anxiety disorders. The strong translational foundation of this work is compelling, and the positive preliminary data gathered so far encourage further work. Issues for future research include delineating optimal dosing, and demonstrating effectiveness in real-world settings. PMID:20599140
This article describes the current status of Cognitive and BehavioralTherapy as well Relapse Prevention and Coping Skill approaches applied in drug abuse treatments. The objective is show a review about theories and technique used by Cognitive Therapy and others approaches derived that, speci- fically Relapse Prevention and Coping Skill Treatments. Cognitive and BehavioralTherapy, Coping Skill, and Relapse Prevention
Cognitive behaviortherapy (CBT) emphasizes the primacy of cognition in mediating psychological disorder. It aims to alleviate distress by modifying cognitive content and process, realigning thinking with reality. Recently, various authors have questioned the need for CBT therapists to use logico?rational strategies to directly challenge maladaptive thoughts. Hayes [Hayes, S.C. (2004). Acceptance and commitment therapy and the new behaviortherapies.
For patients with HIV, depression is a common, distressing condition that can interfere with a critical self-care behavior--adherence to antiretroviral therapy. The present study describes a cognitive-behavioral treatment designed to integrate cognitive-behavioraltherapy for depression with our previously tested approach to improving adherence to…
Safren, Steven A.; Hendriksen, Ellen S.; Mayer, Kenneth H.; Mimiaga, Matthew J.; Pickard, Robert; Otto, Michael W.
That psychoanalytic theory has not been displaced by the behavioral theory of neurosis is remarkable in view of the persuasive evidence that exists for the efficacy of behaviortherapy. One reason for this seems to be the persistence of widespread misperceptions of behaviortherapy. (Author)
Dialectical Behaviour Therapy (DBT) is considered one of the most promising treatments for borderline personality disorder (BPD). Recently, we reported significantly positive effects of 12 months DBT on parasuicidal behaviour and impulsivity in a mixed group of female BPD patients with and without substance abuse. Fifty-eight women with BPD were randomly assigned to either 52 weeks of DBT or treatment
Maarten W. J. Koeter; Theo Stijnen; Roel Verheul; Wim van den Brink
Adventure therapy and cognitive behavioraltherapy share elements, including transformation of distorted thinking patterns, a focus on current and future functioning, consideration of the counselor-client relationship, and the use of stress in the change process. Recognizing cognitive behavioraltherapy as an empirically sound theory underlying…
and repeated opportunities (anticipate future communications) to exchange information and build relationships. To examine the extent to which the process of online therapy resembles face-to-face therapy, online therapy transcripts were examined through a...
Forty years ago it was shown that neuroses are persistent unadaptive anxiety response habits that can be systematically overcome by deconditioning procedures collectively known as behaviortherapy. Indispensable to behaviortherapy is behavior analysis--detailed and accurate specification of the antecedents of the individual's neurotic patterns. In recent years, the behaviortherapy movement has been infiltrated by two alien orientations--"exposure therapy" and cognitivism--which repudiate conditioning theory and dispense with the characteristic behavior analysis. By claiming to be more effective, the alien approaches have induced widespread abandonment of the conditioning model. In fact, outcomes have not been improved by the alien methodologies, and in many cases have become worse. Also, no viable theory of change has been proposed in place of conditioning. The result is an amorphous eclecticism to which psychoanalysis and primal scream could readily be added. Some first steps are suggested towards restoring conditioning principles to their central role in the behaviortherapy field. PMID:2671049
A novel genotype for the initial steps of the oxidative degradation of dibenzothiophene (DBT) is described in a Burkholderia sp. strain isolated from a drain receiving oil refinery wastewater. The strain is capable of transforming DBT with significant efficiency when compared to other microorganisms. Its genotype was discovered by investigating insertional mutants of genes involved in DBT degradation by the Kodama pathway. The cloned dbt genes show a novel genomic organization when compared to previously described genes capable of DBT catabolism in that they constitute two distinct operons and are not clustered in a single transcript. Sequence analysis suggests the presence of a sigma54-dependent positive transcriptional regulator that may be involved in the control of the transcription of the two operons, both activated by DBT. The achieved results suggest the possibility of novel features of DBT biotransformation in nature. PMID:15068372
Di Gregorio, Simona; Zocca, Chiara; Sidler, Stephan; Toffanin, Annita; Lizzari, Daniela; Vallini, Giovanni
This paper aimed to highlight the process of therapist direct contingent responding to shape client behavior in two Child Behavior Analytic Therapy (CBAT) cases using transitional probabilities. The Functional Analytic Psychotherapy Rating Scale (FAPRS) was used to code client behaviors and the Multidimensional System for Coding Behaviors in…
Xavier, Rodrigo Nunes; Kanter, Jonathan William; Meyer, Sonia Beatriz
Recent innovations in the treatment and prevention of depression that build on the foundation of cognitive-behavioraltherapy represent promising directions for clinical practice and research. Specifically, behavioral activation and mindfulness-based cognitive therapy have been a recent focus of attention. Behavioral activation is a brief, structured approach to treating acute depression that seeks to alleviate depression by promoting an individual's contact with sources of reward through increasing activation, improving problem solving, and decreasing avoidance and other barriers to activation. Mindfulness-based cognitive therapy is a brief group intervention that seeks to prevent depressive relapse by promoting mindful attention, acceptance, and skillful action to help individuals interrupt habitual cognitive and affective patterns associated with risk of relapse. Each approach is supported by at least two large-scale, randomized clinical trials; however, many important questions remain. We examine current research on both approaches by addressing the robustness of findings, the extension to novel populations, and the processes by which clinical benefit is achieved. PMID:19909667
The aim of this study is to clarify the effect which aroma (fragrance and\\/or flavor) push to the behavior in a scene of the music therapy. The music therapy is designed to improve the functioning of mind and body at using which music has the function and role for the illness and health. And this therapy is used in broad
Although the specific efficacy of psychoanalytic therapy in the treatment of the neuroses has never been demonstrated, psychoanalytic theory and practices continue to dominate the field of clinical psychology. That psychoanalytic theory has not been displaced by the behavioral theory of neurosis is seen as remarkable in view of the persuasive evidence that exists for the efficacy of behaviortherapy.
This article describes an experimental undergraduate psychology course that ran for two semesters during the 2009 academic year at a private, urban university in the United States. Students learned the techniques and strategies of cognitive behavioraltherapy (CBT) and rational emotive behaviortherapy (REBT) with a focus on the practical elements…
Background Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioraltherapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. Methods In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioraltherapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioraltherapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. Results The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioraltherapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioraltherapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioraltherapy than with sertraline. Conclusions Both cognitive behavioraltherapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.) PMID:18974308
Walkup, John T.; Albano, Anne Marie; Piacentini, John; Birmaher, Boris; Compton, Scott N.; Sherrill, Joel T.; Ginsburg, Golda S.; Rynn, Moira A.; McCracken, James; Waslick, Bruce; Iyengar, Satish; March, John S.; Kendall, Philip C.
Background: The need to develop supplementary or alternative treatments for seasonal affective disorder (SAD) is underscored by the significant minority (47%) of SAD patients that is refractory to light therapy, the persistence of residual symptoms despite light treatment, and poor long-term compliance with light use. Because preliminary studies suggest that cognitive and behavioral factors are involved in SAD, cognitive-behavioraltherapy
Kelly J Rohan; Kathryn Tierney Lindsey; Kathryn A Roecklein; Timothy J Lacy
Twenty treatment outcome studies, 13 of which evaluated behavioral couples therapy (BCT) and seven of which evaluated emotionally focused therapy (EFT) were reviewed, leading to the following conclusions. BCT leads to short and long-term gains for moderate to severe couple distress. In the long term BCT probably leads to no better outcomes than its constituent components—behavioral exchange training and communication
Suggests that behaviortherapy techniques be used to facilitate psychoanalytic treatment. At times, direct efforts to relieve specific troubling behavior and reduce incapacitating anxiety may be necessary for progress in psychoanalytic treatment. The exclusivity of both the behavioral and psychoanalytic approaches is criticized. Case studies illustrate these views.
The present study constitutes a brief literature overview, in which the term of clinical perfectionism, its etiopathology, its assessment and its relation to psychopathology, as well as the therapeutic interventions based on the Cognitive Behavioral Model are discussed. According to Frost, perfectionism is associated with one's desire to achieve the greatest degree of performance and it is accompanied by an extremely strict evaluation of that particular performance. The relationship with oneself as well as the relationship with others are both characterised by high standards and demands which tend to exhaust one individual and dramatically toughen the development of proximity with the others. Perfectionism, as a personality trait, presents functional and dysfunctional elements for a person. Dysfunctional, clinical perfectionism -a term recently coined by researchers- has been linked to a number of disorders, such as social phobia, obsessive-compulsive disorder, eating disorders -anorexia and bulimia nervosa- depression and personality disorders. From a perfectionist's point of view, perfection exists and its attaintment is feasible. The existence of a particularly high and often unrealistic goal can lead the person to severe disappointment when this specific goal is not finally reached. A person with functional perfectionism is possible to set another, more achievable, goal next time, while a person with clinical perfectionism will interpret this failure as a sign of personal inadequacy and will either make another attempt to reach the same goal or will abandon the effort altogether. A sense of weakness and subsequent negative automatic thoughts are the aftermath of both the first and the second choice. Cognitive BehavioralTherapy focuses on the realisation that clinical perfectionism is undesirable, on the dispute of negative automatic thoughts and on the replacement of unfunctional cognitive schemas with other, more functional ones. In the therapeutic process, one individual can learn how to set specific and realistic goals, to focus on the process of a task instead of its result, to organise activities in a hierarchy depending on their significance and, finally, to feel fulfilled even if they have not brought a task to completion. It is a fact that the core schemas of clinical perfectionism are characterised by rigidity due to the excessive number of secondary benefits they provide for one person. The exploration of those benefits and the discovery of alternative sources of fulfillment are areas of therapeutic work. PMID:22549041
This manual describes a clay therapy program appropriate for use with students having a variety of exceptionalities and in an age range from 6 to 18 years. Organization and staffing are briefly discussed followed by a list of long range goals (affective, motoric, and aesthetic), suggestions for clay therapy implementation to achieve these goals,…
A behaviorally-oriented activities therapy program was designed and implemented with adolescents who manifested problems at school, at home, and with peers. Techniques employed included: contingency contracting, assertiveness training, relaxation training, and cognitive restructuring. (Author/KC)
Empirical evidence supports cognitive -behavioral interventions for the treatment Posttraumatic Stress Disorder (PTSD), with exposure therapy typically being the most frequently utilized. While the success of exposure treatments is well established there are factors which may hinder their use in \\
Patrick S. Mulick; Sara J. Landes; Jonathan W. Kanter
Physical therapy assessment and treatment of chronic pain patients focuses on increasing functional ability and decreasing\\u000a disability. A range of behavioral techniques discussed in this paper are used to achieve these goals.
Inappropriate mealtime behaviors of a blind, mentally retarded, behaviorally disordered 10-year-old were modified via behaviortherapy techniques, including audiotape of favorite stories turned off during inappropriate behavior and praise (plus access to food) for appropriate napkin and utensil use, once desired sitting posture had been…
The new sex therapy, a brief outpatient treatment of sexual dysfunction consisting of structured sexual exercises and conjoint therapeutic sessions, is a systematic integration of behavioral and psychodynamic elements. The integration of approaches in the new sex therapy has general significance for psychotherapeutic theory and practice. (Author)
Numerous types of treatments for pathological gambling have been described, but two of the most common are Gamblers Anonymous (GA) and cognitive-behavioraltherapy. This paper describes some outcome data associated with the two approaches. It also reviews evidence suggesting that a combined intervention may enhance therapy engagement and reduce relapse rates.
This manual, a supplement to "Motivational Enhancement Therapy and Cognitive BehavioralTherapy for Adolescent Cannabis Users: 5 Sessions, Cannabis Youth Treatment (CYT) Series, Volume 1", presents a seven-session cognitive behavioral treatment (CBT7) approach designed especially for adolescent cannabis users. It addresses the implementation and…
Webb, Charles; Scudder, Meleney; Kaminer, Yifrah; Kaden, Ron
Objective: This study compared family-focused cognitive behavioraltherapy (CBT: the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders. Method: Forty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral…
Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian
Improved efficacy in the treatment of posttraumatic stress disorder (PTSD) and other anxiety disorders is urgently needed. Traditional anxiety treatments of hypnosis and psychodynamic therapy may be of some help, but uncontrolled studies lead to inconclusive results on the efficacy of these treatment techniques. There is a larger literature supporting the efficacy of cognitive-behavioral procedures with PTSD, including prolonged exposure therapy, eye movement desensitization and reprocessing, and anxiety management techniques. The cutting-edge technology of virtual reality-based exposure therapy for PTSD is particularly exciting. To further build on effective psychosocial treatments, current pharmacological augmentation approaches to emotional learning are being combined with psychotherapy. In particular, D-cycloserine, a partial NMDA agonist, has shown to be effective in facilitating the exposure/extinction therapy to improve the efficacy of treating anxiety disorders, and may guide the way for new pharmacological enhancements of behavioraltherapy. PMID:21309114
Choi, Dennis C; Rothbaum, Barbara O; Gerardi, Maryrose; Ressler, Kerry J
Person-centered, nonpharmacological interventions for managing Alzheimer’s\\/dementia-related behavioral disturbances have received significant attention. However, such interventions are quite often of a single type limiting their benefits. We develop a comprehensive nonpharmacological intervention, the Behavior-Based Ergonomic Therapy (BBET), which consists of multiple therapies. This low-cost, 24\\/7 program uses learning, personality, and behavioral profiles and cognitive function of each resident to develop a
Govind Bharwani; Pratik J. Parikh; Larry W. Lawhorne; Eric VanVlymen; Meena Bharwani
Cognitive behavioraltherapy (CBT) is one of the main approaches in psychotherapy. It teaches the patient to examine the link between dysfunctional thoughts and maladaptive behaviors and to re- evaluate the cognitive biases involved in the maintenance of symptoms by using strategies such as guided discovery. CBT is constantly evolving in part to improve its' effectiveness and accessibility. Thus in the last decade, increasingly popular approaches based on mindfulness and acceptance have emerged. These therapies do not attempt to modify cognitions even when they are biased and dysfunctional but rather seek a change in the relationship between the individual and the symptoms. This article aims to present the historical context that has allowed the emergence of this trend, the points of convergence and divergence with traditional CBT as well as a brief presentation of the different therapies based on mindfulness meditation and acceptance. Hayes (2004) described three successive waves in behaviortherapy, each characterized by "dominant assumptions, methods and goals": traditional behaviortherapy, cognitive therapy and therapies based on mindfulness meditation and acceptance. The latter consider that human suffering occurs when the individual lives a restricted life in order avoid pain and immediate discomfort to the detriment of his global wellbeing. These therapies combine mindfulness, experiential, acceptance strategies with traditional behavior principles in order to attain lasting results. There are significant points of convergence between traditional CBT and therapies based on mindfulness meditation and acceptance. They are both empirically validated, based upon a theoretical model postulating that avoidance is key in the maintenance of psychopathology and they recommend an approach strategy in order to overcome the identified problem. They both use behavioral techniques in the context of a collaborative relationship in order to identify precise problems and to achieve specific goals. They focus on the present moment rather than on historical causes. However, they also present significant differences: control vs acceptance of thoughts, focus on cognition vs behavior, focus on the relationship between the individual and his thoughts vs cognitive content, goal of modifying dysfunctional beliefs vs metacognitive processes, use of experiential vs didactic methods, focus on symptoms vs quality of life, strategies used before vs after the unfolding of full emotional response. The main interventions based on mindfulness meditation and acceptance are: Acceptance and Commitment Therapy, Functional Analytic Therapy, the expanded model of Behavioral Activation, Metacognitive Therapy, Mindfulness based Cognitive Therapy, Dialectic BehaviorTherapy, Integrative Behavioral Couples Therapy and Compassionate Mind Training. These are described in this article. They offer concepts and techniques which might enhance therapeutic efficacy. They teach a new way to deploy attention and to enter into a relationship with current experience (for example, defusion) in order to diminish cognitive reactivity, a maintenance factor for psychopathology, and to enhance psychological flexibility. The focus on cognitive process, metacognition as well as cognitive content might yield additional benefits in therapy. It is possible to combine traditional CBT with third wave approaches by using psychoeducation and cognitive restructuring in the beginning phases of therapy in order to establish thought bias and to then encourage acceptance of internal experiences as well as exposure to feared stimuli rather than to continue to use cognitive restructuring techniques. Traditional CBT and third wave approaches seem to impact different processes: the former enhance the capacity to observe and describe experiences and the latter diminish experiential avoidance and increase conscious action as well as acceptance. The identification of personal values helps to motivate the individual to undertake actions required in order to enhance quality of life. In
Although cognitive-behavioraltherapy (CBT) is touted as the predominant approach in sex offender-specific group treatment, a review of the field shows that the "behavioral" part of CBT has become minimal in relation to that which is cognitive. The authors show how a revitalized "behavioral sensibility" may help to enhance…
and Adolescents with Autism” Report #5 – February 2003, “Family Centered Home Based Models for Treatment Prevention” Report #6 – April 2003, “Children and Adolescents with Asperger Syndrome” c. 2003 State of Kansas Department of Social... is that the program can be categorized in one of these two groups and is necessarily a licensed therapeutic provider, eligible for third-party insurance reimbursement. It is important to note that not all Wilderness Therapy or Long-Term Residential Camping...
Background: Comprehensive cognitive behaviortherapies have been proved to be more effective than behavioral interventions. However, the efficacy of CBT is not studied in the Indian context and also, the amount of change brought about by CBT is not known. Aims: This study aims to examine the efficacy of cognitive behavioral intervention (CBI) in the treatment of panic disorder. Our specific objectives were to assess the effectiveness of CBI in reducing symptom severity as well as cognitions related to panic and panic-related behaviors. Design: The study adopted a two-group comparison with pre- and postassessments design. Materials and Methods: The sample consisted of 30 patients sequentially allotted to the CBI (n = 15) and behavioral intervention (BI, n = 15) groups. Assessment was done using a semistructured interview schedule, panic disorder severity scale, Texas panic attack record form, Anxiety Sensitivity Index, Agoraphobic cognitions questionnaire, Behavioral avoidance checklist, and Panic appraisal inventory. The CBI group was provided with comprehensive cognitive behaviortherapy and the BI group with psycho-education and applied relaxation. Results: CBI was found to be superior to BI in the reduction of panic symptoms, behavioral avoidance, safety behaviors, and cognitions. A large percentage of the CBI group patients met the criteria for clinically significant change with a large magnitude of change. Conclusion: Multicomponent CBI is superior to BI in terms of the amount of change it brings about with respect to panic symptoms, avoidance, safety behaviors, and cognitions. PMID:19823629
Manjula, M.; Kumariah, V.; Prasadarao, P. S. D. V.; Raguram, R.
To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the
James E. Mitchell; Melissa Burgard; Ron Faber; Ross D. Crosby; Martina de Zwaan
Schools are ideal settings for identifying children and adolescents who have been exposed to traumatic events. They are also ideal for providing evidence-based mental health services, such as trauma-focused cognitive behavioraltherapy, to students affected by childhood posttraumatic stress disorder and co-occurring mental health and behavioral problems. Educators and school psychologists are uniquely positioned to educate school staff and families
Twenty-four older adults with persistent psychophysiological insomnia were randomly assigned to an immediate or a delayed cognitive–behavioral intervention in a waiting-list control group design. Cognitive–behaviortherapy consisted of an 8-week group intervention aimed at changing maladaptive sleep habits and altering dysfunctional beliefs and attitudes about sleeplessness. Treatment was effective in reducing sleep latency, wake after sleep onset, and early morning
Charles M. Morin; Robert A. Kowatch; Theresa Barry; Esther Walton
Background Anxiety disorders are common psychiatric conditions affecting children and ado- lescents. Although cognitive behavioraltherapy and selective serotonin-reuptake in- hibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. Methods In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis
John T. Walkup; Anne Marie Albano; John Piacentini; Boris Birmaher; Scott N. Compton; Joel T. Sherrill; Golda S. Ginsburg; Moira A. Rynn; James McCracken; Bruce Waslick; Satish Iyengar; John S. March; Philip C. Kendall
Describes a range of behaviortherapy techniques for treating sleep disturbances, including physical activity, relaxation training, biofeedback, autogenic training, and cognitive techniques. The importance of understanding the client's background is emphasized. Restoring the client's self-control and positive psychological growth are stressed.…
Behavioral Couples Therapy (BCT) is designed for married or cohabiting individuals seeking help for alcoholism or drug abuse. BCT sees the substance-abusing patient together with the spouse or live-in partner. Its purposes are to build support for abstinence and to improve relationship functioning. BCT promotes abstinence with a “recovery contract” that involves both members of the couple in a daily
This study pilot tested a newly developed modular cognitive-behavioraltherapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings…
Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail
Reports that expand the understanding of the treatment of childhood obsessive-compulsive disorder by using exposure-based cognitive-behavioraltherapy in the age group of 5 to 8-year-olds are presented. A model for collecting the common core elements of evidence-based psychosocial treatments for childhood disorders is also presented.
In this article, the authors combine psychodrama and cognitive behavioraltherapy techniques in applied group settings. They illustrate the application of some CBT techniques that they found helpful in the three phases of psychodrama with college students and patients diagnosed with mood, substance abuse, anxiety, and personality disorders. Although both CBT and psychodrama models stress the discovery process through Socratic
Behavioral couples therapy (BCT) sees the substance-abusing patient with the spouse to arrange a daily “sobriety contract” in which the patient states his or her intent not to drink or use drugs and the spouse expresses support for the patient's efforts to stay abstinent. BCT also teaches communication and increases positive activities. Research supports three conclusions. First, BCT for both
This investigation examined response to a manualized cognitive-behavioraltherapy (CBT) protocol for compulsive hoarding (Steketee & Frost, 2007) in a sample of 12 adults over age 65. All participants were cognitively intact, not engaging in any other psychotherapy, and had compulsive hoarding as their primary problem. All received 26 sessions of individual CBT over the course of 17 weeks. The
Catherine R. Ayers; Julie Loebach Wetherell; Shahrokh Golshan; Sanjaya Saxena
Background: There is a lack of evidence about the effectiveness of cognitive behaviortherapies (CBT) in settings of routine clinical care as well as in the treatment of panic and comorbid disorders. Methods: We investigated a group-oriented CBT approach for 80 patients with panic disorder including 35 patients with current comorbid major depression. Assessments took place 6 months before treatment,
Winfried Rief; Susanne Trenkamp; Claudia Auer; Manfred M. Fichter
Empirical evidence supports cognitive-behavioral interventions for the treatment Posttraumatic Stress Disorder (PTSD), with exposure therapy typically being the most frequently utilized. While the success of exposure treatments is well established there are factors which may hinder their use in "real-world" settings (e.g., poor treatment…
Mulick, Patrick S.; Landers, Sara J.; Kanter, Jonathan W.
Objective: To examine the efficacy and durability of a behavioraltherapy (BT) protocol for pediatric TTM compared with a minimal attention control (MAC) condition. It was hypothesized that the BT condition would be superior to MAC at the end of acute treatment, and would also demonstrate durability of gains through the maintenance treatment…
Franklin, Martin E.; Edson, Aubrey L.; Ledley, Deborah A.; Cahill, Shawn P.
The foundation, accomplishments, and proliferation of behaviortherapy have been fueled largely by the movement’s grounding in behavioral principles and theories. Ivan P. Pavlov’s discovery of conditioning principles was essential to the founding of behaviortherapy in the 1950s and continues to be central to modern behaviortherapy. Pavlov’s major legacy to behaviortherapy was his discovery of \\
Applied behavior analysis and behaviortherapy are now nearly a half century old. It is interesting to ask if and how these disciplines have changed over time, particularly regarding some of their key internal controversies (e.g., role of cognitions). We examined the first five years and the 2000-2004 five year period of the "Journal of Applied…
Background: The study was designed to compare cognitive therapy (CT) with intensive behaviortherapy (BT) in obsessive-compulsive disorder (OCD) and to study their change process. Methods: Sixty-five outpatients with DSM-4 OCD were randomized into 2 groups for 16 weeks of individual treatment in 3 centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20
Jean Cottraux; Sai Nan Yao; Sylviane Lafont; Evelyne Mollard; Martine Bouvard; Alain Sauteraud; Marc Bourgeois; Jean-François Dartigues
General or nonpreferential rational-emotive therapy (RET)is synonymous with cognitive behaviortherapy (CBT).Specialized or preferential RET, however, differs from CBT in several ways. Cognitively, it has a pronounced philosophic emphasis, includes a humanistic-existentialist out-look, strives for pervasive and long-lasting rather than symptomatic change, tries to eliminate all self-ratings, stresses antimusturbatory rather than antiempirical disputing methods, recognizes the palliative aspects of cognitive
The central public health challenge in the management of seasonal affective disorder (SAD) is prevention of depression recurrence each fall\\/winter season. The need for time-limited treatments with enduring effects is underscored by questionable long-term compliance with clinical practice guidelines recommending daily light therapy during the symptomatic months each year. We previously developed a SAD-tailored group cognitive-behavioraltherapy (CBT) and tested
Kelly J. Rohan; Kathryn A. Roecklein; Timothy J. Lacy; Pamela M. Vacek
Acceptance and Commitment Therapy (ACT) incorporates developments in behaviortherapy, holds promise but has not been evaluated for methamphetamine use disorders. The objective of this study was to test whether ACT would increase treatment attendance and reduce methamphetamine use and related harms compared to cognitive behaviortherapy (CBT). One hundred and four treatment-seeking adults with methamphetamine abuse or dependence were
Matthew F. Smout; Marie Longo; Sonia Harrison; Rinaldo Minniti; Wendy Wickes; Jason M. White
Cognitive behavioraltherapy (CBT) has a rich history of alleviating the suffering associated with mental disorders. Recently, there have been exciting new developments, including multicomponent approaches, incorporated alternative therapies (e.g., meditation), targeted and cost-effective technologies, and integrated biological and behavioral frameworks. These field-wide changes have led some to emphasize the differences among variants of CBT. Here, we draw attention to commonalities across cognitive-behavioraltherapies, including shared goals, change principles, and therapeutic processes. Specifically, we offer a framework for examining common CBT characteristics that emphasizes behavioral adaptation as a unifying goal and three core change principles, namely (a) context engagement to promote adaptive imagining and enacting of new experiences; (b) attention change to promote adaptive sustaining, shifting, and broadening of attention; and (c) cognitive change to promote adaptive perspective taking on events so as to alter verbal meanings. Further, we argue that specific intervention components, including behavioral exposure/activation, attention training, acceptance/tolerance, decentering/defusion, and cognitive reframing, may be emphasized to a greater or lesser degree by different treatment packages but are still fundamentally common therapeutic processes that are present across approaches and are best understood by their relationships to these core CBT change principles. We conclude by arguing for shared methodological and design frameworks for investigating unique and common characteristics to advance a unified and strong voice for CBT in a widening, increasingly multimodal and interdisciplinary, intervention science. PMID:23611074
Mennin, Douglas S; Ellard, Kristen K; Fresco, David M; Gross, James J
Cognitive behaviortherapy (CBT) is considered a first-line intervention for obsessive-compulsive disorder (OCD) across the lifespan. Efficacy studies of CBT with exposure and response prevention suggest robust symptom reduction, often with sustained remission. Acceptability of CBT is high, and the treatment is devoid of adverse side effects. The primary mechanism of CBT is based on operant principles, specifically extinction learning. The efficacy of extinction-based treatments such as CBT is being shown for other obsessive-compulsive spectrum disorders. This article reviews the theoretic basis, clinical application, and relevant treatment outcome research for CBT and related therapies for several obsessive-compulsive spectrum disorders. PMID:25150570
Lewin, Adam B; Wu, Monica S; McGuire, Joseph F; Storch, Eric A
Although cognitive-behaviortherapy (CBT) is a relatively new psychotherapeutic approach, the theoretical antecedents actually date back two thousand years, to the period of the hellenistic philosophers. The Stoic Epictetus is often acknowledged as the main philosophical father of CBT and especially of rational-emotive therapy (RET). Beck and Ellis frequently noted that they have drawn upon the writings of the ancient philosophers in developing their psychotherapeutic techniques. This paper reviews some implications of hellenistic philosophy for CBT. We like to show that the teachings of the ancient 'healer of souls' are remarkably consistent with the current theoretical framework and techniques of CBT. PMID:3073604
Randomly assigned 41 recurrent tension headache sufferers to either cognitive-behavioraltherapy or to amitriptyline therapy. Both therapies yielded clinically significant improvements in headache activity. In instances where differences in treatment effectiveness were observed, cognitive-behavioraltherapy yielded somewhat more positive outcomes…
Describes Parent-Child Interaction Therapy, a behavioral family therapy approach for the psychological treatment of preschool children and their parents that emphasizes the integration of traditional child play therapy techniques within a behavioral framework of parent-child therapy. Implications for the treatment of a broad range of childhood…
Evaluated effects of group behavioraltherapy including aerobic exercise, behavioraltherapy alone, and aerobic exercise alone on pain and physical and psychological disability among mildly disabled chronic low-back-pain patients (n=96). The combined behavioraltherapy and exercise group improved significantly more pretreatment to posttreatment…
Cognitive behaviortherapy is probably the most well-known and the most practiced form of modern psychotherapy and has been integrated into highly structured package for the treatment of patients suffering from social phobia. The present case study is an attempt to provide therapeutic intervention program to a 27-year-old, unmarried Christian man suffering from social phobia. The patient was treated by using cognitive behavioral techniques. After 17 sessions of therapeutic intervention program, significant improvement was found. He was under follow-up for a period of 6 months and recovered to the premorbid level of functioning. PMID:21234166
This study pilot tested a newly developed modular cognitive–behavioraltherapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22weeks. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre-
Sabine Wilhelm; Katharine A. Phillips; Jeanne M. Fama; Jennifer L. Greenberg; Gail Steketee
The current study examined utilization of cognitive-behavioraltherapy (CBT) by individuals receiving treatment for obsessive-compulsive disorder (OCD). Participants were 202 adults with primary DSM-IV OCD who enrolled in a longitudinal, observational study of the course of OCD and completed 2 years of annual follow-up interviews using the Longitudinal Interval Follow-Up Evaluation. One hundred twenty participants reported that a mental health
Digital breast tomosynthesis (DBT) has been shown to increase mass detection. Detection of microcalcifications in DBT is challenging because of the small, subtle signals to be searched in the large breast volume and the noise in the reconstructed volume. We developed an adaptive diffusion (AD) regularization method that can differentially regularize noise and potential signal regions during reconstruction based on local contrast-to-noise ratio (CNR) information. This method adaptively applies different degrees of regularity to signal and noise regions, as guided by a CNR map for each DBT slice within the image volume, such that potential signals will be preserved while noise is suppressed. DBT scans of an American College of Radiology phantom and the breast of a subject with biopsy-proven calcifications were acquired with a GE prototype DBT system at 21 angles in 3° increments over a +/-30° range. Simultaneous algebraic reconstruction technique (SART) was used for DBT reconstruction. The AD regularization method was compared to the non-convex total p-variation (TpV) method and SART with no regularization (NR) in terms of the CNR and the full width at half maximum (FWHM) of the central gray-level line profile in the focal plane of a calcification. The results demonstrated that the SART regularized by the AD method enhanced the CNR and preserved the sharpness of microcalcifications compared to reconstruction without regularization. The AD regularization was superior to the TpV method for subtle microcalcifications in terms of the CNR while the FWHM was comparable. The AD regularized reconstruction has the potential to improve the CNR of microcalcifications in DBT for human or machine detection.
Background: Parent-child treatments have been shown to be superior to child-focused treatments of childhood obesity. Yet until now, the comparative effectiveness of parent-only and parent-child approaches has been little studied. Method: Fifty-six obese children and their families were randomly assigned to a 16-session cognitive behavioraltherapy (CBT) for the parents only or for a combined treatment of parents and children.
Simone Munsch; Binia Roth; Tanja Michael; Andrea Hans Meyer; Esther Biedert; Sandra Roth; Vanessa Speck; Urs Zumsteg; Emanuel Isler; Jürgen Margraf
Although exercise has both physical and psychological benefits, most older adults do not exercise on a regular basis. Physical therapists need to explore ways to encourage sus- tained commitment. This article proposes that cognitive fac- tors contribute to older adults' inactivity and that the self-regulation of exercise maintenance model is a means of promoting exercise. Cognitive behavioraltherapy (CBT), an
Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of scientific development, which we term "contextual behavioral science." We outline the empirical progress of ACT and describe its distinctive development strategy. A contextual behavioral science approach
The central public health challenge in the management of seasonal affective disorder (SAD) is prevention of depression recurrence each fall/winter season. The need for time-limited treatments with enduring effects is underscored by questionable long-term compliance with clinical practice guidelines recommending daily light therapy during the symptomatic months each year. We previously developed a SAD-tailored group cognitive-behavioraltherapy (CBT) and tested its acute efficacy in 2 pilot studies. Here, we report an intent-to-treat (ITT) analysis of outcomes during the subsequent winter season (i.e., approximately 1 year after acute treatment) using participants randomized to CBT, light therapy, and combination treatment across our pilot studies (N=69). We used multiple imputation to estimate next winter outcomes for the 17 individuals who dropped out during treatment, were withdrawn from protocol, or were lost to follow-up. The CBT (7.0%) and combination treatment (5.5%) groups had significantly smaller proportions of winter depression recurrences than the light therapy group (36.7%). CBT alone, but not combination treatment, was also associated with significantly lower interviewer- and patient-rated depression severity at 1 year as compared to light therapy alone. Among completers who provided 1-year data, all statistically significant differences between the CBT and light therapy groups persisted after adjustment for ongoing treatment with light therapy, antidepressants, and psychotherapy. If these findings are replicated, CBT could represent a more effective, practical, and palatable approach to long-term SAD management than light therapy. PMID:19647524
Rohan, Kelly J; Roecklein, Kathryn A; Lacy, Timothy J; Vacek, Pamela M
The development of neuroimaging methods has enabled significant advances toward elucidating the mechanism of cognition, behavior and emotion. This article first reviews recent human neuroimaging studies that examined the neurocircuitry of emotion and emotion regulation. Next, we review the neuroimaging literature of the effects of cognitive behavioraltherapy for depression. Lastly, we provide the brain mechanism that the emotional support regulates psychological pain in ostracism, and then discuss a biological model of psychotherapy. We hope that the present review can help us, not only to better understand the biological basis of cognition, behavior and emotion in psychotherapy, but also to be aware of effects of psychotherapy on brain. PMID:22250442
A number of recent authors have compared acceptance and commitment therapy (ACT) and traditional cognitive behaviortherapy (CBT). The present article describes ACT as a distinct and unified model of behavior change, linked to a specific strategy of scientific development, which we term “contextual behavioral science.” We outline the empirical progress of ACT and describe its distinctive development strategy. A contextual behavioral science approach is an inductive attempt to build more adequate psychological systems based on philosophical clarity; the development of basic principles and theories; the development of applied theories linked to basic ones; techniques and components linked to these processes and principles; measurement of theoretically key processes; an emphasis on mediation and moderation in the analysis of applied impact; an interest in effectiveness, dissemination, and training; empirical testing of the research program across a broad range of areas and levels of analysis; and the creation of a more effective scientific and clinical community. We argue that this is a reasonable approach, focused on long-term progress, and that in broad terms it seems to be working. ACT is not hostile to traditional CBT, and is not directly buoyed by whatever weaknesses traditional CBT may have. ACT should be measured at least in part against its own goals as specified by its own developmental strategy. PMID:23611068
Hayes, Steven C.; Levin, Michael E.; Plumb-Vilardaga, Jennifer; Villatte, Jennifer L.; Pistorello, Jacqueline
Recently, tomosynthesis (DBT) and CT (BCT) have been developed for breast imaging. Since each modality produces a fundamentally different representation of the breast volume, our goal was to investigate whether a 3D segmentation algorithm for breast masses could be applied to both DBT and breast BCT images. A secondary goal of this study was to investigate a simplified method for comparing manual outlines to a computer segmentation. The seeded mass lesion segmentation algorithm is based on maximizing the radial gradient index (RGI) along a constrained region contour. In DBT, the constraint function was a prolate spherical Gaussian, with a larger FWHM along the depth direction where the resolution is low, while it was a spherical Gaussian for BCT. For DBT, manual lesion outlines were obtained in the in-focus plane of the lesion, which was used to compute the overlap ratio with the computer segmentation. For BCT, lesions were manually outlined in three orthogonal planes, and the average overlap ratio from the three planes was computed. In DBT, 81% of all lesions were segmented at an overlap ratio of 0.4 or higher, based on manual outlines in one slice through the lesion center. In BCT, 93% of all segmentations achieved an average overlap ratio of 0.4, based on the manual outlines in three orthogonal planes. Our results indicate mass lesions in both BCT and DBT images can be segmented with the proposed 3D segmentation algorithm, by selecting an appropriate set of parameters and after images have undergone specific pre-processing.
Reiser, I.; Joseph, S. P.; Nishikawa, R. M.; Giger, M. L.; Boone, J.; Lindfors, K.; Edwards, A.; Packard, N.; Moore, R. H.; Kopans, D. B.
Investigated extent to which cognitive-behavioraltherapy can be used successfully in treatment of secondary depressed panic patients. Findings from eight panic patients with major depression and seven panic patients without major depression showed that cognitive-behavioraltherapy was significantly superior to information-based therapy in…
The dopamine agonist medications, pramipexole and ropinirole, are commonly used to treat Parkinson's disease. These two drugs have a highly specific affinity for cerebral D3 receptors, known to be localized to the mesolimbic system. Herein is described a common side effect of these drugs, encountered in our routine clinical practice: pathological behaviors. This includes excessive gambling, hypersexuality, shopping, hyperphagia or obsessive hobbying, which may develop in up to 30% of people taking higher agonist doses. In contrast, treatment with the dopamine precursor, levodopa, in the absence of D3 agonist therapy very rarely provokes such behavioral syndromes. Although these agonist-induced behaviors have been called "impulse control disorders", the problem is not simply loss of impulse control, but rather a novel obsessive-compulsion directed at one or a few behaviors, often taking on pathological proportions. This experience points to the dopamine D3 receptor as a potential therapeutic target for gambling, sex or other addictions occurring spontaneously in the general population. PMID:21557955
In psychotherapy research, practice, and training, there remains marked controversy about the merits of theoretical purism (i.e., model specific), versus integration, as well as how such principles may be represented in practice. Adding to the confusion is that many attributes of the therapeutic relationship, processes in therapy, and techniques have been popularized in the context of one or two theoretical approaches, but are incorporated into the practice of many approaches. This article demonstrates the various ways in which three core interventions (i.e., activity scheduling, self-monitoring, and identification, evaluation, and modification of thoughts) can be applied within the context of different cognitive and behavioral therapeutic models. It also demonstrates the role of in-session therapist language in describing the theoretical basis and processes underpinning therapeutic interventions. Case examples are presented to illustrate therapy provided by two hypothetical clinicians, Therapist A and Therapist B. Whether or not a practitioner elects to practice integrative psychotherapy, we advocate for consistency in the theoretical approach through the course of a service for a particular patient. Implications are outlined and discussed within the context of the current state of cognitive and behaviorally focused psychotherapies and integrative psychotherapy. PMID:24000858
Petrik, Alexandra M; Kazantzis, Nikolaos; Hofmann, Stefan G
Process and outcome of a smoking cessation program using behaviortherapy along (BT) or behaviortherapy plus the nicotine patch (BTP) was studied in 64 participants. Abstinence was significantly higher for the BTP group from the end of behavioral treatment (79% vs. 63%) through the three-month follow-up, with the effects weakening at the six- and…
This article describes a brief, 12-week dialectical behaviortherapy program modified for female victims of domestic abuse and provides a preliminary examination of this intervention. Dialectical behaviortherapy is a comprehensive cognitive–behavioral treatment, which was originally developed to treat multiproblem clients with severe and chronic emotion dysregulation, and was adapted for this study to treat female victims of domestic abuse.
Katherine M. Iverson; Chad Shenk; Alan E. Fruzzetti
The efficacy and the mechanisms of action of two behavioral treatments for essential hyper- tension were compared: cognitive group therapy for anger control and biofeedback for heart rate control. The cognitive therapy aimed at lowering the \\
JUDITH ACHMON; MICHEL GRANEK; MIRA GOLOMB; JACOB HART
Rational-emotive behaviortherapy (REBT) is a widely utilized treatment approach for many mental disorders, but it has been\\u000a “relatively neglected in the professional scientific literature” (Ellis 2003b). This neglect has been attributed in part to a lack of solid REBT outcome studies, which in turn stems from the difficulty\\u000a of measuring constructs of interest in REBT, such as irrational beliefs,
Samantha A. Rodman; Stacey B. Daughters; C. W. Lejuez
Objective: To compare cognitive-behavioraltherapy (CBT) and standard medical care (SMC) as treatments for psychogenic nonepileptic seizures (PNES). Methods: Our randomized controlled trial (RCT) compared CBT with SMC in an outpatient neuropsychiatric setting. Sixty-six PNES patients were randomized to either CBT (plus SMC) or SMC alone, scheduled to occur over 4 months. PNES diagnosis was established by video-EEG telemetry for most patients. Exclusion criteria included comorbid history of epilepsy, <2 PNES/month, and IQ <70. The primary outcome was seizure frequency at end of treatment and at 6-month follow-up. Secondary outcomes included 3 months of seizure freedom at 6-month follow-up, measures of psychosocial functioning, health service use, and employment. Results: In an intention-to-treat analysis, seizure reduction following CBT was superior at treatment end (group × time interaction p < 0.0001; large to medium effect sizes). At follow-up, the CBT group tended to be more likely to have experienced 3 months of seizure freedom (odds ratio 3.125, p = 0.086). Both groups improved in some health service use measures and on the Work and Social Adjustment Scale. Mood and employment status showed no change. Conclusions: Our findings suggest that cognitive-behavioraltherapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients. Classification of evidence: This study provides Class III evidence that CBT in addition to SMC, as compared to SMC alone, significantly reduces seizure frequency in patients with PNES (change in median monthly seizure frequency: baseline to 6 months follow-up, CBT group, 12 to 1.5; SMC alone group, 8 to 5). GLOSSARY AED = antiepileptic drug; CBT = cognitive-behavioraltherapy; CI = confidence interval; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HADS = Hospital Anxiety and Depression Scale; IQR = interquartile range; ITT = intention-to-treat; OR = odds ratio; PNES = psychogenic nonepileptic seizures; RCT = randomized controlled trial; SMC = standard medical care; WASAS = Work and Social Adjustment Scale. PMID:20548043
This article presents a brief conceptual overview of acceptance-based behavioraltherapies (ABBTs) for anxiety disorders, followed by a review and summary of the recent efficacy studies of ABBTs for anxiety and comorbid disorders. We discuss clinical implications, including the importance of targeting reactivity and experiential avoidance in interventions for anxiety disorders through the use of mindfulness and other acceptance-based strategies, as well the encouragement of engagement in meaningful activities or valued action. We also address future directions for research, such as expanding research to include more randomized control trials comparing ABBTs for specific anxiety disorders to other active treatments, examining mechanisms of change, exploring adaptations in different care-delivery contexts, as well as determining the applicability of these approaches to clients from marginalized or non-dominant statuses. PMID:24078067
Roemer, Lizabeth; Williston, Sarah K; Eustis, Elizabeth H; Orsillo, Susan M
This study pilot tested a newly developed modular cognitive–behavioraltherapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-month follow-ups. At posttreatment, BDD and related symptoms (e.g., mood) were significantly improved. Treatment gains were maintained at follow-up. A relatively low drop-out rate, high patient satisfaction ratings, and patient feedback indicated that the treatment was highly acceptable to patients. To our knowledge, this represents the first test of a broadly applicable, individual psychosocial treatment for BDD. PMID:22035991
Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail
This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive–behavioraltherapy (CBT), light therapy (LT), and their combination to a concurrent wait-list control. Adults (N = 61) with major depression, recurrent with seasonal pattern, were randomized to one of four 6-week conditions: CBT (1.5-hr twice-weekly group therapy), LT (10,000-lux for 90-min\\/day with administration time individually adjusted), combined
Kelly J. Rohan; Kathryn A. Roecklein; Kathryn Tierney Lindsey; Leigh G. Johnson; Robert D. Lippy; Timothy J. Lacy; Franca B. Barton
This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive-behavioraltherapy (CBT), light therapy (LT), and their combination to a concurrent wait-list control. Adults (N = 61) with major depression, recurrent with seasonal pattern, were randomized to one of four 6-week conditions: CBT (1.5-hr…
Rohan, Kelly J.; Roecklein, Kathryn A.; Tierney Lindsey, Kathryn; Johnson, Leigh G.; Lippy, Robert D.; Lacy, Timothy J.; Barton, Franca B.
Examines the effectiveness of group interpersonal therapy (IPT) in treating overweight, binge-eating patients. Participants were randomly allocated to cognitive-behavioraltherapy (CBT) or to an assessment-only group. After 12 weeks, those who did not respond to CBT were assigned 12 weeks of IPT. IPT led to no further improvement. (JPS)
Background: Writing assignments have shown promising results in treating traumatic symptomatology. Yet no studies have compared their efficacy to the current treatment of choice, cognitive behaviortherapy (CBT). The present study evaluated the efficacy of structured writing therapy (SWT) and CBT as compared to a waitlist control condition in treating acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Methods:
Arnold A. P. van Emmerik; Jan H. Kamphuis; Paul M. G. Emmelkamp
This manual is designed to help train substance abuse treatment counselors to conduct a brief five-session treatment intervention for adolescents with cannabis use disorders presenting for outpatient treatment. It combines two sessions of motivational enhancement therapy provided individually and three sessions of cognitive behavioraltherapy…
There has been little research examining group cognitive-behavioraltherapy (CBT) for schizophrenia, especially compared to an active control treatment. The purpose of this study was to investigate the effectiveness of group CBT for auditory hallucinations compared to an enhanced supportive therapy (ST). Sixty five participants with schizophrenia spectrum disorders and persistent hallucinations were randomly assigned to group CBT or enhanced
David L. Penn; Piper S. Meyer; Elizabeth Evans; R. J. Wirth; Karen Cai; Margaret Burchinal
A nurse practising at Limoges psychiatric hospital enriched her skills by training in the cognitive behavioural therapies developed in her department, notably mindfulness-based therapies. PMID:24654332
Background and AimsCognitive behavioral group therapy (CBGT) is an effective, well-established, but not widely available treatment for social anxiety disorder (SAD). Internet-based cognitive behaviortherapy (ICBT) has the potential to increase availability and facilitate dissemination of therapeutic services for SAD. However, ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT
Erik Hedman; Gerhard Andersson; Brjánn Ljótsson; Erik Andersson; Christian Rück; Ewa Mörtberg; Nils Lindefors; Antonio Verdejo García
The present investigation was aimed at studying the efficacy of cognitive behaviortherapy (CBT) in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering) and exclusion criteria (clients with brian damage), substance abuse or mental retardation were enrolled for the study. A single-case design was adopted. The pre-, mid- and post-assessment were carried out using Stuttering Severity Scale (SSI), Perception of Stuttering Inventory (PSI), Beck's Anxiety Inventory (BAI), Dysfunctional Attitude (DAS), Fear of Negative Evaluation (FNE), Assertiveness Scale (AS), Rosenberg's Self-Esteem Scale (RSES), and World Health Organization - Quality of Life Scale (WHO-QOL). Five clients received cognitive behavioral intervention comprising of psycho-education, relaxation, deep breathing, humming, prolongation, cognitive restructuring, problem-solving strategies and assertiveness. At post-treatment assessment, there was improvement. The findings of the study are discussed in the light of available research work, implications, limitations of the study and suggestions for future research. PMID:21799560
Sudden gains in psychotherapy are characterized by large and relatively stable decreases in psychiatric symptoms and have been associated with cognitive shifts in clients and shown to predict superior treatment outcomes in studies of depression and, to a lesser extent, anxiety disorders. The purpose of this study was to examine prevalence and impact of sudden gains during a transdiagnostic cognitive-behavioral group therapy (CBGT) for anxiety disorders, as well as the temporal relationship between sudden gains and cognitive changes. Data were used from two trials of transdiagnostic CBGT for anxiety disorders (n = 130). Criteria for determining sudden gains in anxiety symptoms were based upon previous research on sudden gains from trials of cognitive behavioral treatments for major depressive disorder. A total of 17 out of 98 (17.3%) clients experienced at least one sudden gain, with three clients showing two sudden gains during treatment. Three patients showing a sudden gain experienced a reversal of these gains, although one of these three had a subsequent second sudden gain. Clients experiencing sudden gains showed greater overall improvement following treatment than did clients who did not experience a sudden gain, with 65% of the sudden gainers' overall improvement accounted for by the sudden gain. Greater cognitive change in the pregain sessions was observed for clients with a sudden gain than those not showing a sudden gain. This finding lends support to the theory of cognitive mediation through CBGT in which substantial cognitive changes in pregain sessions lead to greater improvement overall. PMID:20621441
Norton, Peter J.; Klenck, Suzanne C.; Barrera, Terri L.
Abstract Abstract Abstract Abstract Objectives and main techniques of cognitive behaviortherapy for the treatment of bipolar disorder patients are described. K K K K Keywords eywords eywords eywords eywords: Cognitive therapy, Bipolar disorder\\/therapy; Bipolar disorder\\/psychology; Mood disorders; Psychotherapy
The authors compared clients' emotional processing in good and bad outcome cases in cognitive behavioraltherapy (CBT) and process-experiential therapy (PET) and investigated whether clients' emotional processing increases over the course of therapy. Twenty minutes from each of 3 sessions from 40 clients were rated on the Experiencing Scale. A 2 *…
Homework, or self-help, is an essential and required part of cognitive behavioral treatment. It offers several opportunities for the therapist to extend and increase therapy contact by having the patient “live” the therapy outside of the consulting room. It can also serve as a measure of the patient’s motivation for therapy or for change. Homework offers the patient an opportunity
Homework, or self-help, is an essential and required part of cognitive behavioral treatment. It offers several opportunities for the therapist to extend and increase therapy contact by having the patient "live" the therapy outside of the consulting room. It can also serve as a measure of the patient's motivation for therapy or for change. Homework…
Unusual compulsive behaviors (weighing, card and video game playing, fishing, gardening, intense interest in established hobbies, locking and unlocking doors, repetitive dressing and undressing) occurred in relation to dopamine agonist therapy (six patients) and levodopa therapy (one patient) in seven patients with parkinsonism (seven Parkinson's disease, one multiple system atrophy). These behaviors occurred in tandem with pathological gambling, hypersexuality, compulsive
Andrew McKeon; Keith A. Josephs; Kevin J. Klos; Kathleen Hecksel; James H. Bower; J. Michael Bostwick; J. Eric Ahlskog
This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive-behavioraltherapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake,…
Hogue, Aaron; Henderson, Craig E.; Dauber, Sarah; Barajas, Priscilla C.; Fried, Adam; Liddle, Howard A.
To be responsive to clients' evaluations of the unfolding therapy process, therapists must first accurately "read" client behavior, a particularly challenging task in conjoint family therapy. In this study, the authors compared client behavior in 28 sessions that one family member and the therapist concurred, on the Session Evaluation…
Exposure with response prevention and cognitive behaviortherapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive- compulsive disorder - particularly those living in rural areas - do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behaviortherapy for obsessive-compulsive disorder. Two open trials are reported, for
Steven Taylor; Dana S. Thordarson; Truman Spring; Angela H. Yeh; Kathleen M. Corcoran; Kathy Eugster; Colin Tisshaw
In response to clinical observations and research findings that individuals with generalized anxiety disorder are reactive to their internal experiences, avoid and suppress painful emotions, thoughts, and sensations, and limit their involvement in meaningful activities, an Acceptance Based BehavioralTherapy (ABBT) was developed to specifically target these responses. ABBT incorporates acceptance and mindfulness strategies with more traditional behaviortherapy techniques.
Sarah A. Hayes-Skelton; Susan M. Orsillo; Lizabeth Roemer
Questions adequacy with which insight-oriented marital therapy (IOMT) and behavioral marital therapy (BMT) were represented in Snyder, Wills, and Grady-Fletcher's (1991) comparative treatment study. Contends that BMT treatment manual fails to include recent innovations in behavioral technology and IOMT manual includes many skills integral to BMT.…
The aim of this study was to evaluate the effectiveness of the addition of manual-based cognitive-behavioraltherapy to a medication regimen of clomipramine and fluoxetine and the withdrawal of medication during cognitive-behavioraltherapy. The participant was an 11-year-old girl with symptoms of obsessive thoughts about germs and illness and…
Sallinen, Bethany J.; Nangle, Douglas W.; O'Grady, April C.
Background: Female offenders incarcerated in Washington State have demonstrated higher rates of mental health needs than boys. Linehan's (1993a, b) Dialectical Behavioural Therapy (DBT) is an effective treatment for adult women with Borderline Personality Disorder. DBT utilises a combination of skills training, problem solving, and validation to enable patients to reduce self-destructive, impulsive and aggressive behaviours. The prevalence of similar
Background This study examines whether adding nicotine replacement therapy (NRT) to cognitive behavioraltherapy (CBT) for pregnant smokers increases rates of smoking cessation. Methods An open-label randomized trial (Baby Steps, n = 181) of CBT-only versus CBT+NRT (choice of patch, gum, or lozenge; 1:2 randomization) was used. Data were collected from 2003 through 2005; analyses were conducted in 2006 and 2007. Outcomes were biochemically validated self-reported smoking status at 7-weeks post-randomization, 38-weeks gestation, and 3-months postpartum. Results Women in the CBT+NRT arm were almost three times more likely than women in the CBT-only arm to have biochemically validated cessation at both pregnancy timepoints (after 7 weeks: 24% vs 8%, p = 0.02; at 38-weeks gestation: 18% vs 7%, p =0.04), but not at 3-months postpartum (20% vs 14%, p=0.55). Recruitment was suspended early by an independent Data and Safety Monitoring Board when an interim analysis found a greater rate of negative birth outcomes in the CBT+NRT arm than in the CBT arm. At the final analysis the difference between the arms in rate of negative birth outcomes was 0.09 (p=0.26), adjusted for prior history of preterm birth. Conclusions The addition of NRT to CBT promoted smoking cessation in pregnant women. This effect did not persist postpartum. More data are needed to determine the safety and to confirm the efficacy of NRT use during pregnancy. PMID:17888856
Pollak, Kathryn I.; Oncken, Cheryl A.; Lipkus, Isaac M.; Lyna, Pauline; Swamy, Geeta K.; Pletsch, Pamela K.; Peterson, Bercedis L.; Heine, R. Phillips; Namenek Brouwer, Rebecca J.; Fish, Laura; Myers, Evan R.
This study tested a family-based skills-building intervention in veterans with chronic combat-related posttraumatic stress disorder (PTSD). Veterans and a family member were randomly assigned to 1 of 3 conditions: (a) waiting list, (b) 18 sessions of twice-weekly exposure therapy, or (c) 18 sessions of twice-weekly exposure therapy followed by 16 sessions of behavioral family therapy (BFT). Participation in exposure therapy
Shirley M. Glynn; Spencer Eth; Eugenia T. Randolph; David W. Foy; Marleen Urbaitis; Laurie Boxer; George G. Paz; Gregory B. Leong; Gregory Firman; Jonathan D. Salk; Jeffrey W. Katzman; Judith Crothers
Digital breast tomosynthesis (DBT) is considered in clinics as a standard three-dimensional imaging modality, allowing the earlier detection of cancer. It typically acquires only 10-30 projections over a limited angle range of 15-60° with a stationary detector and typically uses a computationally-efficient filtered-backprojection (FBP) algorithm for image reconstruction. However, a common FBP algorithm yields poor image quality resulting from the loss of average image value and the presence of severe image artifacts due to the elimination of the dc component of the image by the ramp filter and to the incomplete data, respectively. As an alternative, iterative reconstruction methods are often used in DBT to overcome these difficulties, even though they are still computationally expensive. In this study, as a compromise, we considered a projection-angle-dependent filtering method in which one-dimensional geometry-adapted filter kernels are computed with the aid of a conjugate-gradient method and are incorporated into the standard FBP framework. We implemented the proposed algorithm and performed systematic simulation works to investigate the imaging characteristics. Our results indicate that the proposed method is superior to a conventional FBP method for DBT imaging and has a comparable computational cost, while preserving good image homogeneity and edge sharpening with no serious image artifacts.
Park, Yeonok; Park, Chulkyu; Cho, Hyosung; Je, Uikyu; Hong, Daeki; Lee, Minsik; Cho, Heemoon; Choi, Sungil; Koo, Yangseo
Followup school assessments were conducted 12 months and 18 months following completion of Parent-Child Interaction Therapy (PCIT), a behavioral family therapy for preschool children with disruptive behavior disorders. Subjects in the treatment group displayed significant home and school behavior problems prior to treatment, and showed clinically significant improvement in home behavior after completing the 14-session program. Additionally, behavioral improvements generalized
Beverly W. Funderburk; Sheila M. Eyberg; Katharine Newcomb; Cheryl B. McNeil; Toni Hembree-Kigin; Laura Capage
This paper provides a description of the Witmer Wellness Center, the first successful military application of dialectical behaviortherapy in a theater of war. Dialectical behaviortherapy is a dynamic and provocative evidenced-based modification of cognitive behavioral treatment developed by Dr Marsha Linehan for patients with severe emotional dysregulation. One of the primary concepts of dialectical behaviortherapy is that self-harming behaviors are learned, and provide evidence of maladaptive coping that is reinforced in an invalidating environment. Dialectical behaviortherapy recommends a hierarchy of goals to effectively address the behaviors associated with dysregulation. Chief among these goals is reducing risk of violence to self or others. Dialectical behaviortherapy is especially well-suited for the complex and dynamic environment of the noncontiguous battlefield with its chronic threat of ultraviolence, strain of nonresponse, shifting rules of engagement, and extended duration and frequency of combat deployments. The Witmer Wellness Center program uses an intensive outpatient organizational structure and minimal, but innovative, modifications to standard dialectical behaviortherapy designed to meet the special requirements of Warriors in a combat zone. The Wellness Center program was designed and implemented during Operation Iraqi Freedom 07-09, at a time during the troop surge when suicide rates among US forces had reached an unprecedented level. PMID:20088061
This article presents an introduction to "The Behavior-Analytic Origins of Constraint-Induced Movement Therapy: An Example of Behavioral Neurorehabilitation," by Edward Taub and his colleagues (Taub, 2012). Based on extensive experimentation with animal models of peripheral nerve injury, Taub and colleagues have created an approach to overcoming…
Synopsis Eating disorders and obesity in children and adolescents involve harmful behavior and attitude patterns that infiltrate daily functioning. Cognitive behavioraltherapy (CBT) is well-suited to treat these conditions, given the emphasis on breaking negative behavior cycles. This article reviews the current empirically-supported treatments and the considerations for youth with weight control issues. New therapeutic modalities (i.e., Enhanced CBT and the socio-ecological model) are discussed. Rationale is provided for extending therapy beyond the individual treatment milieu to include the family, peer network, and community domains to promote behavior change, minimize relapse, and support healthy long-term behavior maintenance. PMID:21440855
Wilfley, Denise E.; Kolko, Rachel P.; Kass, Andrea E.
Women with lifelong vaginismus (N = 117) were randomly assigned to cognitive-behavioral group therapy, cognitive-behavioral bibliotherapy, or a waiting list. Manualized treatment comprised sexual education, relaxation exercises, gradual exposure, cognitive therapy, and sensate focus therapy. Group therapy consisted of ten 2-hr sessions with 6 to 9…
Van Lankveld, Jacques J. D. M.; ter Kuile, Moniek M.; de Groot, H. Ellen; Melles, Reinhilde; Nefs, Janneke; Zandbergen, Maartje
Behavioral and family systems theories provide two current approaches to treating distressed families. This paper describes and compares the ways in which both theories conceptualize family problems and explain maintenance and change processes within the family system. Systems and behavioral theories share functional views of problem behaviors and interactive sequences. However, behavioral theory uses more molecular analyses of processes than
This study examined mealtime behaviors in families of young children with type 1 diabetes (T1DM) on intensive insulin therapy. Behaviors were compared to published data for children on conventional therapy and examined for correlations with glycemic control. Thirty-nine families participated and had at least three home meals videotaped while children wore a continuous glucose monitor. Videotaped meals were coded for parent, child, and child eating behaviors using a valid coding system. A group difference was found for child request for food only. There were also associations found between children's glycemic control and child play and away. However, no associations were found between parent and child behaviors within meals and children's corresponding post-prandial glycemic control. Results reinforce existing research indicating that mealtime behavior problems exist for families of young children even in the context of intensive therapy and that some child behaviors may relate to glycemic control. PMID:24183137
Patton, Susana R; Dolan, Lawrence M; Smith, Laura B; Brown, Morton B; Powers, Scott W
This study attempted to compare the behavioral effects of active, rhythm-based group music therapy vs. those of passive, listening-based group music therapy on preadolescents with emotional, learning, and behavioral disorders. It was hypothesized that preadolescents who participated in active music therapy would more significantly improve target behaviors than those involved in passive music therapy. Achenbach's Teacher Report Form (TRF) was used to confirm changes among subjects in attention, motivation, and hostility as rated by homeroom teachers. Twelve music therapy sessions were conducted over a 4-month period with three different groups of subjects (n = 16), with two groups participating in active music therapy and the other receiving passive music therapy. Results indicate that subjects improved significantly after receiving both music therapy interventions. The most significant change in subjects was found on the aggression/hostility scale. These results suggest that group music therapy can facilitate the process of serf-expression in emotionally disturbed/learning disabled adolescents and provide a channel for transforming frustration, anger, and aggression into the experience of creativity and self-mastery. Discussion of results also includes recommendations for chousing one music therapy approach over another based on personality types and/or clinical diagnoses of subjects. PMID:10519828
The purpose of this article is to explore the use of behavioral activation therapy in patients with medication-responsive chronic depression who continue to experience social and occupational deficits. The classification of chronic depression includes a variety of disorders that are both common and debilitating and that frequently leave patients socially impaired even after remission of mood symptoms. Medication is often only partially effective in remedying these social impairments. As a result, other interventions, including forms of psychotherapy, may be justified as an adjunct to medication to improve residual social impairment. Behavioral activation therapy is one such treatment that may be especially appropriate for such individuals. The authors offer a brief description of behavioral activation therapy and examine how to adapt this therapy for use in patients with medication-responsive chronic depression. Preliminary evidence suggests that the therapy can be easily implemented with few modifications to improve social and occupational difficulties. PMID:21586994
Historical events in the development of cognitive-behaviortherapy with children are reviewed. Suggestions are offered for areas which might be valuable for therapists to consider in the 1980s. (Author/GK)
The present study examined to examine whether improvement of insomnia is mediated by a reduction in sleep-related dysfunctional beliefs through cognitive behavioraltherapy for insomnia. In total, 64 patients with chronic insomnia received cognitive behavioraltherapy for insomnia consisting of 6 biweekly individual treatment sessions of 50 minutes in length. Participants were asked to complete the Athens Insomnia Scale and the Dysfunctional Beliefs and Attitudes about Sleep scale both at the baseline and at the end of treatment. The results showed that although cognitive behavioraltherapy for insomnia greatly reduced individuals’ scores on both scales, the decrease in dysfunctional beliefs and attitudes about sleep with treatment did not seem to mediate improvement in insomnia. The findings suggest that sleep-related dysfunctional beliefs endorsed by patients with chronic insomnia may be attenuated by cognitive behavioraltherapy for insomnia, but changes in such beliefs are not likely to play a crucial role in reducing the severity of insomnia. PMID:25025164
Although cognitive-behavioraltherapy (CBT) is efficacious in the treatment of generalized anxiety disorder (GAD), many individuals remain symptomatic following treatment, indicating a need for further treatment development. As a result, many researchers have developed unique cognitive-behavioraltherapies that highlight specific targets for intervention. The current study examined the effect of an acceptance-based behavioraltherapy for GAD on the proposed targets for intervention highlighted in several of these theoretical models: emotion regulation difficulties, intolerance of uncertainty, and low perceptions of control. Clients were randomly assigned to immediate (n = 15) or delayed (n = 16) treatment. Individuals treated with the acceptance-based behavioraltherapy reported significantly fewer difficulties in emotion regulation and fear of emotional responses, as well as greater tolerance of uncertainty and perceived control over anxiety than individuals in the waitlist control condition. In addition, these effects were maintained at 3- and 9-month follow-up assessments. PMID:21284065
Treanor, Michael; Erisman, Shannon M.; Salters-Pedneault, Kristalyn; Roemer, Lizabeth; Orsillo, Susan M.
\\u000a Individuals with autism spectrum disorders (ASDs) who have acquired functional communication strategies – particularly more\\u000a cognitively able individuals at or beyond the elementary school age group – may be candidates for talk-based therapies similar\\u000a to those employed with children and adults with mental health disorders, such as anxiety (e.g., cognitive behavioraltherapy,\\u000a CBT). While talk-based therapies are widely used in
Given the prevalence of null hypothesis significance testing, cognitive-behavioraltherapy's effect on depressive symptoms of bipolar disorder is not fully understood in the absence of effect size statistics. The present study discusses the disadvantages associated with null hypothesis significance testing and seeks to overcome these shortcomings via conducting a meta-analysis which examines cognitive-behavioraltherapy for depressive symptoms in persons with
Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…
This study evaluated the specific effectiveness of cognitive-behaviortherapy (CBT) combined with medication tapering for benzodiazepine discontinuation among generalized anxiety disorder (GAD) patients by using a nonspecific therapy control group. Sixty-one patients who had used benzodiazepines for more than 12 months were randomly assigned to…
Gosselin, Patrick; Ladouceur, Robert; Morin, Charles M.; Dugas, Michel J.; Baillargeon, Lucie
Used a meta-analysis to integrate the research literature on the treatment of obsessive-compulsive disorder. Antidepressants, such as clomipramine, and behaviortherapy have produced appreciable changes in obsessive-compulsive and depressive symptoms. The effects of tricyclic medication and exposure therapies have not differed significantly, but…
We examined the role of specific therapist verbal behaviors in predicting successful completion of Parent-Child Interaction Therapy (PCIT) in 22 families, including 11 families that successfully completed treatment and 11 that discontinued treatment prematurely. The children were 3 to 6 years old and diagnosed with oppositional defi- ant disorder (ODD). Chamberlain et al.'s (1986) Therapy Process Code (TPC) was used
Background: Few studies have examined the link between child-therapist alliance and outcome in manual-guided cognitive behavioraltherapy (CBT) for children diagnosed with anxiety disorders. This study sought to clarify the nature and strength of this relation. Methods: The Therapy Process Observational Coding System for Child…
Chiu, Angela W.; McLeod, Bryce D.; Har, Kim; Wood, Jeffrey J.
The efficacy of contemporary cognitive therapy for obsessive–compulsive disorder (OCD) has only recently been investigated. The current study compares exposure and response prevention (ERP) and cognitive behaviortherapy (CBT) delivered in an individual format. Participants were randomly assigned to the 12 consecutive-week CBT or ERP treatment. Based on 59 treatment completers, there was no significant difference in YBOCS scores between
Maureen L. Whittal; Dana S. Thordarson; Peter D. McLean
To improve cognitive and behavioraltherapies (CBT) for depression, several approaches recommend an increased focus on the occurrence of problems as they occur in the therapeutic relationship or in relation to the live therapy process, referred to as present-focused. A lingering question has been the degree to which CBT therapists already engage in present-focused work. This study utilized sessions from
JONATHAN W. KANTER; LAURA C. RUSCH; SARA J. LANDES; GARETH I. HOLMAN; URSULA WHITESIDE; SONJA K. SEDIVY
In a randomized trial, this study compared the longitudinal outcome patterns of veterans (N = 66) with substance use disorders and major depressive disorder receiving standard pharmacotherapy and either 12-Step Facilitation Therapy (TSF) or disorder-specific Integrated Cognitive Behavioral Treatment (ICBT). Depression and substance use were assessed at intake, during and after treatment using the Hamilton Depression Rating Scale and the
Sandra A. Brown; Suzette V. Glasner-Edwards; Susan R. Tate; John R. McQuaid; John Chalekian; Eric Granholm
Background: Alcohol abuse serves as a chronic stressor between partners and has a deleterious effect on relationship functioning. Behavioral Couples Therapy (BCT) for alcohol dependence, studied as an adjunct to individual outpatient counseling, has shown to be effective in decreasing alcohol consumption and enhancing marital functioning, but no study has directly tested the comparative effectiveness of stand-alone BCT versus an
Ellen Vedel; Paul M. G. Emmelkamp; Gerard M. Schippers
Background: Dialectic behaviour therapy (DBT) has been widely used with individuals diagnosed with borderline personality disorder who exhibit severe emotional and behavioural dysregulation. There is a paucity of research in assessing the effectiveness of DBT with forensic clients with intellectual disability (ID). Methods: This pilot study aims…
Cognitive behaviortherapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more…
This study's purpose was to examine the extent to which participants (N = 143) receiving cognitive-behavioraltherapy for bulimia nervosa (BN) reported implementing therapeutic strategies to abstain from BN behaviors, and to assess whether use of specific strategies predicts outcome at treatment end and 1-and 6-month follow-up. Frequency of…
Binford, Roslyn B.; Mussell, Melissa Pederson; Crosby, Ross D.; Peterson, Carol B.; Crow, Scott J.; Mitchell, James E.
This case report describes the benefits of antibiotic and antifungal therapy on behavior in a child with autism undergoing treatment for encopresis. Over the course of treatment, the child exhibited a reduction in aberrant behaviors, increased gastrointestinal function, and improved quality of life. PMID:23853732
In late 1993, Oklahoma Department of Corrections officials implemented Moral Reconation Therapy (MRT), a cognitive behavioral treatment program, throughout the correctional system. Relying on official records of institutional misconduct and community recidivism, the analysis of the Oklahoma implementation of the program compared the outcomes of individuals who participated in the MRT cognitive-behavioral program to both individuals who participated in other
Robert Brame; Doris Layton MacKenzie; Arnold R. Waggoner
The first-line treatment for bulimia nervosa (BN), cognitive-behavioraltherapy (CBT), uses food-based self-monitoring. Six young women presenting with BN or significant purging behavior were treated with a modification, Appetite-Focused CBT (CBT-AF), in which self-monitoring is based on appetite cues and food monitoring is proscribed. This change…
Cognitive behavioraltherapy (CBT) has been found to be effective in preventing suicide-related behavior. However, it is often difficult to engage patients who are at-risk in treatment. Motivational Interviewing (MI) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments. As a…
Britton, Peter C.; Patrick, Heather; Wenzel, Amy; Williams, Geoffrey C.
Cognitive behaviortherapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more effective body image interventions led to the development of mirror
Contends that there is a weak empirical basis for the move toward more behaviorally oriented modalities as appropriate for non-White and non-YAVIS (young, attractive, verbal, intelligent, and successful) clients. Behaviortherapy has been proposed because traditional approaches are seen as \\
Prior studies have supported the efficacy of cognitive behavioraltherapy (CBT) for insomnia comorbid with cancer. This article reports secondary analyses that were performed on one of these studies to investigate the predictive role of changes in dysfunctional beliefs about sleep, adherence to behavioral strategies, and some nonspecific factors…
Schizophrenia is a psychotic disorder that has been considered to be the epitome of a severe mental illness. The negative psychosocial consequences of schizophrenia are well documented. Despite the advent of antipsychotic medication, residual symptoms persist for many persons diagnosed with schizophrenia. Cognitive-behavioraltherapy (CBT) has emerged as an adjunctive treatment to pharmacotherapy. Cognitive-behavioral theories of positive and negative symptoms
In recent years there has been widespread acceptance that cognitive behaviortherapy (CBT) is the treatment of choice for bulimia nervosa. The cognitive behavioral treatment of bulimia nervosa (CBT-BN) was first described in 1981. Over the past decades the theory and treatment have evolved in response to a variety of challenges. The treatment has…
DBT and EMDR as primary treatment methods provide effective treatment for adolescents in the setting of group residential facilities. Regardless of the intensity of the pathology or the length of stay, these compatible treatment methods provide adolescents with significant decreases in the impact of traumatic memories and increased emotional…
A treatment-outcome study was conducted to study the impact of behavior and physical therapy on components of the chronic low back pain syndrome. Eighteen patients received behaviortherapy and 15 patients received physical therapy. All patients had at least a 6-month history of seeking treatment for chronic low back pain. Prior to treatment patients were assessed in four principal areas
Richard L. Heinrich; Michael J. Cohen; Bruce D. Naliboff; Gretchen A. Collins; Adelita D. Bonebakker
Objective:Since peers have such an important influence on adolescents, we evaluated the efficacy of adding peer-based ‘adventure therapy’ to a standard cognitive-behavioral weight control program for overweight adolescents.Methods:Adolescents (N=76) aged 13–16 years and 20 to 80% overweight (M=60.56%, s.d.=15.17%), were randomly assigned to one of two treatment conditions: cognitive-behavioral group treatment with ‘adventure therapy’ similar to Outward Bound® (cognitive-behavioral treatment
E Jelalian; R Mehlenbeck; E E Lloyd-Richardson; V Birmaher; R R Wing
Randomly assigned 72 social phobics to behavioral (flooding) or drug treatment with atenolol or placebo. Found that flooding consistently was superior to placebo, whereas atenolol was not. Flooding also was superior to atenolol on behavioral measures and composite indexes. Subjects who improved during treatment maintained gains at six-month…
. Further, we argue that specific intervention components, including behavioral exposure/activation, at for examining common CBT characteristics that emphasizes behavioral adaptation as a unifying goal and three core processes that are present across approaches and are best understood by their relation- ships to these core
Behavior therapists view psychopathology differently from dynamically oriented therapists, in that behaviorists are taught to regard symptoms primarily as sets of learned behaviors rather than cues to underlying psychological disorders. Even though there is a split among behaviorists as to which procedure is best to follow, there are some special…
This commentary focuses on the current status of assessment in rational-emotive and cognitive-behaviortherapy, in the context\\u000a of making comments about three assessment articles published in the same journal issue. The commentary describes important\\u000a characteristics of rational-emotive and cognitive-behavior assessment measures, suggests several avenues of psychometric research\\u000a on behavioral tests of distress tolerance as clinical measures, reviews psychometric and other
Objective: Clinicians commonly "drift" away from using proven therapeutic techniques. This study examined the degree to which such drift occurs among cognitive behavioraltherapy (CBT) clinicians working with a specific clinical population--adults with eating disorders. Method: The study used a correlational design. The participants were 80…
DBT is one of the promising imaging modalities that may improve the sensitivity and specificity for breast cancer detection. We are developing a computer-aided detection (CADe) system for clustered microcalcifications (MC) in DBT. A data set of two-view DBTs from 42 breasts was collected with a GE prototype system. We investigated a 2D approach to MC detection using projection view (PV) images rather than reconstructed 3D DBT volume. Our 2D approach consisted of two major stages: 1) detecting individual MC candidates on each PV, and 2) correlating the MC candidates from the different PVs and detecting clusters in the breast volume. With the MC candidates detected by prescreening on PVs, a trained multi-channel (MCH) filter bank was used to extract signal response from each MC candidate. A ray-tracing process was performed to fuse the MCH responses and localize the MC candidates in 3D using the geometrical information of the DBT system. Potential MC clusters were then identified by dynamic clustering of the MCs in 3D. A two-fold cross-validation method was used to train and test the CADe system. The detection performance of clustered MCs was assessed by free receiver operating characteristic (FROC) analysis. It was found that the CADe system achieved a case-based sensitivity of 90% at an average false positive rate of 2.1 clusters per DBT volume. Our study demonstrated that the CADe system using 2D MCH filter bank is promising for detection of clustered MCs in DBT.
Wei, Jun; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A.; Zhou, Chuan; Lu, Yao
This review focuses on the predictive value of neurobiological factors in relation to cognitive-behavioraltherapy outcome among individuals with antisocial behavior. Ten relevant studies were found. Although the literature on this topic is scarce and diverse, it appears that specific neurobiological characteristics, such as physiological arousal levels, can predict treatment outcome. The predictive value of neurobiological factors is important as it could give more insight into the causes of variability in treatment outcome among individuals with antisocial behavior. Furthermore, results can contribute to improvement in current treatment selection procedures and to the development of alternative treatment options. PMID:23839226
Cornet, Liza J M; de Kogel, Catharina H; Nijman, Henk L I; Raine, Adrian; van der Laan, Peter H
Adherence of therapists to behaviors specified in cognitive–behaviortherapy, interpersonal therapy, and clinical management manuals was studied. Raters used the Collaborative Study Psychotherapy Rating Scale (CSPRS) to rate therapist adherence in each of four sessions from 180 patients in the treatment phase of the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP). Results indicate that therapists
This paper discusses a recent translational success in combining behavioral psychotherapy with a novel medication, d-cycloserine (DCS), to augment cognitive-behavioraltherapy (CBT) for anxiety disorders. The literature on behavioral theory of exposure-based therapies is provided, followed by a discussion of the role of DCS in enhancing extinction…
Storch, Eric A.; McKay, Dean; Reid, Jeannette M.; Geller, Daniel A.; Goodman, Wayne K.; Lewin, Adam B.; Murphy, Tanya K.
The aim of this study was to review the efficacy of different methods of cognitive and/or behavioraltherapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioraltherapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioraltherapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioraltherapies for body dysmorphic disorder. PMID:23467711
Prazeres, Angelica M; Nascimento, Antonio L; Fontenelle, Leonardo F
Synopsis CBT has emerged as a well-established treatment for depression in children and adolescents but treatment trials for adolescents with suicidality are few in number, and their efficacy to date is rather limited. Although a definitive treatment for adolescent suicide attempters has yet to be established, the limited literature suggests that suicidal thoughts and behavior should be directly addressed for optimal treatment outcome. This chapter reviews the rationale underlying the use of CBT for the treatment of depression and suicidality in adolescents, the literature supporting the efficacy of CBT for depressed adolescents, and whether CBT for depression reduces suicidal thoughts and behavior. A description of some of the core cognitive, affective, and behavioral techniques used in CBT treatments of suicidal ideation and behavior in depressed adolescents is included. PMID:21440850
Spirito, Anthony; Esposito-Smythers, Christianne; Wolff, Jennifer; Uhl, Kristen
Three behavior therapists and three analytically oriented psychotherapists treated a total of 60 neurotic outpatients for four months. It was concluded that patient improvement was more a function of patient characteristics than of specific therapist interventions. (Author)
Describes the theory of self-defeating behaviors and discusses the theory's relevance for treatment of families' systems dysfunctions. Presents a case study illustrating the theory's application in a family systems approach for counselors. (RC)
Background: The efficacy of cognitive behaviour therapy (CBT) in social phobia has been demonstrated in several controlled trials and meta-analyses, but no comparison of CBT with supportive therapy (ST) can be found in the literature. Method: The aim of the trial was to study the effectiveness of CBT versus ST carried out ‘as usual’. Sixty-seven DSM-4 social phobic patients (89%
Jean Cottraux; Eliane Albuisson; Saï Nan Yao; Evelyne Mollard; Françoise Bonasse; Isabelle Jalenques; Janine Guérin; André Julien Coudert
The present study investigated the effectiveness of music therapy for dementia patients using endocrinological and behavioral evaluations. The study comprised 10 patients with senile dementia who received music therapy; six had Alzheimer's dementia and four had vascular dementia. Music therapy was performed twice a week for 8 consecutive weeks (16 sessions). As a result, total scores on the Mini-Mental State Examination (MMSE) did not significantly change, but the scores of a subscale, "language", improved significantly. According to the Multidimensional Observation Scale For Elderly Subjects (MOSES), scores for "irritability" decreased significantly. Regarding changes in salivary chromogranin A (CgA) levels, the average was significantly decreased before session 16 compared to after this. These results suggest that the combination of endocrinological measurements, behavioral evaluations and functional assessment methods are useful in evaluating the effects of music therapy in persons with senile dementia. PMID:14764189
This paper discusses a recent translational success in combining behavioral psychotherapy with a novel medication, d-cycloserine\\u000a (DCS), to augment cognitive-behavioraltherapy (CBT) for anxiety disorders. The literature on behavioral theory of exposure-based\\u000a therapies is provided, followed by a discussion of the role of DCS in enhancing extinction learning that is core to such therapies.\\u000a As well, pragmatic issues such as
Eric A. StorchDean; Dean McKay; Jeannette M. Reid; Daniel A. Geller; Wayne K. Goodman; Adam B. Lewin; Tanya K. Murphy
The goal of this review is to examine the clinical studies on d-cycloserine, a partial glutamatergic N-methyl-D-aspartate agonist, as an augmentation strategy for exposure procedures during cognitive behavioraltherapy for anxiety disorders. Although cognitive behavioraltherapy and anxiolytic medications are more effective than placebo for treating anxiety disorders, there is still considerable room for further improvement. Traditional combination strategies typically yield disappointing results. However, recent studies based on translational research have shown promise to augment the neural circuitry underlying fear extinction with pharmacological means. We discuss the current state of the literature, including inconsistencies of findings and issues concerning the drug mechanism, dosing, and dose timing. D-cycloserine is a promising combination strategy for cognitive behavioraltherapy of anxiety disorders by augmenting extinction learning. However, there is also evidence to suggest that d-cycloserine can facilitate reconsolidation of fear memory when exposure procedures are unsuccessful. PMID:23768232
Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT) are part of the new wave of treatments and analyses\\u000a that seem to be emerging in cognitive behaviortherapy. In this article, data in support of these new approaches are provided,\\u000a and evidence that ACT works through different processes than traditional CBT are presented. The integrative proposals of Ciarrochi\\u000a and
\\u000a This chapter describes the deployment of Virtual Reality (VR) for Cognitive BehavioralTherapy (CBT) to treat anxiety and\\u000a other psychological disorders. Regarding anxiety, the most common technique is constituted of Exposure Therapy that, transposed\\u000a to Virtual Reality, allows the patient to face a digital version of the feared object or situation, instead of a real or imaginal\\u000a one. Virtual Reality
Synopsis CBT represents a combination of behavioral and cognitive theories of human behavior and psychopathology, and a melding of emotional, familial, and peer influences. The numerous intervention strategies that comprise CBT reflect its complex and integrative nature and include such topics as extinction, habituation, modeling, cognitive restructuring, problem-solving, and the development of coping strategies, mastery, and a sense of self-control. CBT targets multiple areas of potential vulnerability (e.g., cognitive, behavioral, affective) with developmentally-guided strategies and traverses multiple intervention pathways. Although CBT is often considered the “first line treatment” for many psychological disorders in youth, additional work is necessary to address treatment non-responders and to facilitate the dissemination of efficacious CBT approaches. PMID:21440849
Benjamin, Courtney L.; Puleo, Connor M.; Settipani, Cara A.; Brodman, Douglas M.; Edmunds, Julie M.; Cummings, Colleen M.
Mobile applications have proven to be promising tools for supporting people in adhering to their health goals. Although coaching and reminder apps abound, few of them are based on established theories of behavior change. In the present work, a behavior change support system is presented that uses a computational model based on multiple psychological theories of behavior change. The system determines the user's reason for non-adherence using a mobile phone app and an online lifestyle diary. The user automatically receives generated messages with persuasive, tailored content. The system was designed to support chronic patients with type 2 diabetes, HIV, and cardiovascular disease, but can be applied to many health and lifestyle domains. The main focus of this work is the development of the model and the underlying reasoning method. Furthermore, the implementation of the system and some preliminary results of its functioning will be discussed. PMID:24858491
Klein, Michel; Mogles, Nataliya; van Wissen, Arlette
Objective The additional value of a short-term, clinically based, intensive multimodal behaviortherapy to optimally titrated methylphenidate\\u000a in children with attention-deficit hyperactivity disorder (ADHD) was investigated.\\u000a \\u000a \\u000a \\u000a Method Fifty children with ADHD (ages 8–12) were randomized to treatment of methylphenidate or treatment with methylphenidate combined\\u000a with 10 weeks of multimodal behaviortherapy. The multimodal behaviortherapy consisted of a child and parent behavioraltherapy
Saskia van der Oord; Pier J. M. Prins; Jaap Oosterlaan; Paul M. G. Emmelkamp
We have treated 20 autistic children with behaviortherapy. At intake, most of the children were severely disturbed, having symptoms indicating an extremely poor prognosis. The children were treated in separate groups, and some were treated more than once, allowing for within- and between-subject replications of treatment effects. We have employed reliable measures of generalization across situations and behaviors as well as across time (follow-up). The findings can be summarized as follows: (1) Inappropriate behaviors (self-stimulation and echolalia) decreased during treatment, and appropriate behaviors (appropriate speech, appropriate play, and social non-verbal behaviors) increased. (2) Spontaneous social interactions and the spontaneous use of language occurred about eight months into treatment for some of the children. (3) IQs and social quotients reflected improvement during treatment. (4) There were no exceptions to the improvement, however, some of the children improved more than others. (5) Follow-up measures recorded 1 to 4 yr after treatment showed that large differences between groups of children depended upon the post-treatment environment (those groups whose parents were trained to carry out behaviortherapy continued to improve, while children who were institutionalized regressed). (6) A brief reinstatement of behaviortherapy could temporarily re-establish some of the original therapeutic gains made by the children who were subsequently institutionalized. PMID:16795385
Lovaas, O. Ivar; Koegel, Robert; Simmons, James Q.; Long, Judith Stevens
The dopamine agonist medications, pramipexole and ropinirole, are commonly used to treat Parkinson's disease. These two drugs have a highly specific affinity for cerebral D3 receptors, known to be localized to the mesolimbic system. Herein is described a common side effect of these drugs, encountered in our routine clinical practice: pathological behaviors. This includes excessive gambling, hypersexuality, shopping, hyperphagia or
Examined the relationship between outcomes of behaviorally oriented treatment for children (N=366) and eye color. Findings were consistent with theoretical expectations: Dark-eyed children and teenagers responded better to reactive treatment programs than their light-eyed counterparts, while the reverse was true for self-paced treatment programs.…
Homework is particularly important in the cognitive-behavioral treatment of depression because the pervasive nature of the characteristic cognitive, affective, and motivational disturbances undercut the impact of didactic and supportive verbal interventions. Despite the importance of homework, a relatively small number of studies have quantified the causal relationship between homework completion and symptomatic outcome. Most of these studies have limited power
Widely regarded as the definitive clinical reference and text in the field, this authoritative volume presents effective cognitive-behavioral approaches for treating frequently encountered child and adolescent disorders. The editor and contributors are leading experts who provide hands-on, how-to-do-it descriptions illustrated with clinical…
Assigned 24 older adults with persistent psychophysiological insomnia to immediate or delayed cognitive-behavioral intervention in waiting-list control group design. Treatment was effective in reducing sleep latency, wake after sleep onset, and early morning awakening, and in increasing sleep efficiency. Sleep improvements obtained by…
The primary purpose of this chapter is to present and critically evaluate current evidence-based interventions for oppositional behavior (OB) in young children. Children with OB are typically described by parents and teachers as argumentative, disobedient, disruptive, demanding, and defiant. We have operationalized “young children” as including children between the ages of 3 and 8, thus encompassing the preschool and early
The authors suggest ways to establish quality behavioral programs within a hospital for the mentally ill. They emphasize the importance of staff morale, consistency of effort, teamwork, staff training and reinforcement. Procedures said to be responsible for successful maintenance include a flexible credit economy system. (Author/CL)
Provides a model of understanding and evaluating manualized treatments by beginning with a review of the theory and data-driven principles upon which one treatment, Parent-Child Interaction Therapy (PCIT), is based. As a point of illustration, several principles of PCIT, such as reinforcement, punishment, and stimulus control, are highlighted, and…
Greco, Laurie A.; Sorrell, John T.; McNeil, Cheryl B.
Narrative reviews conclude that behavioral couples therapy (BCT) produces better outcomes than individual-based treatment for alcoholism and drug abuse problems (e.g., [Epstein, E. E., & McCrady, B. S. (1998). Behavioral couples treatment of alcohol and drug use disorders: Current status and innovations. Clinical Psychology Review, 18(6), 689–711; O'Farrell, T. J., & Fals-Stewart, W. (2003). Alcohol abuse. Journal of Marital and
The current study investigated the relations among therapist adherence to an evidence-based treatment for youth with serious\\u000a antisocial behavior (i.e., Multisystemic Therapy), organizational climate and structure, and improvement in youth behavior\\u000a problems one-year post treatment. Participants were 1979 youth and families treated by 429 therapists across 45 provider organizations\\u000a in North America. Hierarchical Linear Modeling (HLM) results showed therapist adherence
Sonja K. Schoenwald; Rickey E. Carter; Jason E. Chapman; Ashli J. Sheidow
Objective: This study assessed the long-term effects of group behavioral treatment plus individual cognitive behavioraltherapy (CBT) and\\/or fluoxetine in binge eating disorder (BED) patients.Research Methods and Procedures: A total of 116 individuals were randomized to an initial five-month trial and were followed up over two years. Assessments, including binge frequency, weight, and self-report measures, were administered at pre-treatment, post-treatment,
Michael J. Devlin; Juli A. Goldfein; Eva Petkova; Linxu Liu; B. Timothy Walsh
The purpose of this study was to investigate the effect of cognitive behavioraltherapy and cognitive behavioraltherapy plus media on the reduction of bullying and victimization and the increase in empathy and bystander response in a bully prevention program for urban sixth-graders. Sixty-eight students participated. Because one of the…
Sexual dysfunctions in women are classified into disorders of desire, arousal, orgasm, and pain (including dyspareunia and vaginismus). As the cognitive behavioral treatment (CBT) procedures differ among these sexual disorders, the treatments for each disorder are reviewed separately. The efficacy of CBT differs depending on the specific sexual dysfunction to be treated. It is concluded that only a few CBT treatments for women's sexual dysfunction have yet been empirically investigated in a methodologically sound way and little is known about which of the treatment components are most effective. PMID:20599135
ter Kuile, Moniek M; Both, Stephanie; van Lankveld, Jacques J D M
Despite demonstrated efficacy of behavioral and cognitive techniques in treating the impact of tinnitus (constant ringing in the ears), little is known about the mechanisms by which these techniques achieve their effect. The present study examined acceptance of tinnitus as a potential mediator of treatment changes on global tinnitus severity in internet-delivered acceptance and commitment therapy (iACT) and internet-delivered cognitive behaviortherapy (iCBT). Data from 67 participants who were distressed by tinnitus and who were randomly assigned to 1 of the 2 treatments were analyzed using a multilevel moderated mediation model. We predicted that acceptance as measured with the two subscales of the tinnitus acceptance questionnaire (i.e., activity engagement and tinnitus suppression) would mediate the outcome in iACT, but not in iCBT. Results provided partial support to the notion that mediation was moderated by treatment: tinnitus suppression mediated changes in tinnitus severity in iACT, but not in iCBT. However, inconsistent with the view that the treatments worked through different processes of change, activity engagement mediated treatment changes across both iACT and iCBT. Acceptance is identified as a key source of therapeutic change in behavioral-based treatments for tinnitus. PMID:23881309
Hesser, Hugo; Westin, Vendela Zetterqvist; Andersson, Gerhard
Background: Research suggests that cognitive- behavioraltherapy (CBT) is the most effective psycho- therapeutic treatment for bulimia nervosa. One excep- tion was a study that suggested that interpersonal psychotherapy (IPT) might be as effective as CBT, al- though slower to achieve its effects. The present study is designed to repeat this important comparison. Method: Two hundred twenty patients meeting DSM-
W. Stewart Agras; B. Timothy Walsh; Christopher G. Fairburn; G. Terence Wilson; Helena C. Kraemer
Cognitive-behavioraltherapy (CBT) for bulimia nervosa (BN) has received considerable empirical support for its efficacy. However, few investigators have examined the mechanisms proposed to account for the reduction of BN symptoms during CBT. The current study examined the associations between therapist interventions, client mechanisms, and…
Spangler, Diane L.; Baldwin, Scott A.; Agras, W. Stewart
Objective: Randomized controlled trials have attested the efficacy of cognitive behavioraltherapy (CBT) in reducing psychotic symptoms. Now, studies are needed to investigate its effectiveness in routine clinical practice settings. Method: Eighty patients with schizophrenia spectrum disorders who were seeking outpatient treatment were randomized…
Anxiety disorders in adolescence are common and disruptive, pointing to a need for effective treatments for this age group. Cognitive behaviortherapy (CBT) is one of the most popular interventions for adolescent anxiety, and there is empirical support for its application. However, a significant proportion of adolescent clients continue to report…
Sauter, Floor M.; Heyne, David; Westenberg, P. Michiel
Purpose: The aims of the present study were to (a) examine the rate of social phobia among adults who stutter, (b) study the effects of speech restructuring treatment on social anxiety, and (c) study the effects on anxiety and stuttering of a cognitive-behaviortherapy (CBT) package for social anxiety. Method: Thirty-two adults with chronic…
Menzies, Ross G.; O'Brian, Sue; Onslow, Mark; Packman, Ann; St Clare, Tamsen; Block, Susan
The present study tested cognitive-behavioraltherapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW,…
Belief in one's ability to change is an important cognitive variable related to treatment gains. This study investigated pretreatment expectancy for anxiety change and early homework compliance in relation to initial and total cognitive change in group cognitive-behavioraltherapy (CBT) for anxiety. Participants, who met diagnostic criteria for at…
Westra, Henny A.; Dozois, David J. A.; Marcus, Madalyn
Ninety cannabis-dependent adults seeking treatment were randomly assigned to receive cognitive-behavioraltherapy, abstinence-based voucher incentives, or their combination. Treatment duration was 14 weeks, and outcomes were assessed for 12 months post treatment. Findings suggest that (a) abstinence-based vouchers were effective for engendering…
Budney, Alan J.; Moore, Brent A.; Rocha, Heath L.; Higgins, Stephen T.
My concerns about Rational Emotive BehaviorTherapy (REBT) began over a decade ago. I find its concepts lack adequate and consistent definitions, its distinctive hypotheses are not confirmed by empirical data and are untestable, and its scientific foundations fall outside mainstream psychology. Contrary to what it claims, its practice and philosophy are not consisten with the use of reason in
This study examines the effect of homework compliance on treatment outcome in 123 participants receiving cognitive-behavioraltherapy (CBT) for cocaine dependence. Regression analyses revealed a significant relationship between homework compliance and cocaine use that was moderated by readiness to change. Homework compliance predicted less cocaine…
Gonzalez, Vivian M.; Schmitz, Joy M.; DeLaune, Katherine A.
Compared the effectiveness of behavioral (BT) or physical therapy (PT) for treating chronic low back pain (CLBP), for 13 BT patients and 12 PT patients. Treatments were conducted in a group outpatient setting. Posttreatment results showed general improvement for patients in both groups, but few treatment-specific differences in outcome measures.…
We developed and evaluated a brief (8-session) version of cognitive-behavioraltherapy (BCBT) for anxiety disorders in youth ages 6 to 13. This report describes the design and development of the BCBT program and intervention materials (therapist treatment manual and child treatment workbook) and an initial evaluation of child treatment outcomes.…
Crawley, Sarah A.; Kendall, Philip C.; Benjamin, Courtney L.; Brodman, Douglas M.; Wei, Chiaying; Beidas, Rinad S.; Podell, Jennifer L.; Mauro, Christian
The current project evaluated the use of behavior management techniques utilized in Parent- Child Interaction Therapy (PCIT) in head start classrooms. The sample included seven Head Start classrooms; four classrooms receiving treatment and three classrooms receiving no treatment. Evaluation of the progress included observation of teacher and…
Background Questions remain regarding the sustainment of evidence-based practices following implementation. The present study examined the sustainment of community clinicians’ implementation (i.e., penetration) of cognitive-behavioraltherapy, attitudes toward evidence-based practices, and knowledge of cognitive-behavioraltherapy for youth anxiety two years following training and consultation in cognitive-behavioraltherapy for youth anxiety. Methods Of the original 115 participants, 50 individuals (43%) participated in the two-year follow-up. A t- test examined sustainment in penetration over time. Hierarchical linear modeling examined sustainment in knowledge and attitudes over time. Time spent in consultation sessions was examined as a potential moderator of the change in knowledge and attitudes. Results Findings indicated sustained self-reported penetration of cognitive-behavioraltherapy for anxious youth, with low fidelity to some key CBT components (i.e., exposure tasks). Follow-up knowledge was higher than at baseline but lower than it had been immediately following the consultation phase of the study. Belief in the utility of evidence-based practices was sustained. Willingness to implement an evidence-based practice if required to do so, appeal of evidence-based practices, and openness toward evidence-based practices were not sustained. Participation in consultation positively moderated changes in knowledge and some attitudes. Conclusions Sustainment varied depending on the outcome examined. Generally, greater participation in consultation predicted greater sustainment. Implications for future training include higher dosages of consultation. PMID:25030651
This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16…
Habigzang, Luisa Fernanda; Damasio, Bruno Figueiredo; Koller, Silvia Helena
Cognitive-behavioraltherapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering…
The goal of this study was to evaluate the efficacy of cognitive-behavioraltherapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…
Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree
Cognitive-behavioraltherapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus…
Hofmann, Stefan G.; Meuret, Alicia E.; Rosenfield, David; Suvak, Michael K.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.
Objective: To test a collaborative-care, cognitive-behavioraltherapy (CBT) program adjunctive to selective serotonin reuptake inhibitor (SSRI) treatment in HMO pediatric primary care. Method: A randomized effectiveness trial comparing a treatment-as-usual (TAU) control condition consisting primarily of SSRI medication delivered outside the…
Clarke, Gregory; DeBar, Lynn; Lynch, Frances; Powell, James; Gale, John; O'Connor, Elizabeth; Ludman, Evette; Bush, Terry; Lin, Elizabeth H. B.; Von Korff, Michael; Hertert, Stephanie
Objective: To evaluate cognitive-behavioraltherapy, antidepressant medication alone, and combined CBT and antidepressant medication in the treatment of depressive disorders in adolescents. Method: Seventy-three adolescents (ages 12-18 years) with a primary diagnosis of DSM-IV major depressive disorder, dysthymic disorder, or depressive disorder…
Melvin, Glenn A.; Tonge, Bruce J.; King, Neville J.; Heyne, David; Gordon, Michael S.; Klimkeit, Ester
Cognitive-behavioraltherapy (CBT) offers benefit in rehabilitation, particularly with pain problems. Its conceptual basis and certain of its techniques fit well with the type of occupational rehabilitation that encourages patient involvement and comprehensive attention to impediments to reaching functional goals. The physician-patient encounter remains a pivotal force from the onset of illness or injury through rehabilitation and resolution. Communications within
Major depressive disorder is commonly treated in primary care settings. Psychotherapy occurring in primary care should take advantage of the unique aspects of the setting and must adapt to the problems and limitations of the setting. In this open trial, the authors used a treatment development model to adapt behaviortherapy for primary care…
Uebelacker, Lisa A.; Weisberg, Risa B.; Haggarty, Ryan; Miller, Ivan W.
Using secondary analyses from a randomized trial comparing the effectiveness of manualized cognitive-behavioraltherapy for posttraumatic stress disorder, we compared ratings of therapist competency and adherence between two service delivery modes: telepsychiatry (TP) and same room (SR). Patients were 38 male treatment-seeking veterans recruited…
Frueh, B. Christopher; Monnier, Jeannine; Grubaugh, Anouk L.; Elhai, Jon D.; Yim, Eunsil; Knapp, Rebecca
Demonstrated that therapeutic empathy had moderate-to-large causal effect on recovery from depression among 185 patients treated with cognitive-behavioraltherapy. Homework compliance had separate effect on clinical recovery, over and above effect of therapeutic empathy. Patients of novice therapists improved significantly less than did patients…
Objective: The purpose of this study was to examine predictors of treatment response to cognitive-behavioraltherapy (CBT) for depression in Parkinson's disease (PD). Method: The sample comprised 80 depressed ("DSM-IV" criteria) adults with PD (60% male) and their caregivers who participated in an National Institutes of Health-sponsored…
Dobkin, Roseanne D.; Rubino, Jade Tiu; Allen, Lesley A.; Friedman, Jill; Gara, Michael A.; Mark, Margery H.; Menza, Matthew
Motivational Interviewing (MI) has recently been applied to the treatment of anxiety disorders in an effort to bolster engagement with and response rates to cognitive behavioraltherapy (CBT). In a recent randomized control trial, the addition of MI as a pretreatment compared to no pretreatment was found to significantly improve response to CBT…
Recent meta-analytic data suggest a need for ongoing evaluation of treatments for youth depression. The present article calls attention to a number of issues relevant to the empirical evaluation of if and how cognitive behaviortherapy for child depression works. A case series of 6 children and a primary caregiver received treatment--individual…
Objective: This study evaluated the success of implementing cognitive behavioraltherapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS. Method: The implementation interventions were the…
Factor analysis of the Self-Help Inventory (Burns, Shaw, & Crocker, 1987) in a group of 307 consecutive outpatients seeking cognitive–behavioraltherapy (CBT) for affective disorders revealed 3 factors that assessed the frequency with which subjects used active coping strategies when depressed, the perceived helpfulness of these coping strategies, and their willingness to learn new coping strategies. The Frequency and Helpfulness
ObjectiveThe growing insights from neuropsychological research, including within biosocial criminology, have not yet been systematically incorporated into the study of correctional rehabilitation. Given developments in related fields, we argue that moving toward a biosocial theory of offender rehabilitation or neurocriminology will enrich our understanding and effectiveness of these interventions. A particularly promising area to investigate is cognitive-behavioraltherapy (CBT). In
In this study, we examined the effectiveness of cognitive-behavioraltherapy (CBT) for adolescent depression. Outcomes of 80 youth treated with CBT in an outpatient depression specialty clinic, the Services for Teens at Risk Center (STAR), were compared to a "gold standard" CBT research benchmark. On average, youths treated with CBT in STAR…
Weersing, V. Robin; Iyengar, Satish; Kolko, David J.; Birmaher, Boris; Brent, David A.
A chronic psychiatric condition among children and adolescents of concern is obsessive-compulsive disorder, which involves comorbid conditions. The impact of a range of comorbid illnesses on cognitive-behavioraltherapy response and remission rates was conducted, with results revealing a negative impact on treatment response.
Storch, Eric A.; Merlo, Lisa J.; Larson, Michael J.; Geffken, Gary R.; Lehmkuh, Heather D.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.
Individuals with Binge Eating Disorder (BED) often evidence comorbid Substance Use Disorders (SUD), resulting in poor outcome. This study is the first to examine treatment outcome for this concurrent disordered population. In this pilot study, 38 individuals diagnosed with BED and SUD participated in a 16-week group Mindfulness-Action Based Cognitive BehavioralTherapy (MACBT). Participants significantly improved on measures of objective
Christine M. Courbasson; Yasunori Nishikawa; Leah B. Shapira
Co-occurring posttraumatic stress disorder (PTSD) is prevalent in addiction treatment programs and a risk factor for negative outcomes. Although interventions have been developed to address substance use and PTSD, treatment options are needed that are effective, well tolerated by patients, and potentially integrated with existing program services. This paper describes a cognitive behavioraltherapy (CBT) for PTSD that was adapted
Mark P. McGovern; Chantal Lambert-Harris; Stephanie Acquilano; Haiyi Xie; Arthur I. Alterman; Roger D. Weiss
This study examines the effect of homework compliance on treatment outcome in 123 participants receiving cognitive-behavioraltherapy (CBT) for cocaine dependence. Regression analyses revealed a significant relationship between homework compliance and cocaine use that was moderated by readiness to change. Homework compliance predicted less cocaine use during treatment but only for participants higher in readiness to change. For those lower
Vivian M. Gonzalez; Joy M. Schmitz; Katherine A. DeLaune
This paper describes a model of group cognitive-behavioraltherapy (CBT) for women with posttraumatic stress disorder (PTSD) and substance use disorder (SUD). The need for specialized treatment derives from the high incidence of these comorbid disorders among women as well as from their particular clinical presentation and treatment needs. The treatment educates patients about the two disorders, promotes self-control skills
Although obsessive-compulsive disorder (OCD) is a heterogeneous condition, OCD subtypes have received limited attention in trials of cognitive behaviortherapy (CBT). Because many patients with OCD do not respond optimally to CBT, it is important for clinicians to consider whether variability in treatment response is related to symptom presentation. Treatment modifications for patients without overt compulsions or with hoarding symptoms
Debbie Sookman; Jonathan S. Abramowitz; John E. Calamari; Sabine Wilhelm; Dean McKay
Although cognitive behaviortherapy has been found to be very effective in the treatment of body dysmorphic disorder (BDD), there still remain a number of challenges that clinicians face in the treatment of individuals with BDD. In this article, we discuss issues related to comorbid depression, suicidality, substance use disorders, personality disorders as well as the role of early life
Ulrike Buhlmann; Hannah E. Reese; Stefanie Renaud; Sabine Wilhelm
This study evaluated the efficacy of Integrated Family and Cognitive-BehavioralTherapy (IFCBT), a multisystems treatment for adolescent drug abuse, versus a Drugs Harm Psychoeducation curriculum (DHPE). A randomized controlled trial assessed youth and parents at baseline and at 1, 3 and 6-month posttreatment points. Youth participants (N=43) met diagnostic criteria for one or more psychoactive substance use disorders with most
William W. Latimer; Ken C. Winters; Thomas D'Zurilla; Mike Nichols
Just as psychology, psychiatry, and philosophy have influenced the field of literary studies, literature provides insight about the theories and practices of its sister disciplines. The purpose of this article is to demonstrate how literary works of Kurt Vonnegut illuminate principles of the influential branch of psychotherapy known as rational emotive behaviortherapy (REBT). This article traces the similar philosophies
Just as psychology and philosophy have influenced the field of literary studies, literature provides insight about the theories and practices of its sister disciplines. The purpose of this thesis is to demonstrate how literary works of Kurt Vonnegut illuminate principles of the influential branch of psychotherapy known as Rational Emotive BehaviorTherapy (REBT). This thesis traces the similar philosophies and
In this report, we conducted a secondary analysis of the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study to explore the impact of specific cognitive-behavioraltherapy (CBT) treatment components on outcome. In TORDIA, 334 youths (ages 12 to 18 years) with major depressive disorder who had failed to respond to an adequate…
Kennard, Betsy D.; Clarke, Greg N.; Weersing, V. Robin; Asarnow, Joan Rosenbaum; Shamseddeen, Wael; Porta, Giovanna; Berk, Michele; Hughes, Jennifer L.; Spirito, Anthony; Emslie, Graham J.; Keller, Martin B.; Wagner, Karen D.; Brent, David A.
Cognitive-behavioraltherapy (CBT) is known to be effective for a number of disorders, and can be delivered effectively by trainees in controlled settings. However, the effectiveness of trainee therapists in general practice compared to that of more experienced therapists is unknown. In this study, the authors used a benchmarking strategy to…
Forand, Nicholas R.; Evans, Susan; Haglin, Dean; Fishman, Baruch
We examined the role of specific therapist verbal behaviors in predicting successful completion of Parent?Child Interaction Therapy (PCIT) in 22 families, including 11 families that successfully completed treatment and 11 that discontinued treatment prematurely. The children were 3 to 6 years old and diagnosed with oppositional defiant disorder…
Patients with schizophrenia are at high risk of suicide. Cognitive behaviortherapy (CBT) has been shown to reduce symptoms in schizophrenia. This study examines whether CBT also changes the level of suicidal ideation in patients with schizophrenia compared to a control group. Ninety ambulatory patients with symptoms of schizophrenia resistant to…
Bateman, Katy; Hansen, Lars; Turkington, Douglas; Kingdon, David
Objective: Major depression is the most common psychiatric disorder among breast cancer patients and is associated with substantial impairment. Although some research has explored the utility of psychotherapy with breast cancer patients, only 2 small trials have investigated the potential benefits of behaviortherapy among patients with…
Hopko, Derek R.; Armento, Maria E. A.; Robertson, Sarah M. C.; Ryba, Marlena M.; Carvalho, John P.; Colman, Lindsey K.; Mullane, Christen; Gawrysiak, Michael; Bell, John L.; McNulty, James K.; Lejuez, Carl W.
Effective cognitive-behavioraltherapies for insomnia have been developed over the past 2 decades, but they have not been systematically evaluated in some clinical settings. While insomnia is common among veterans with mental health problems, the availability of effective treatments is limited. We report on the group application of a…
Perlman, Lawrence M.; Arnedt, J. Todd; Earnheart, Kristie L.; Gorman, Ashley A.; Shirley, Katherine G.
Objective: Multiple trials have found telephone-administered cognitive behavioraltherapy (T-CBT) to be effective for the treatment of depression. The aim of this study was to evaluate T-CBT for the treatment of depression among veterans served by community-based outpatient clinics (CBOCs) outside of major urban areas. Method: Eighty-five veterans…
This study explored the efficacy of semantic behaviortherapy in the management of chronic osteoarthritis pain in elderly patients as well as the relationships among pain, physical health, personality, and social characteristics in this population. The sample consisted of 8 elderly persons who had osteoarthritis of the knee, and 11 healthy elderly…
This research represents the first controlled treatment study of hypnosis and cognitive- behavioraltherapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure,…
Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Nixon, Reginald D. V.
Objective: This study evaluated the success of implementing cognitive behavioraltherapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS. Method: The implementation interventions were the following: spreading information about the new treatment setting to general practitioners and CFS
Korine Scheeres; Michel Wensing; Hans Knoop; Gijs Bleijenberg
Although strong evidence supports cognitive-behavioraltherapy for late-life depression and depression in racial and ethnic minorities, there are no empirical studies on the treatment of depression in older sexual minorities. Three distinct literatures were tapped to create a depression treatment protocol for an older gay male. Interventions were…
We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory…
Addison, Laura R.; Piazza, Cathleen C.; Patel, Meeta R.; Bachmeyer, Melanie H.; Rivas, Kristi M.; Milnes, Suzanne M.; Oddo, Jackie
Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioraltherapy, in resource poor, ethnic minority, and/or disaster-affected communities with disparities in mental health. Community-academic participatory partnerships are a promising approach to addressing disparities by implementing community-appropriate, evidence-based depression care. A community-academic collaborative was formed in New Orleans after Hurricane Katrina to expand resources for effective depression care, including cognitive behavioraltherapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioraltherapy for depression in post-disaster community-based settings; 2) discuss the impact of this training program on therapist reported practice; and 3) share lessons learned regarding disseminating and sustaining evidence-based interventions in the context of a disaster impacted community. Using a mixed methods approach, we found that this model was feasible, acceptable, and disseminated knowledge about cognitive behavioraltherapy in community settings. Over the course of two years, community providers demonstrated the feasibility of implementing evidence-based practice and potential for local community leadership. The lessons learned from this model of implementation may help address barriers to disseminating evidence-based interventions in other low-resource, disaster-impacted community settings. PMID:22352079
Several possible mediators of a group cognitive-behavioraltherapy (CBT) for depressed adolescents were examined. Six measures specific to CBT (e.g., negative cognitions, engagement in pleasurable activities) and 2 nonspecific measures (therapeutic alliance, group cohesion) were examined in 93 adolescents with comorbid major depressive disorder…
Kaufman, Noah K.; Rohde, Paul; Seeley, John R.; Clarke, Gregory N.; Stice, Eric
Cognitive–behavioraltherapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1
Stefan G. Hofmann; Alicia E. Meuret; David Rosenfield; Michael K. Suvak; David H. Barlow; Jack M. Gorman; M. Katherine Shear; Scott W. Woods
An initial ideal, rational model of alliance rupture and rupture resolution provided by cognitive–behavioraltherapy (CBT) experts was assessed and compared with empirical observations of ruptures and their resolution in two cases of successful CBT. The initial rational model emphasized nondefensive acknowledgment and exploration of the rupture. Results indicated differences between what therapists think they should do to resolve ruptures
Helen Aspland; Susan Llewelyn; Gillian E. Hardy; Michael Barkham; William Stiles
Public speaking anxiety (PSA) is a common phobia. Although cognitive behaviortherapy (CBT) is preferred, difficulties arise with the exposure component (lack of therapist control, patient's inability to imagine, self-flooding, loss of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. This study examined whether VRCBT is an alternative
Helene S. Wallach; Marilyn P. Safir; Margalit Bar-Zvi
Background: A history of major depressive disorder (MDD) predicts failure to quit smoking. We deter- mined the effect of nortriptyline hydrochloride and cog- nitive-behavioraltherapy on smoking treatment out- come in smokers with a history of MDD. The study also addressed the effects of diagnosis and treatment condi- tion on dysphoria after quitting smoking and the effects of dysphoria on
Sharon M. Hall; Victor I. Reus; Ricardo F. Munoz; Karen L. Sees; Gary Humfleet; Diane T. Hartz; Sydney Frederick; Elisa Triffleman
BACKGROUND: Although patients with Treatment Resistant Depression (TRD) often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioraltherapy (group-CBT) to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one
Premature, unilateral interruption of inpatient treatment of eating disorders (ED) is a key factor limiting success. We evaluated the role of personality dimensions (temperament and character) in predicting drop-out in 145 consecutive ED inpatients (133 females) who entered cognitive behaviortherapy. Baseline assessment included anthropometry, the Eating Disorder Examination, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Temperament
Riccardo Dalle Grave; Simona Calugi; Francesca Brambilla; Giulio Marchesini
Cognitive-behavioraltherapy (CBT) is the most thoroughly studied nonpharmacologic approach to the treatment of social anxiety disorder, and its efficacy has been demonstrated in a large number of investigations. This article summarizes the data on the efficacy of CBT for the treatment of the symptoms of social anxiety disorder and impaired quality of life. The relative efficacy of various CBT
Given the lack of empirically supported treatments available for adolescents with eating disorders, it is important to investigate the clinical utility of extending treatments for adults with eating disorders to younger populations. Dialectical behaviortherapy for binge eating disorder, based on the affect-regulation model, conceptualizes binge…
Safer, Debra L.; Couturier, Jennifer L.; Lock, James
Eating disorder not otherwise specified (EDNOS; American Psychiatric Association, 2000) is, by far, the most common eating disorder that college counseling professionals encounter among their female clients. Empirical evidence and best practice guidelines support use of cognitive behaviortherapy (CBT) with women experiencing EDNOS. This article…
There is growing interest in understanding the usefulness of mentorship programs for children's rehabilitation service providers. This evaluation study examined the effects of an occupational therapy mentorship program on the skills and behaviors of 8 new and 17 experienced occupational therapists practicing at a regional children's rehabilitation…
The present study investigates the efficacy of an Internet-based cognitive-behavioraltherapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n =…
Wagner, Birgit; Knaevelsrud, Christine; Maercker, Andreas
who. while hospitalized at Patton State Hospital. served as subjects in an experiment evaluating 'Individualized BehaviorTherapy (IBT)' techniques. Subjects were initially assigned to either a controlled drinking or non-drinking (abstinence) treatment goal. and were then randomly assigned to either an experimental group receiving IBT or a control group receiving conventional state hospital treatment oriented towards abstinence. Previously reported results
Cognitive-behavioraltherapy (CBT) is an effective modality for the treatment of alcoholism. Given widespread interest in incorporating spirituality into professional treatment, this article orients practitioners to spiritually modified CBT, an approach that may enhance outcomes with some spiritually motivated clients. More specifically, by…
A working relationship between the patient and therapist is an essential part of any psychotherapy, yet few guidelines exist for this component of cognitive- behavioral treatment. Findings of therapy process and outcome research suggest that the therapeutic relationship strongly influences treatment results, and that interpersonal factors and technical applications interact in forming an effective alliance. Considering the perspective of the
Photothermal therapy using (Near Infrared) NIR region of EM spectrum is a fast emerging technology for cancer therapy. Different types of nanoparticles may be used for enhancing the treatment. Though the treatment protocols are developed based on experience driven estimated temperature increase in the tissue, it is not really known what spatiotemporal thermal behavior in the tissue is. In this work, this thermal behavior of tissue models is investigated with and without using nanoparticles. An increased temperature inside tissue compared to surface is observed which is counter intuitive from the present state of knowledge. It is shown from fiber level microstructure that this increased temperature leads to enhanced damage at the deeper parts of biomaterials. Nanoparticles can be utilized to control this temperature increase spatially. A multiple scattering based physical model is proposed to explain this counterintuitive temperature rise inside tissue. The results show promising future for better understanding and standardizing the protocols for photothermal therapy. PMID:24730236
There has been much discussion in the literature recently regarding the conceptual and technical differences between so-called second- (e.g., Beckian cognitive therapy) and third-wave (e.g., acceptance and commitment therapy) behavioraltherapies. Previous research has not addressed the potential similarities and differences among the…
Brown, Lily A.; Gaudiano, Brandon A.; Miller, Ivan W.
Medical professionals and public consumers expect that new physical therapy graduates possess cognitive, technical, and behavioral skills required to provide safe and high-quality care to patients. The purpose of this study was to determine if a repertoire of ten professional behaviors assessed at the beginning of doctorate of physical therapy…
Youdas, James W.; Krause, David A.; Hellyer, Nathan J.; Rindflesch, Aaron B.; Hollman, John H.
Describes follow-up assessments conducted with 84 children who had completed Parent-Child Interaction Therapy (PCIT), a behavioral family therapy for preschool children with disruptive behavior problems. When compared with control groups, subjects improved to within the normal range of conduct problems and social competence, but by the 18-month…
Funderburk, Beverly W.; Eyberg, Shelia M.; Newcomb, Katharine; McNeil, Cheryl B.; Hembree-Kigin, Toni; Capage, Laura
Unusual compulsive behaviors (weighing, card and video game playing, fishing, gardening, intense interest in established hobbies, locking and unlocking doors, repetitive dressing and undressing) occurred in relation to dopamine agonist therapy (six patients) and levodopa therapy (one patient) in seven patients with parkinsonism (seven Parkinson's disease, one multiple system atrophy). These behaviors occurred in tandem with pathological gambling, hypersexuality, compulsive eating, compulsive shopping or punding in six of the seven cases. Obsessive thoughts were present in one patient, with no prior history of obsessive-compulsive disorder. The simultaneous occurrence of these phenomenologically distinct behaviors in this group of patients suggests that a broad spectrum of psychopathology may occur in this context and should be monitored for in routine neurological practice. PMID:17544807
McKeon, Andrew; Josephs, Keith A; Klos, Kevin J; Hecksel, Kathleen; Bower, James H; Michael Bostwick, J; Eric Ahlskog, J
The field of clinical behavior analysis is growing rapidly and has the potential to affect and transform mainstream cognitive behaviortherapy. To have such an impact, the field must provide a formulation of and intervention strategies for clinical depression, the “common cold” of outpatient populations. Two treatments for depression have emerged: acceptance and commitment therapy (ACT) and behavioral activation (BA). At times ACT and BA may suggest largely redundant intervention strategies. However, at other times the two treatments differ dramatically and may present opposing conceptualizations. This paper will compare and contrast these two important treatment approaches. Then, the relevant data will be presented and discussed. We will end with some thoughts on how and when ACT or BA should be employed clinically in the treatment of depression. PMID:22478462
Kanter, Jonathan W; Baruch, David E; Gaynor, Scott T
Describes the organizing concepts and strategies for the development and evaluation of self-help behavioral treatment manuals. Reviews programs that have been published or empirically tested for the treatment of phobias, smoking, obesity, sexual dysfunction, assertiveness, child behavior problems, study skills, and physical fitness, as well as…
J. A. Gray’s (1975) theory distinguishes between two motivational systems, which he refers to as the behavioral activation system (BAS) and the behavioral inhibition system (BIS). D. C. Fowles (1980) has shown that heart rate responses reflect activity of the BAS, and electrodermal responses reflect activity of the BIS. Both BAS and BIS are reliably activated during in-vivo exposure to
Frank H. Wilhelm; Monique C. Pfaltz; James J. Gross; Iris B. Mauss; Sun I. Kim; Brenda K. Wiederhold
Background: To date, there have been no studies comparing cognitive behaviortherapy (CBT) with Rogerian therapy in post-traumatic stress disorder. Method: Sixty outpatients with DSM-IV chronic post-traumatic stress disorder were randomized into two groups for 16 weekly individual sessions of CBT or Rogerian supportive therapy (ST) at two centers. No medication was prescribed. Measures included the Post-Traumatic Stress Disorder Checklist
Jean Cottraux; Sai Nan Yao; Chantal de Mey-Guillard; Françoise Bonasse; Diane Djamoussian; Evelyne Mollard; Yaohua Chen
The present study compared the relative effectiveness of “preferential” rational-emotive therapy (RET) and general cognitive-behaviortherapy (CBT) in the treatment of low self-esteem and related emotional disturbances. Thirty-three subjects were randomly assigned to RET, CBT, and waiting-list control (WLC) groups. Therapy consisted of 8 weekly 1 1\\/2hour group sessions. At posttest, both the RET and CBT groups changed significantly more
This study assessed the treatment specificity and impact on outcome of large, abrupt symptomatic improvements occurring prior to and during cognitive-behavioral, family, and supportive therapy. Eighty-seven depressed adolescents receiving at least 8 therapy sessions were included. Abrupt large decreases in depressive symptoms were identified by changes in weekly Beck Depression Inventory scores. Overall, 28% experienced a pretreatment gain and 39%
Scott T. Gaynor; V. Robin Weersing; David J. Kolko; Boris Birmaher; Jungeun Heo; David A. Brent
This research study compared the efficacy of three treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioraltherapy based on…
Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Murphy, Christopher J.; Hunter, Linda A.; Siv, Alexander M.
This research study compared the efficacy of three treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioraltherapy based on…
This research study compared the efficacy of two treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioraltherapy based on…
Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Siv, Alexander M.
Objective: Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behaviortherapy (CBT), in guided self-help format. Method: Ninety-nine participants (mean age = 48.5 years; 43% female) who were…
In the treatment of addictions, the gap between the availability of evidence-based therapies and their limited implementation in practice has not yet been bridged. Two empirically validated behavioraltherapies, contingency management (CM) and cognitive behavioraltherapy (CBT), exemplify this challenge. Both have a relatively strong level of empirical support but each has weak and uneven adoption in clinical practice. This review highlights examples of how barriers to their implementation in practice have been addressed systematically, using the Stage Model of BehavioralTherapies Development as an organizing framework. For CM, barriers such as cost and ideology have been addressed through the development of lower-cost and other adaptations to make it more community friendly. For CBT, barriers such as relative complexity, lack of trained providers, and need for supervision have been addressed via conversion to standardized computer-assisted versions that can serve as clinician extenders. Although these and other modifications have rendered both interventions more disseminable, diffusion of innovation remains a complex, often unpredictable process. The existing specialty addiction-treatment system may require significant reforms to fully implement CBT and CM, particularly greater focus on definable treatment goals and performance-based outcomes. PMID:25204847
Thought Field Therapy (TFT) is a self-administered treatment developed by psychologist Roger Cal lahan. TFT uses energy meridian treatment points and bilateral optical-cortical stimulation while focusing on the targeted symptoms or problem being addressed. The clinical applications of TFT summarized included anxiety; adjustment disorder with anxiety and depression; anxiety due to medical condition; anger; acute stress; bereavement; chronic pain; cravings;
Caroline Sakai; David Paperny; Marvin Mathews; Greg Tanida; Geri Boyd; Alan Simons; Charlene Yamamoto; Carolyn Mau; Lynn Nutter
Objective: To evaluate cognitive-behaviortherapy plus bright light therapy (CBT plus BLT) for adolescents diagnosed with delayed sleep phase disorder (DSPD). Design: Randomized controlled trial of CBT plus BLT vs. waitlist (WL) control with comparisons at pre- and post-treatment. There was 6-month follow-up for the CBT plus BLT group only. Setting: Flinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia. Patients: 49 adolescents (mean age 14.6 ± 1.0 y, 53% males) diagnosed with DSPD; mean chronicity 4 y 8 months; 16% not attending school. Eighteen percent of adolescents dropped out of the study (CBT plus BLT: N = 23 vs WL: N = 17). Interventions: CBT plus BLT consisted of 6 individual sessions, including morning bright light therapy to advance adolescents' circadian rhythms, and cognitive restructuring and sleep education to target associated insomnia and sleep hygiene. Measurements and Results: DSPD diagnosis was performed via a clinical interview and 7-day sleep diary. Measurements at each time-point included online sleep diaries and scales measuring sleepiness, fatigue, and depression symptoms. Compared to WL, moderate-to-large improvements (d = 0.65-1.24) were found at post-treatment for CBT plus BLT adolescents, including reduced sleep latency, earlier sleep onset and rise times, total sleep time (school nights), wake after sleep onset, sleepiness, and fatigue. At 6-month follow-up (N = 15), small-to-large improvements (d = 0.24-1.53) continued for CBT plus BLT adolescents, with effects found for all measures. Significantly fewer adolescents receiving CBT plus BLT met DPSD criteria at post-treatment (WL = 82% vs. CBT plus BLT = 13%, P < 0.0001), yet 13% still met DSPD criteria at the 6-month follow-up. Conclusions: CBT plus BLT for adolescent DSPD is effective for improving multiple sleep and daytime impairments in the immediate and long-term. Studies evaluating the treatment effectiveness of each treatment component are needed. Clinical Trial Information: Australia – New Zealand Trials Registry Number: ACTRN12610001041044. Citation: Gradisar M; Dohnt H; Gardner G; Paine S; Starkey K; Menne A; Slater A; Wright H; Hudson JL; Weaver E; Trenowden S. A randomized controlled trial of cognitive-behaviortherapy plus bright light therapy for adolescent delayed sleep phase disorder. SLEEP 2011;34(12):1671-1680. PMID:22131604
A model incorporating physiological, behavioral, and psychological parameters are presented to explain the maintenance and\\u000a consequences of pediatric encopresis. It was hypothesized that the more comprehensive a treatment in addressing these parameters,\\u000a the more efficacious it would be and the more children it would benefit. Eighty-seven children between the ages of 6 and 15\\u000a with the primary complaint of encopresis
Daniel J. Cox; James Sutphen; Steve Borowitz; Boris Kovatchev; William Ling
This brief review discusses experimental therapy with neurotrophic factors in a model of central nervous system (CNS) neural atrophy and synaptic loss resulting from unilateral cortical infarctions. It discusses the trophic factor protection of the cholinergic phenotype of neurons belonging to the forebrain-to-neocortex projection, as well as the capacity of trophic therapy to elicit synaptogenesis in the cerebral cortex of adult animals. Finally, it addresses the behavioral consequences of trophic factor-induced synaptic remodeling of the neocortex in this model. Images Figure 3 PMID:9002392
The purpose of this study was to develop a fundamental understanding of the adsorption and first-step hydrogenation mechanisms of sulfur and nitrogen compounds over molybdenum disulfide (MoS2). To do so, molecular simulation of the dibenzothiophene (DBT) and carbazole over NiMoS micro-crystal active surface was performed using Zerner's intermediate neglect of differential overlap (ZINDO) program with Hyperchem software. This study discusses
A. Duan; J. Gao; C. Xu; D. Wang; Z. Zhao; T. Dou; K. H. Chung
Describes a pragmatic approach using cognitive-behaviortherapy (CBT) to help correct parents' dysfunctional cognitions and strengthen confidence in parenting. Details three components of CBT: (1) focusing on positive behavior; (2) ignoring negative behavior if not dangerous; and (3) using special time. Notes that positive reinforcement is key to…
Despite the efficacy of cognitive behavioraltherapy for insomnia (CBT-I) in treating chronic insomnia, it remains underutilized. Lack of appropriately-trained CBT-I providers is a major reason. Master's-level practitioners (MLPs) may, in addition to doctoral-level psychologists, be uniquely positioned to fill this role, based not only on “goodness of professional fit” but also given a handful of studies showing these individuals' care outcomes meet or exceed standard outcomes. However, the ability of MLPs to provide CBT-I will be significantly restricted until a clear pathway is established that extends from training opportunities to credentialing. Further questions remain about how to attract and incorporate MLPs into established practices. Citation: Fields BG; Schutte-Rodin S; Perlis ML; Myers M. Master's-level practitioners as cognitive behavioraltherapy for insomnia providers: an underutilized resource. J Clin Sleep Med 2013;9(10):1093-1096. PMID:24127157
Fields, Barry G.; Schutte-Rodin, Sharon; Perlis, Michael L.; Myers, Megin
A wave of new developments has occurred in the behavioral and cognitive therapies that focuses on processes such as acceptance, mindfulness, attention, or values. In this review, we describe some of these developments and the data regarding them, focusing on information about components, moderators, mediators, and processes of change. These "third wave" methods all emphasize the context and function of psychological events more so than their validity, frequency, or form, and for these reasons we use the term "contextual cognitive behavioraltherapy" to describe their characteristics. Both putative processes, and component and process evidence, indicate that they are focused on establishing a more open, aware, and active approach to living, and that their positive effects occur because of changes in these processes. PMID:21219193
Hayes, Steven C; Villatte, Matthieu; Levin, Michael; Hildebrandt, Mikaela
Cognitive behaviortherapy (CBT) evolved from behavioral theory and developed to focus more on cognitive models that incorporated reappraisal of thinking errors and schema change strategies. This article will describe the key elements of CBT for schizophrenia and the current evidence of its efficacy and effectiveness. We conclude with a description of recent concepts that extend the theoretical basis of practice and expand the range of CBT strategies for use in schizophrenia. Mindfulness, meta-cognitive approaches, compassionate mind training, and method of levels are postulated as useful adjuncts for CBT with psychotic patients. PMID:19661198
A low-cost microcomputer was used to analyze systematically the behavioral interactions between a music therapist and a 55-year-old mentally retarded female. The microcomputer permitted the authors to determine quickly and cost effectively the effect of music therapy sessions on the client's behavior. The study demonstrates that current microcomputer technology can now be used to collect and analyze process-oriented data for application in both research and training activities. The implications for process-oriented research and training are discussed. PMID:10254570
Despite the efficacy of family-based interventions for improving outcomes for adolescent behavior problems such as substance use, engaging and retaining whole families in treatment is one of the greatest challenges therapists confront. This article illustrates how the Brief Strategic Family Therapy® (BSFT®) model, a family-based, empirically validated intervention designed to treat children and adolescents’ problem behaviors, can be used to increase engagement, improve retention, and bring about positive outcomes for families. Research evidence for efficacy and effectiveness is also presented. PMID:23731415
Szapocznik, Jose; Zarate, Monica; Duff, Johnathan; Muir, Joan
In this study, the spin coating of template-assisted method is used to synthesize poly[2,7-(9,9-dioctylfluorene)-alt-4,7-bis(thiophen-2-yl)benzo-2,1,3-thiadiazole] (PFO-DBT) nanorod bundles. The morphological, structural, and optical properties of PFO-DBT nanorod bundles are enhanced by varying the spin coating rate (100, 500, and 1,000 rpm) of the common spin coater. The denser morphological distributions of PFO-DBT nanorod bundles are favorably yielded at the low spin coating rate of 100 rpm, while at high spin coating rate, it is shown otherwise. The auspicious morphologies of highly dense PFO-DBT nanorod bundles are supported by the augmented absorption and photoluminescence. PMID:24872806
In this study, the spin coating of template-assisted method is used to synthesize poly[2,7-(9,9-dioctylfluorene)-alt-4,7-bis(thiophen-2-yl)benzo-2,1,3-thiadiazole] (PFO-DBT) nanorod bundles. The morphological, structural, and optical properties of PFO-DBT nanorod bundles are enhanced by varying the spin coating rate (100, 500, and 1,000 rpm) of the common spin coater. The denser morphological distributions of PFO-DBT nanorod bundles are favorably yielded at the low spin coating rate of 100 rpm, while at high spin coating rate, it is shown otherwise. The auspicious morphologies of highly dense PFO-DBT nanorod bundles are supported by the augmented absorption and photoluminescence. PMID:24872806
The present study investigates the efficacy of an Internet-based cognitive-behavioraltherapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology– therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n = 55) were randomly assigned to either the treatment group or a waiting list control condition. The 5-week intervention consisted
Birgit Wagner; Christine Knaevelsrud; Andreas Maercker
The present study investigated the efficacy of a coping-technique, applied relaxation (AR) and cognitive behaviortherapy (CBT), in the treatment of panic disorder. Thirty-eight outpatients fulfilling the DSM-III-R criteria for panic disorder with no (n = 30) or mild (n = 8) avoidance were assessed with independent assessor ratings, self-report scales and self-observation of panic attacks before and after treatment,
This study examined whether categorical or dimensional personality disorder variables affected treatment outcome in a sample of 52 patients with obsessive compulsive disorder who followed a standardized cognitive behaviortherapy program. Treatment consisted of 12 weekly sessions and was completed by 43 patients. The Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was taken before the start of treatment by
This treatment-development study is a Stage I evaluation of an intervention that combines mindfulness meditation with cognitive-behaviortherapy for insomnia (CBT-I). Thirty adults who met research diagnostic criteria for Psychophysiological Insomnia (Edinger et al., 2004) participated in a 6-week, multi-component group intervention using mindfulness meditation, sleep restriction, stimulus control, sleep education, and sleep hygiene. Sleep diaries and self-reported pre-sleep arousal
In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using\\u000a an existing Cognitive BehavioralTherapy and Motivational Interviewing based treatment program (‘Lifestyle Training’) to treat\\u000a internet addiction. The current study evaluates this pilot treatment program by providing a qualitative analysis of the experiences\\u000a of the therapists with the treatment of
Antonius J. van Rooij; Mieke F. Zinn; Tim M. Schoenmakers; Dike van de Mheen
The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioraltherapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology
Steven A. Safren; Michael W. Otto; Susan Sprich; Carol L. Winett; Timothy E. Wilens; Joseph Biederman
In subjects with obsessive-compulsive disorder (OCD), lower pre-treatment metabolism in the right orbitofrontal cortex (OFC) and anterior cingulate gyrus (AC) has been associated with a better response to clomipramine. We sought to determine pre-treatment metabolic predictors of response to behavioraltherapy (BT) vs. pharmacotherapy in subjects with OCD. To do this, [18F]fluorodeoxyglucose positron emission tomography scans of the brain were
Arthur L Brody; Sanjaya Saxena; Jeffrey M Schwartz; Paula W Stoessel; Karron Maidment; Michael E Phelps; Lewis R Baxter
This paper describes a hands-off socially assistive therapist robot designed to monitor, assist, encourage, and socially interact\\u000a with post-stroke users engaged in rehabilitation exercises. We investigate the role of the robot’s personality in the hands-off\\u000a therapy process, focusing on the relationship between the level of extroversion–introversion of the robot and the user. We\\u000a also demonstrate a behavior adaptation system capable
Coping strategies are emerging as a predictor of treatment outcome for substance users and may be particularly important among computerized and self-change approaches. We used data from a randomized clinical trial of a computer-based version of cognitive–behavioraltherapy (CBT4CBT) to: (1) examine the association between observer ratings of coping skills and self-reported coping strategies; (2) evaluate whether participants assigned to
Dawn E. Sugarman; Charla Nich; Kathleen M. Carroll
Patients remanded to forensic hospitals often experience a marked situational depression once initial psychotic symptoms subside\\u000a and the reality of their legal situation becomes evident. Individual psychotherapy is not often used with this population\\u000a due to a generally high level of impairment. It is suggested, that with modifications, the cognitive-behavioraltherapy manual\\u000a by Michael Thase (in: VanHasselt, Hersen (eds) Sourcebook
Several possible mediators of a group cognitive-behavioraltherapy (CBT) for depressed adolescents were examined. Six measures specific to CBT (e.g., negative cognitions, engagement in pleasurable activities) and 2 nonspecific measures (therapeutic alliance, group cohesion) were examined in 93 adolescents with comorbid major depressive disorder and conduct disorder who were randomly assigned to the Adolescent Coping With Depression (CWD-A) course or
Noah K. Kaufman; Paul Rohde; John R. Seeley; Gregory N. Clarke; Eric Stice
This study examined predictive relations between therapeutic alliance and treatment outcomes in manual-guided, cognitive-behavioraltherapy for adolescent depression. Fifty-four adolescents met criteria for a depressive disorder and were treated in school-based clinics. Alliance was measured after the third session from both therapist and adolescent perspectives, and change in depressive symptoms was assessed by structured interview and self-report. Two models of
Stephen R. Shirk; Gretchen Gudmundsen; Heather Crisp Kaplinski; Dana L. McMakin
This study investigates students' need for a web-based cognitive-behaviortherapy (CBT) intervention program for preventing depression, the mental health status of those who felt a need for such a program, and underlying factors of the intention to use web-based self-help. A conceptual model for explaining intention to use web-based self-help is proposed. Nearly half of the participants reported a need
Ove K. Lintvedt; Kristian Sørensen; Andreas R. Østvik; Bas Verplanken; Catharina E. Wang
Although presentation of a treatment rationale is posited to enhance expectations for change, this contention has not been\\u000a directly evaluated. In this analogue study, the Cognitive BehavioralTherapy (CBT) rationale for social anxiety was presented\\u000a via videotape by an experienced CBT therapist, to 77 undergraduate students with high fear of negative evaluation. Results\\u000a indicated significant increases in self-efficacy for anxiety
This meta-analysis is the first to examine cognitive behavioraltherapy (CBT) techniques for distress and pain specifically\\u000a in breast cancer patients. Twenty studies that used CBT techniques with breast cancer patients were identified and effect\\u000a sizes were calculated to determine (1) whether CBT techniques have a significant impact on distress and pain, (2) if individual\\u000a or group treatments are more
Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behaviortherapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient’s inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these
Marilyn P. Safir; Helene S. Wallach; Margalit Bar-Zvi
Background: The present study was designed to verify the efficacy of cognitive-behavioral group therapy (CBGT) in reducing obsessive-compulsive symptoms and the intensity of overvalued ideas, as well as in improving the patient’s quality of life. Methods: Forty-seven patients meeting DSM-IV criteria for obsessive-compulsive disorder (OCD) were randomly assigned to either 12 weekly CBGT sessions or a waiting list (control group).
Objective: A significant number of patients with obsessive- compulsive disorder (OCD) fail to benefit sufficiently from treatments. This study aimed to evaluate whether certain OCD symptom dimensions were associated with cognitive-behavioraltherapy (CBT) outcome. Method: Symptoms of 104 CBT-treated in-patients with OCD were assessed with the clinician-rated Yale-Brown Obsessive-Compulsive Scale symptom checklist. Logistic regression analyses examined outcome predictors. Results: The
This study examined emotion-related functioning following cognitive-behavioraltherapy (CBT) with 37 youth with anxiety disorders (22 boys, 15 girls) ranging in age from 7 to 15 with a principal diagnosis of generalized anxiety disorder (n = 27), separation anxiety disorder (n = 12), and\\/or social phobia (n = 13). Treated youth exhibited a reduction in anxiety and increased anxiety self-efficacy and emotional awareness at posttreatment. Treated
Cynthia Suveg; Erica Sood; Jonathan S. Comer; Philip C. Kendall
Cognitive–behavioraltherapies (CBTs) can be effective treatments for posttraumatic stress disorder (PTSD) but their effectiveness is limited by high rates of premature dropout. Few studies have compared pretreatment characteristics of treatment completers and dropouts, and only one has examined these factors in Operations Iraqi Freedom and Enduring Freedom (OIF\\/OEF) Veterans. This study analyzed archival clinical data from 117 OEF\\/OIF Veterans
Hector A. Garcia; Lance P. Kelley; Timothy O. Rentz; Shuko Lee
Background: Previous studies have found a strong association between dissociation and obsessive-compulsive disorder (OCD). The purpose of the present study was to evaluate whether dissociation is a predictor of cognitive behaviortherapy (CBT) outcome in patients with OCD. Methods: Fifty-two patients with OCD were assessed using the Dissociative Experience Scale (DES), the Yale-Brown Obsessive-Compulsive Scale and the Beck Depression Inventory.
Michael Rufer; Dada Held; Julia Cremer; Susanne Fricke; Steffen Moritz; Helmut Peter; Iver Hand
The present study tested cognitive–behavioraltherapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW, CBT participants had larger improvements on 8 out of 10 self-report
Bruce Rybarczyk; Edward Stepanski; Louis Fogg; Martita Lopez; Paulette Barry; Andrew Davis
The article presents a synopsis on rational-emotive behaviortherapy (REBT), its fundamental theoretical framework, its applications,\\u000a and future directions. The paper is organized according to the following structure: in part one, REBT fundamental\\/basic research\\u000a is discussed; in the second part clinical\\/applied research in REBT is presented, including aspects of efficacy and effectiveness,\\u000a discrimination of disorders for which REBT works most
Daniel David; Aurora Szentagotai; Kallay Eva; Bianca Macavei
Examined the efficacy of an Emotion-focused Cognitive-BehavioralTherapy (ECBT) for six anxious youths ages 7–13 years. All participants had a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia) based on the Anxiety Disorder Interview Schedule for Children—Child and Parent versions. Children and parents reported on anxious symptomatology using the Multidimensional Anxiety Scale for Children (MASC). To
Cynthia Suveg; Philip C. Kendall; Jonathan S. Comer; Joanna Robin
Introduction and Hypotheses The objective of this study was to examine the effects of drug therapy alone and combined with behavioraltherapy on urgency and 24-voiding frequency in women with urge-predominant incontinence and to identify predictors of change. Methods A planned analysis of data from a multi-site, randomized, controlled trial (N=307). Bladder diaries were used to document voids, incontinence, and urgency severity. Results Urgency scores decreased significantly within both treatment groups, but changes did not differ between groups (p=0.30). Improvement in urgency was associated with greater baseline urgency (p<0.0001) and black ethnicity (p=0.03). Voiding frequency increased with drug alone and decreased slightly with combined therapy (p=0.009), and improvement was associated with combined treatment (p<0.0001), higher baseline frequency (p<0.0001), and lower baseline incontinence episode frequency (p=0.001). Conclusions Although combined drug and behavioraltherapy does not appear to improve urgency more than drug alone, it resulted in better outcomes on voiding frequency. PMID:20143047
Burgio, Kathryn L.; Kraus, Stephen R.; Borello-France, Diane; Chai, Toby C.; Kenton, Kimberly; Goode, Patricia S.; Xu, Yan; Kusek, John W.
This study examines the long-term efficacy of cognitive-behavioraltherapy (CBT) for fear of flying (FOF) after a catastrophic fear-relevant event, the September 11, 2001, terrorist attacks. Participants (N = 115) were randomly assigned to and completed treatment for FOF using 8 sessions of either virtual reality exposure therapy (VRE) or standard exposure therapy (SE) prior to September 11, 2001. Individuals were reassessed in June, 2002, an average of 2.3 years after treatment, with a response rate of 48% (n = 55). Analyses were run on the original data and, using multiple imputation procedures, on imputed data for the full sample. Individuals maintained or improved upon gains made in treatment as measured by standardized FOF questionnaires and by number of flights taken. There were no differences between VRE and SE. Thus, results suggest that individuals previously treated for FOF with cognitive-behavioraltherapy can maintain treatment gains in the face of a catastrophic fear-relevant event, even years after treatment is completed. PMID:16942964
Individuals with public speaking phobia experience fear and avoidance that can cause extreme distress, impaired speaking performance, and associated problems in psychosocial functioning. Most extant interventions for public speaking phobia focus on the reduction of anxiety and avoidance, but neglect performance. Additionally, very little is known about the relationship between verbal working memory and social performance under conditions of high anxiety. The current study compared the efficacy of two cognitive behavioral treatments, traditional Cognitive BehavioralTherapy (tCBT) and acceptance-based behaviortherapy (ABBT), in enhancing public speaking performance via coping with anxiety. Verbal working memory performance, as measured by the backwards digit span (BDS), was measured to explore the relationships between treatment type, anxiety, performance, and verbal working memory. We randomized 30 individuals with high public speaking anxiety to a 90-minute ABBT or tCBT intervention. As this pilot study was underpowered, results are examined in terms of effect sizes as well as statistical significance. Assessments took place at pre and post-intervention and included self-rated and objective anxiety measurements, a behavioral assessment, ABBT and tCBT process measures, and backwards digit span verbal working memory tests. In order to examine verbal working memory during different levels of anxiety and performance pressure, we gave each participant a backwards digit span task three times during each assessment: once under calm conditions, then again while experiencing anticipatory anxiety, and finally under conditions of acute social performance anxiety in front of an audience. Participants were asked to give a video-recorded speech in front of the audience at pre- and post-intervention to examine speech performance. Results indicated that all participants experienced a very large and statistically significant decrease in anxiety (both during the speech and BDS), as well as an improvement in speech performance regardless of intervention received. While not statistically significant, participants who received an acceptance-based intervention exhibited larger improvements in observer-rated speech performance at post-treatment in comparison to tCBT (F (1,21) = 1.91, p =.18, etap2 = .08) such that individuals in the ABBT condition exhibited a considerably greater improvement in observer-rated speech performance than those in the tCBT condition. There was no differential impact of treatment condition on subjective speech anxiety or working memory task performance. Potential mediators and moderators of treatment were also examined. Results provide support for a brief 90-minute intervention for public speaking anxiety, but more research is needed in a study with a larger sample to fully understand the relationship between ABBT strategies and improvements in behavioral performance.
Whither, or wither, empirically supported therapies? Increasingly rigorous research in behavioraltherapies has yielded a large number of effective therapies, but comparatively little work, demonstrating that integrating empirically supported therapies (ESTs) into standard practice results in meaningful improvements in patient outcomes. Methodology and strategies for evaluating ESTs and their effectiveness in clinical practice is a fairly recent innovation, and a host of unanswered questions remain regarding issues such as selection among different ESTs and what type of ESTs should be emphasized in dissemination efforts, what type of clinicians should be trained in what type of ESTs, the most effective training strategies for various types of clinicians, the need for ongoing supervision to maintain minimum levels of treatment fidelity and skill. In this review, we call for broader use of new research strategies and methods relevant to dissemination of ESTs; these may include adaptive designs, identification of mechanisms of action to foster greater emphasis on effective change principles, training and adoption trials, as well as novel implementation strategies including computer-assisted therapy and computer-assisted training. PMID:17523974
The purpose of this study was to compare the efficacy of individual and group cognitive behavioraltherapy for insomnia (CBT-I) in outpatients with primary insomnia diagnosed by DSM-IV-TR. The participants were 20 individually treated (I-CBT-I) and 25 treated in a group therapy format (three to five patients per group) (G-CBT-I), which showed no significant difference regarding demographic variables between groups. The same components of CBT-I stimulus control therapy, sleep restriction therapy, cognitive therapy, and sleep hygiene education were applied on both groups. The short-term outcome (4 weeks after treatment) was measured by sleep logs, actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), and was compared between I-CBT-I and G-CBT-I. The results indicated that CBT-I was effective in improving subjective and objective sleep parameters and subjective sleep evaluations for both individual and group treatment. However, I-CBT-I resulted in significantly better improvements over G-CBT-I, in (i) objective and subjective sleep onset latency time, (ii) objective sleep efficacy and moving time during sleeping, (iii) overall sleep quality and duration of actual sleep time in PSQI, (iv) consequences of insomnia, control and predictability of sleep, sleep requirement expectation, and sleep-promoting practices in DBAS. The present study suggested the superiority of I-CBT-I over G-CBT-I in clinical settings, and further evaluations are necessary. PMID:24098091
We aimed to examine the core elements of cognitive behavioraltherapy and acceptance and commitment therapy that target distressing negative cognitions, cognitive restructuring (CR) and cognitive defusion (CD), respectively. Participants (N=142) recalled a saddening autobiographical event, identified a distressing thought it triggered, and completed a task that induced rumination on these cognitions. They then completed one of four brief interventions that targeted these emotionally charged cognitions: analogue versions of CR and CD, and two control interventions. The personal negative cognitions were then reactivated to examine the protective effects of these interventions. CR and CD were similarly efficacious in alleviating distress, compared to a control intervention that focused on participants' negative thoughts. Mood improvement was associated with state levels of reappraisal and not with acceptance in CR, whereas the reverse was observed in CD. Improvement was associated with perceived efficacy of the intervention in CR but not in CD. The present findings suggest that although CR and CD effectively promote different types of cognitive strategies, they may share important features that set them both apart from maladaptive forms of coping. PMID:24912461
... most effective treatment for children with autism spectrum disorders , children who have ADHD symptoms in addition may need a different approach to ... the time that your child was diagnosed with ADHD, any coexisting disorders ... your child exhibits symptoms that make you suspect she has a disruptive ...
Hospice family caregivers experience significantly higher rates of psychological distress than demographically similar noncaregivers. Interventions based on cognitive-behavioraltherapy have been shown to reduce psychological distress in the general population by providing tools to modify thinking patterns that directly affect emotions and behavior. Such interventions might reasonably be incorporated into hospice social work; however, numerous contextual factors must be taken into account to ensure that any interventions are appropriate to the unique needs of clients. The purpose of the study discussed in this article was to contex- tualize one aspect of the cognitive-behavioral model based on firsthand accounts of hospice family caregivers. Following a modified grounded theory approach, researchers engaged in a secondary analysis of data from a larger study provided in a subsample of 90 audio-recorded conversations between hospice family caregivers and interventionists. Findings indicated that distressed caregivers engaged in five dominant thinking patterns: (1) "should" statements, (2) catastrophizing or minimizing, (3) personalizing, (4) absolute thinking, and (5) making assumptions. Implementing cognitive-behavioraltherapies based on identified caregiver thinking patterns will allow hospice social workers to empower caregivers to cope more effectively with the numerous stressors they encounter while caring for a dying loved one. PMID:25369725
Washington, Karla T; Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Baldwin, Paula K; Tappana, Jessica; Wright, Jesse H; Demiris, George
The efficacy of behaviortherapy based mainly on real-life exposure situations as well as applied tension was examined for a combined case of blood-injury-injection (BII) phobia and social anxiety disorder. Treatment involved 28 behaviortherapy sessions, while applied tension technique was also described and practiced. The specific contribution of social skills techniques, fantasy, and real-life situations exposure was examined in a single case design. The subject was a 39-year-old male with anxiety symptoms when confronting an audience, as well as symptoms of the autonomic nervous system (bradycardia and syncope), which were better explained by BII. All self-report measures regarding fear, social phobia, and anxiety were reduced after behaviortherapy and remained maintained at followup, while BII decreased further after applied tension techniques. The contribution of behaviortherapy to the overall outcome of the case is considered significant for many reasons that are discussed in the pape. PMID:23304602
There has been much discussion in the literature recently regarding the conceptual and technical differences between so-called second- (e.g., Beckian cognitive therapy) and third-wave (e.g., acceptance and commitment therapy) behavioraltherapies. Previous research has not addressed the potential similarities and differences among the practitioners of these types of approaches. The current study examined possible differences in the characteristics of second-wave
Lily A. Brown; Brandon A. Gaudiano; Ivan W. Miller
This manuscript describes early work to develop a cognitive-behavioraltherapy protocol for returning OEF\\/OIF veterans with co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD). Based on the unique characteristics of this population, and on the literature supporting cognitive behavioral coping skills and significant other involvement for both PTSD and for AUD, the new therapy involves both of those
The purpose of this study was to investigate the effects of improvisational music therapy on joint attention behaviors in\\u000a pre-school children with autism. It was a randomized controlled study employing a single subject comparison design in two\\u000a different conditions, improvisational music therapy and play sessions with toys, and using standardized tools and DVD analysis\\u000a of sessions to evaluate behavioral changes
Objective: To describe child- and family-focused cognitive-behavioraltherapy (CFF-CBT), a new developmentally sensitive psychosocial intervention for pediatric bipolar disorder (PBD) that is intended for use along with medication. CFF-CBT integrates principles of family-focused therapy with those of CBT. The theoretical framework is based on (1)…
Pavuluri, Mani N.; Graczyk, Patricia A.; Henry, David B.; Carbray, Julie A.; Heidenreich, Jodi; Miklowitz, David J.
Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioraltherapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized
This paper discusses specialized approaches developed for patients with obsessive-compulsive disorder (OCD) who are resistant to cognitive behaviortherapy (CBT). Following a review of theoretical and outcome research, two approaches developed to resolve persistent OCD are described and illustrated. Cognitive therapy (CT) designed to address…
Few studies have evaluated short-term psychosocial treatments with physically abused school-aged children and their offending parents or families. This study compares the treatment outcomes of 55 cases that were randomly assigned to individual child and parent cognitive behavioraltherapy (CBT) or family therapy (FT) with those who received routine community services (RCS). Measures of child, parent, and family dysfunction and
New evidence raises concerns that posttraumatic stress disorder (PTSD) in preschool children is unremit- ting over years even with unstructured community treatment. This report presents proof of concept of the feasibility and effectiveness of a structured therapy, cognitive-behavioraltherapy (CBT), for preschool PTSD that follows a range of different traumatic events. Two cases are presented, including transcribed dialogue, from a
Michael S. Scheeringa; Alison Salloum; Ruth A. Arnberger; Carl F. Weems; Lisa Amaya-Jackson; Judith A. Cohen
The purpose of this study was to investigate the effects of improvisational music therapy on joint attention behaviors in pre-school children with autism. It was a randomized controlled study employing a single subject comparison design in two different conditions, improvisational music therapy and play sessions with toys, and using standardized…
This study aims to examine the changes in task-related brain activity induced by rehabilitative therapy using brain-computer interface (BCI) technologies and whether these changes are relevant to functional gains achieved through the use of these therapies. Stroke patients with persistent upper-extremity motor deficits received interventional rehabilitation therapy using a closed-loop neurofeedback BCI device (n = 8) or no therapy (n = 6). Behavioral assessments using the Stroke Impact Scale, the Action Research Arm Test (ARAT), and the Nine-Hole Peg Test (9-HPT) as well as task-based fMRI scans were conducted before, during, after, and 1 month after therapy administration or at analogous intervals in the absence of therapy. Laterality Index (LI) values during finger tapping of each hand were calculated for each time point and assessed for correlation with behavioral outcomes. Brain activity during finger tapping of each hand shifted over the course of BCI therapy, but not in the absence of therapy, to greater involvement of the non-lesioned hemisphere (and lesser involvement of the stroke-lesioned hemisphere) as measured by LI. Moreover, changes from baseline LI values during finger tapping of the impaired hand were correlated with gains in both objective and subjective behavioral measures. These findings suggest that the administration of interventional BCI therapy can induce differential changes in brain activity patterns between the lesioned and non-lesioned hemispheres and that these brain changes are associated with changes in specific motor functions. PMID:25076886
Young, Brittany M.; Nigogosyan, Zack; Walton, Leo M.; Song, Jie; Nair, Veena A.; Grogan, Scott W.; Tyler, Mitchell E.; Edwards, Dorothy F.; Caldera, Kristin; Sattin, Justin A.; Williams, Justin C.; Prabhakaran, Vivek
Abstract Objective To explore symptoms, understanding of menopausal therapies, medication use and health-related behavior in women with and without premature menopause. Methods Cross-sectional, questionnaire-based study involving a community-based sample of 77 women in Australia: 23 premenopausal, 25 with premature ovarian failure (POF) and 29 with medically induced premature menopause (MIPM). Results The median (interquartile range) age of each group was: premenopausal = 29 (13) years, POF = 36 (8.0) years and MIPM = 38 (4.0) years (p < 0.001). The reported frequency of menopausal symptoms differed across the groups for difficulty sleeping (premenopausal = 26%, POF = 44%, MIPM = 69%, p = 0.01), some depression symptoms (premenopausal = 4.4-22%, POF = 20-25%, MIPM = 38-59%, p < 0.05), hot flushes (premenopausal = 4.4%, POF = 28%, MIPM = 59%, p < 0.001), sweating at night (premenopausal = 4.4%, POF = 20%, MIPM = 52%, p < 0.001) and loss of interest in sex (premenopausal = 17%, POF = 52%, MIPM = 54%, p = 0.02). More women with premature menopause than premenopausal women reported taking prescription medication (premenopausal = 52%, POF = 92%, MIPM = 86%, p = 0.002), perceived that hormone therapy (HT) was associated with increased breast cancer risk (premenopausal = 43%, POF = 56%, MIPM = 79%, p = 0.03) and that HT prevented fractures (premenopausal = 13%, POF = 56%, MIPM = 39%, p = 0.01). Most women reported not knowing risks/benefits of bioidentical hormone therapy (premenopausal = 86%, POF = 56%, MIPM = 75%, p = 0.06). Regarding health-related behavior around prevention and screening, varying rates of bone densitometry (premenopausal = 4.4%, POF = 64%, MIPM = 59%, p < 0.001), blood glucose testing (premenopausal = 39%, POF = 67%, MIPM = 57%, p = 0.16) and cholesterol testing (premenopausal = 22%, POF = 71%, MIPM = 54%, p = 0.003) were reported. Conclusions Differences in understanding of menopausal therapies and health-related behavior exist among women with premature menopause of differing etiology and premenopausal women. While perceived understanding of HT was greater than other therapies, targeted education is needed regarding specific risks/benefits of menopausal therapies and regarding preventive health screening after premature menopause. PMID:24742007
Background and Aims Given the limitations of conventional therapies and restrictions imposed on newer pharmacological agents, there is an urgent need to develop efficacious and efficient treatments that teach patients behavioral self management skills for relieving irritable bowel syndrome (IBS) symptoms and associated problems. Method 75 Rome II diagnosed IBS patients (86% female) without comorbid GI disease were recruited from local physicians and the community and randomized to either 2 versions of cognitive behaviortherapy (10 session, therapist administered CBT vs. 4 session, patient administered CBT) or a wait list comparison (WLC) that controlled for threats to internal validity Final assessment occurred two weeks after the 10 week treatment phase ends. Outcome measures included adequate relief from pain and bowel symptoms; global improvement of IBS symptoms (CGI-Improvement Scale); IBS symptom severity (IBS SSS); quality of life (IBSQOL); psychological distress (Brief Symptom Inventory); patient satisfaction (Client Satisfaction Scale). Results At week 12, both CBT versions were significantly (p < .0001) superior to WLC in the percentage of participants reporting adequate relief (e.g., MC-CBT = 72%, S-CBT = 60.9%, WLC = 7.4%) and improvement of symptoms. CBT treated patients reported significantly improved quality of life and IBS symptom severity but not psychological distress than WL patients (p < .0001) Conclusions Data from this pilot study lend preliminary empirical support to a brief patient administered CBT regimen capable of providing short term relief from IBS symptoms largely unresponsive to conventional therapies. PMID:18524691
Lackner, Jeffrey M.; Jaccard, James; Krasner, Susan S.; Katz, Leonard A.; Gudleski, Gregory D.; Holroyd, Kenneth
The purpose of the present study was to investigate specific clinical behaviors exhibited by music therapy students in their 1st through 4th semesters of practicum. A secondary purpose of the study was to determine if a relationship exists between therapy students' behaviors and their assessed clinical success. Participants were instructed to submit 20-minutes of videotape from one practicum session, chosen at random from the current practicum semester. Two trained observers then viewed the videotapes and simultaneously recorded the occurrence and duration of practicum student behaviors using SCRIBE, a data collection computer program. The SCRIBE program was configured to include 5 broad categories of therapist behaviors: musical behaviors (singing, playing, listening), physical behaviors (such as hand-over-hand assistance, cueing, or clapping), verbal behaviors (therapy-related verbal interactions or other), a combination of two of the above, and other nonspecified behaviors. The percentage of time practicum students exhibited behaviors within in each category was calculated for all session segments. These same videotapes were also evaluated by 2 professional board certified music therapists who were unfamiliar with the practicum students. Students were assigned an overall rating for clinical effectiveness. Evaluators were also asked to provide comments related to their ratings. A descriptive analysis of clinical behaviors indicate that students spend nearly 40% of their practicum time engaged in musical behaviors and over 50% of their time engaged in verbal behaviors. No significant differences were found in the behaviors exhibited by students in the various practicum levels; however, behavioral differences were found for individual student therapists. Additionally, no relationship was found between students' behaviors and their clinical effectiveness. An analysis of comments by the evaluators indicates that the quantity of musical behaviors does not affect clinical effectiveness as much as the quality of the musical behaviors. Evaluator comments also indicate that students identified as personable or as having rapport with their clients were also more effective in the practicum setting. PMID:11796080
Darrow, A A; Johnson, C M; Ghetti, C M; Achey, C A
Cognitive-behavioraltherapy (CBT) for the treatment of Social Anxiety Disorder (SAD) has demonstrated efficacy in numerous randomized trials. However, few studies specifically examine the applicability of such treatment for ethnic minority clients. Thus, the purpose of this article is to present two case studies examining the utility of individualized CBT for SAD with two clients who immigrated to the United States, one from Central America and one from China, for whom English was not their primary language. Both clients demonstrated improvement on a semi-structured interview and self-report measures. Necessary adaptations were modest, suggesting that therapy could be conducted in a culturally sensitive manner without much deviation from the treatment protocol. Results are discussed in terms of adapting treatment to enhance acceptability for and better fitting the needs of ethnic minority clients and non-native speakers of English. Implications for treating ethnic minority clients, as well as the practice of culturally sensitive treatment, are discussed. PMID:22844232
Weiss, Brandon J.; Singh, J. Suzane; Hope, Debra A.
Sleep disturbances are common among alcohol-dependent individuals and are often associated with relapse. The utility of behavioraltherapies for sleep disturbances, including cognitive-behavioraltherapy for insomnia (CBT-I), among those with alcohol-related disorders is not well understood. This review systematically evaluates the evidence of CBT-I and related behavioraltherapies applied to those with alcohol-related disorders and accompanying sleep disturbances. A search of four research databases (PubMed, PsycINFO, Embase, and CINAHL Plus) yielded six studies that met selection criteria. Articles were reviewed using Cochrane’s Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) scoring system. A majority of the studies demonstrated significant improvements in sleep efficiency among behavioraltherapy treatment group(s), including but not limited to CBT-I. While behavioral sleep interventions have been successful in varied populations, they may not be utilized to their full potential among those with alcohol-related disorders as evidenced by the low number of studies found. These findings suggest a need for mixed-methods research on individuals’ sleep experience to inform interventions that are acceptable to the target population. PMID:25288884
The aim of the current review is to provide a summary of research into Internet-delivered cognitive behavioraltherapy (iCBT) for anxiety disorders. We include 37 randomized controlled trials that examined the efficacy of iCBT programs in adults (aged over 18 years), as compared with waiting list or active control. The included studies were identified from Medline searches and from reference lists, and only published data were included. Several trials of iCBT for generalized anxiety disorder, panic disorder, and social phobia were identified. Two trials of iCBT for obsessive-compulsive disorder were identified, whilst one trial each was identified for hypochondriasis, specific phobia (spiders), and post-traumatic stress disorder. Finally, there were five trials that focused on transdiagnostic therapy for either a range of comorbid anxiety disorders or comorbid anxiety and depression. Between-group effect sizes were moderate to large for all disorders, and ranged from 0.30 to 2.53. iCBT was found to be commensurate with face-to-face cognitive behavioraltherapy whether delivered individually or in group format. Guidance may not be necessary for iCBT to be effective for immediate gains, but may be more important in longer-term maintenance of symptom improvement and maximizing patient adherence. The clinical experience of the individual providing guidance does not appear to impact treatment outcomes. Future research needs to focus on the optimal level of guidance required to generate maximum patient benefits, whilst balancing the efficient use of clinician time and resources. Evidence-based contraindications to iCBT should also be developed so that the choice of treatment modality accurately reflects patients' needs. Further research should be conducted into the effective elements of iCBT, as well as the extent to which therapy enhancers and advancing technology can be accommodated into established iCBT frameworks. PMID:24511246
The aim of the current review is to provide a summary of research into Internet-delivered cognitive behavioraltherapy (iCBT) for anxiety disorders. We include 37 randomized controlled trials that examined the efficacy of iCBT programs in adults (aged over 18 years), as compared with waiting list or active control. The included studies were identified from Medline searches and from reference lists, and only published data were included. Several trials of iCBT for generalized anxiety disorder, panic disorder, and social phobia were identified. Two trials of iCBT for obsessive-compulsive disorder were identified, whilst one trial each was identified for hypochondriasis, specific phobia (spiders), and post-traumatic stress disorder. Finally, there were five trials that focused on transdiagnostic therapy for either a range of comorbid anxiety disorders or comorbid anxiety and depression. Between-group effect sizes were moderate to large for all disorders, and ranged from 0.30 to 2.53. iCBT was found to be commensurate with face-to-face cognitive behavioraltherapy whether delivered individually or in group format. Guidance may not be necessary for iCBT to be effective for immediate gains, but may be more important in longer-term maintenance of symptom improvement and maximizing patient adherence. The clinical experience of the individual providing guidance does not appear to impact treatment outcomes. Future research needs to focus on the optimal level of guidance required to generate maximum patient benefits, whilst balancing the efficient use of clinician time and resources. Evidence-based contraindications to iCBT should also be developed so that the choice of treatment modality accurately reflects patients’ needs. Further research should be conducted into the effective elements of iCBT, as well as the extent to which therapy enhancers and advancing technology can be accommodated into established iCBT frameworks. PMID:24511246
Objective: To assess the efficacy of trauma-focused cognitive behavioraltherapy (TF-CBT) delivered by nonclinical facilitators in reducing posttraumatic stress, depression, and anxiety and conduct problems and increasing prosocial behavior in a group of war-affected, sexually exploited girls in a single-blind, parallel-design, randomized,…
Youth traumatized by natural disasters report high levels of posttraumatic stress such as symptoms of posttraumatic stress disorder, other anxiety disorders, and depression. Research suggests that cognitive behavioraltherapies are promising interventions for symptom reduction; however, few cognitive behavioral treatments have been systematically…
The purpose of this study was to investigate the effects of improvisational music therapy on joint attention behaviors in pre-school children with autism. It was a randomized controlled study employing a single subject comparison design in two different conditions, improvisational music therapy and play sessions with toys, and using standardized tools and DVD analysis of sessions to evaluate behavioral changes in children with autism. The overall results indicated that improvisational music therapy was more effective at facilitating joint attention behaviors and non-verbal social communication skills in children than play. Session analysis showed significantly more and lengthier events of eye contact and turn-taking in improvisational music therapy than play sessions. The implications of these findings are discussed further. PMID:18592368
We provide a detailed description of the clinical application of brief cognitive-behavioraltherapy (BCBT) for anxious youth. A rationale for the development of BCBT is presented, followed by a description and discussion of the 8 sessions of the treatment. Mike, a 7-year-old youth with anxiety disorders, is used to illustrate the inner workings of implementing BCBT. Case conceptualization, session details, and pre-, post- and follow-up-treatment information are provided. Conclusions regarding clinical advantages and future directions are made. PMID:25083131
Beidas, Rinad S.; Mychailyszyn, Matthew P.; Podell, Jennifer L.; Kendall, Philip C.
Background This study’s purpose was twofold: (1) to establish adherence rates to a behavioraltherapy (BT) sleep intervention and (2)\\u000a to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer\\u000a chemotherapy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I–IIIA breast\\u000a cancer (n?=?113) received a BT
Dennis E. McChargue; Jayashri Sankaranarayanan; Constance G. Visovsky; Ellyn E. Matthews; Krista B. Highland; Ann M. Berger
This study evaluated the implementation of computerized cognitive-behavioraltherapy (cCBT) for depression and anxiety in a university health center. Students reporting symptoms of depression and/or anxiety were offered cCBT and randomized to a session email reminder or no-reminder condition. Participants reported significant symptom and functional improvement after receiving treatment, comparable to outcomes achieved in controlled efficacy trials. However, rates of session completion were low, and reminders did not enhance retention. Results suggest that cCBT is a promising intervention in this population, with little attenuation of gains relative to efficacy trials but low levels of treatment completion. PMID:23592231
Santucci, Lauren C; McHugh, R Kathryn; Elkins, R Meredith; Schechter, Brandon; Ross, Margaret S; Landa, Carrie E; Eisen, Susan; Barlow, David H
Objectives To evaluate the feasibility of a randomized-controlled trial (RCT) and to obtain estimates of the effects of combined cognitive behavioraltherapy (CBT) and milnacipran for the treatment of fibromyalgia (FM). Methods Fifty eight patients with FM were randomized to one of the 3 treatment arms: (1) combination therapy (n=20), (2) milnacipran + education (n=19), and (3) placebo + CBT (n=19). Subjects received either milnacipran (100 mg/day) or placebo. Subjects also received 8 sessions of phone-delivered CBT or educational instructions, but only from baseline to week 9. Assessments were conducted at baseline, week 9 and 21. The primary endpoints were baseline to week 21 changes in weekly average pain intensity and physical function (SF-36 physical function scale). Results Compared to milnacipran, combination therapy demonstrated a moderate effect on improving SF-36 physical function (mean difference (SE) = 9.42 (5.48), p=0.09, effect size (ES) =0.60) and in reducing weekly average pain intensity (mean difference (SE) = ?1.18 (0.62), p=0.07, ES=0.67). Compared to milnacipran, CBT had a moderate to large effect in improving SF-36 physical function (mean difference (SE) = 11.0 (5.66), p=0.06, ES=0.70). Despite the presence of concomitant centrally-acting therapies, dropout rate was lower than anticipated (15% at week 21). Importantly, at least 6 out of the 8 phone-based therapy sessions were successfully completed by 89% of the subjects; and adherence to the treatment protocols was >95%. Conclusions In this pilot study, a therapeutic approach that combines phone-based CBT and milnacipran was feasible and acceptable. Moreover, the preliminary data supports conducting a fully powered RCT. PMID:23446065
Ang, Dennis C.; Jensen, Mark P.; Steiner, Jennifer L.; Hilligoss, Janna; Gracely, Richard H.; Saha, Chandan
This research aims to develop evidence based affordable psychological therapy for Indonesian older adults. An affordable psychological therapy is important as there is virtually no managed care or health insurance that covers psychological therapy in Indonesia. Multicomponent group cognitive behaviortherapy (GCBGT) was chosen as a starting point due to its extensive evidence, short sessions, and success for a wide range of psychological problems. The group format was chosen to address both the economic and the cultural context of Indonesia. Then, the developed treatment is tested to common psychological problems in older adults' population (anxiety, chronic pain, depression, and insomnia). The treatment consists of 8 sessions with twice a week meetings for 2.5 hours. There are similarities and differences among the techniques used in the treatment for the different psychological problems. The final participants are 38 older adults that are divided into the treatment groups; 8 participants joined the anxiety treatment, 10 participants for the chronic pain treatment, 10 participants for depression treatment, and lastly, 10 participants joined the insomnia treatment. The research design is pre-test post-test with within group analysis. We used principal outcome measure that is specific for each treatment group, as well as additional outcome measures. Overall, the result shows statistical significance change with large effect size for the principal outcome measure. In addition, the result for the additional measures varies from slight improvement with small effect size to statistically significant improvement with large effect size. The result indicates that short multicomponent GCBT is effective in alleviating various common psychological problems in Indonesian older adults. Therefore, multicomponent GCBT may be a good starting point to develop an effective and affordable psychological therapy for Indonesian older adults. Lastly, this result adds to the accumulating body of evidence on the effectiveness of multicomponent GCBT outside western context. PMID:23437339
Lubis, Dharmayati Utoyo; Jaya, Edo Sebastian; Arjadi, Retha; Hanum, Lathifah; Astri, Kresna; Putri, Maha Decha Dwi
Research suggests that experiential avoidance may play an important role in generalized anxiety disorder (GAD); see . Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54-68, for a review). Therefore, a treatment that emphasizes experiential acceptance, as well as intentional action, may lead to both reduced symptomatology and improved quality of life and functioning for individuals with this chronic disorder. In an open trial of a newly developed acceptance-based behaviortherapy for GAD, 16 treated clients demonstrated significant reductions in clinician-rated severity of GAD and reports of anxiety and depressive symptoms and fear and avoidance of their internal experience, as well as significant improvements in reports of quality of life, at both posttreatment and 3-month follow-up. Directions for future treatment development and research are discussed. PMID:17292696
Beliefs that are negatively biased, inaccurate, and rigid are thought to play a key role in the mood and anxiety disorders. Our goal in this study was to examine whether a change in maladaptive beliefs mediated the outcome of individual cognitive-behavioraltherapy (CBT) for social anxiety disorder (SAD). In a sample of 47 individuals with SAD receiving CBT, we measured maladaptive interpersonal beliefs as well as emotional and behavioral components of social anxiety, both at baseline and after treatment completion. We found that (a) maladaptive interpersonal beliefs were associated with social anxiety at baseline and treatment completion; (b) maladaptive interpersonal beliefs were significantly reduced from baseline to treatment completion; and (c) treatment-related reductions in maladaptive interpersonal beliefs fully accounted for reductions in social anxiety after CBT. These results extend the literature by providing support for cognitive models of mental disorders, broadly, and SAD, specifically. PMID:22445947
Boden, Matthew Tyler; John, Oliver P.; Goldin, Philippe R.; Werner, Kelly; Heimberg, Richard G.; Gross, James J.
In recent years there has been widespread acceptance that cognitive behaviortherapy (CBT) is the treatment of choice for bulimia nervosa. The cognitive behavioral treatment of bulimia nervosa (CBT-BN) was first described in 1981. Over the past decades the theory and treatment have evolved in response to a variety of challenges. The treatment has been adapted to make it suitable for all forms of eating disorder—thereby making it “transdiagnostic” in its scope— and treatment procedures have been refined to improve outcome. The new version of the treatment, termed enhanced CBT (CBT-E) also addresses psychopathological processes “external” to the eating disorder, which, in certain subgroups of patients, interact with the disorder itself. In this paper we discuss how the development of this broader theory and treatment arose from focusing on those patients who did not respond well to earlier versions of the treatment. PMID:23814455
In practical applications of three-dimensional (3D) tomographic techniques, such as digital breast tomosynthesis (DBT), computed tomography (CT), etc., there are often challenges for accurate image reconstruction from incomplete data. In DBT, in particular, the limited-angle and few-view projection data are theoretically insufficient for exact reconstruction; thus, the use of common filtered-backprojection (FBP) algorithms leads to severe image artifacts, such as the loss of the average image value and edge sharpening. One possible approach to alleviate these artifacts may employ iterative statistical methods because they potentially yield reconstructed images that are in better accordance with the measured projection data. In this work, as another promising approach, we investigated potential applications to low-dose, accurate DBT imaging with a state-of-the-art reconstruction scheme based on compressed-sensing (CS) theory. We implemented an efficient CS-based DBT algorithm and performed systematic simulation works to investigate the imaging characteristics. We successfully obtained DBT images of substantially very high accuracy by using the algorithm and expect it to be applicable to developing the next-generation 3D breast X-ray imaging system.
Park, Yeonok; Cho, Hyosung; Je, Uikyu; Hong, Daeki; Lee, Minsik; Park, Chulkyu; Cho, Heemoon; Choi, Sungil; Koo, Yangseo
In a randomized controlled trial, we evaluated the efficacy of cognitive-behavioral treatment for insomnia to improve sleep and daytime symptoms, and to reduce relapse in recovering alcohol dependent (AD) participants. Seventeen abstinent AD patients with insomnia (6 women, mean age 46.2 ± 10.1 years) were randomized to 8 sessions of cognitive behavioral treatment for insomnia for AD (CBTI-AD, n=9) or to a behavioral placebo treatment (BPT, n=8). Subjective measures of sleep, daytime consequences of insomnia and AD, alcohol use, and treatment fidelity were collected at baseline and post-treatment. Diary-rated sleep efficiency and wake after sleep onset, and daytime ratings of General Fatigue on the Multidimensional Fatigue Inventory improved more in the CBTI-AD compared to the BPT group. In addition, more subjects were classified as treatment responders following CBTI-AD. No group differences were found in the number of participants who relapsed to any drinking or who relapsed to heavy drinking. The findings suggest that cognitive-behavioral insomnia therapy benefits subjective sleep and daytime symptoms in recovering AD participants with insomnia more than placebo. The benefits of treating insomnia on drinking outcomes are less apparent. PMID:21377144
Arnedt, J. Todd; Conroy, Deirdre A.; Armitage, Roseanne; Brower, Kirk J.
Objective: Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems. Method: This is the first randomized controlled trial to test directly whether cognitive-behavioraltherapy (CBT) could be augmented with the addition of a module targeting interpersonal…
Newman, Michelle G.; Castonguay, Louis G.; Borkovec, Thomas D.; Fisher, Aaron J.; Boswell, James F.; Szkodny, Lauren E.; Nordberg, Samuel S.
This study evaluated a treatment combining bupropion with a novel acceptance and relationship focused behavioral intervention based on the acceptance and relationship context (ARC) model. Three hundred and three smokers from a community sample were randomly assigned to bupropion, a widely used smoking cessation medication, or bupropion plus functional analytic psychotherapy (FAP) and acceptance and commitment therapy (ACT). Objective measures
Elizabeth V. Gifford; Barbara S. Kohlenberg; Steven C. Hayes; Heather M. Pierson; Melissa P. Piasecki; David O. Antonuccio; Kathleen M. Palm
The aims of the present study were: a) to examine associations between pre-treatment BMI, body dissatisfaction, perfectionism, alexithymia, and restraint, emotional and external eating behaviour in obese patients; b) to analyze the impact of the pre-treatment measures in psychological variables on the outcome of cognitive-behavioraltherapy (CBT) program; c) to test the effectiveness of rhythmic movement therapy (RMT) in the treatment of disordered eating behaviors and obesity with the CBT non-responders. At the first stage of treatment a total of 104 patients (32 males and 72 females, mean age was 37.6 +/- 6.7 years) self-referred or referred by professionals to CBT weight management program were selected at random. At the second stage 58 obese CBT-non-responders were randomly divided among the continuing CBT individual treatment group and RMT group. Control group was included. Results revealed that: a) significant associations existed between pre-treatment BMI, external eating and two dimensions of perfectionism, as well as between emotional and external eating and all dimensions of perfectionism, alexithymia and body image dissatisfaction; b) pre-treatment means of psychological variables significantly impacted the CBT program outcome; c). the efficacy of RMT approach for weight reduction as well as for the improvement of psychological status for CBT-non-responders was confirmed. PMID:23156940
Treatment resistant depression is common, persistent, and results in substantial functional and social impairment. This study describes the development and preliminary outcome evaluation of a dialectical behaviortherapy-based skills training group to treat depressive symptoms in adult outpatients for whom antidepressant medication had not produced remission. The 16-session, once-weekly group covered the 4 dialectical behaviortherapy skill sets: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Twenty-four patients with ongoing depressive symptoms despite stable, adequate medication treatment for major depressive disorder were randomly assigned to either the skills group or a wait-list condition. The depressive symptoms of participants who completed the study (9 wait-list participants, 10 skills group participants) were compared using a clinician-rated Hamilton rating scale for depression and then replicated using a self-report measure Beck depression inventory. Clinician raters were blind to each participant's assigned study condition. Skills group participants showed significantly greater improvements in depressive symptoms compared with the control condition. Effect sizes were large for both measures of depression (Cohen's d = 1.45 for Hamilton rating scale for depression and 1.31 for Beck depression inventory), suggesting that larger scale trials are warranted. PMID:18277222
The study examined the effectiveness of Functional Family Therapy (FFT), as compared to probation services, in a community juvenile justice setting 12 months post treatment. The study also provides specific insight into the interactive effects of therapist model specific adherence and measures of youth risk and protective factors on behavioral outcomes for a diverse group of adolescents. The findings suggest that FFT was effective in reducing youth behavioral problems, although only when the therapists adhered to the treatment model. High adherent therapists delivering FFT had a statistically significant reduction of (35%) in felony, a (30%) violent crime, and a marginally significant reduction (21%) in misdemeanor recidivisms as compared to the control condition. The results represent a significant reduction in serious crimes one year after treatment, when delivered by a model adherent therapist. The low adherent therapists were significantly higher than the control group in recidivism rates. There was an interaction effect between youth risk level and therapist adherence demonstrating that the most difficult families (those with high peer and family risk) had a higher likelihood of successful outcomes when their therapist demonstrated model specific adherence. These results are discussed within the context of the need and importance of measuring and accounting for model specific adherence in the evaluation of community-based replications of evidence-based family therapy models like FFT. PMID:20545407
Progressive disruption of circadian rhythmicity associated with disturbance of the sleep-wake cycle is one of the most insidious symptoms of Huntington's disease (HD) and represents a critical management issue for both patients and their care takers. The R6/2 mouse model of HD shows a progressive disruption of the circadian rhythmicity at both behavioral and molecular levels, although the intrinsic cellular machinery that drives circadian rhythmicity in individual cells appears to be fundamentally intact. Circadian rhythms are controlled by a master clock located in the suprachiasmatic nuclei (SCN) and can be synchronized by light and non-photic factors such as exercise. Here, we aimed to test whether or not stimulating the SCN directly could prevent the loss of circadian rhythmicity in R6/2 mice. We used combinations of bright light therapy and voluntary exercise as our treatment regimes. We found that all treatments had some beneficial effects, as measured by delayed disintegration of the rest-activity rhythm and improved behavioral synchronization to the light-dark cycle. The best effects were observed in mice treated with a combination of bright light therapy and restricted periods of voluntary exercise. Neither the cause nor the consequence of deteriorating sleep-wake activity in HD patients is known. Nevertheless, our findings can be translated immediately to human patients with little cost or risk, since both light therapy and restricted exercise regimes are non-pharmacological interventions that are relatively easy to schedule. Improved circadian rhythmicity is likely to have beneficial knock-on effects on mood and general health in HD patients. Until effective treatments are found for HD, strategies that reduce deleterious effects of disordered physiology should be part of HD patient treatment programs. PMID:24269914
Objective: To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behaviortherapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Design: Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Setting: Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. Participants: One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). Interventions: A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Measurements: Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sleep. Results: The brief group-administered CBT-I program produced improvements in the timing and quality of sleep including later bedtimes, earlier out-of-bed times, reduced wake after sleep onset, and improved sleep efficiency. Participants also reported a reduction of the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. Conclusions: The treatment program used in the current study has demonstrated potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population. Citation: Lovato N; Lack L; Wright H; Kennaway DJ. Evaluation of a brief treatment program of cognitive behaviortherapy for insomnia in older adults. SLEEP 2014;37(1):117-126. PMID:24470701
Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J.
The objective of the study was to evaluate the effects of cognitive behavioraltherapy [sleep-related behavior modification and progressive muscle relaxation on insomnia of maintenance hemodialysis (MHD) patients] on improving insomnia of MHD patients. 103 MHD patients complicated with insomnia were randomly assigned to treatment (n = 52) and control (n = 51) groups. The control group was treated with conventional hemodialysis, and the treatment group was additionally treated with cognitive behavioraltherapy for 3 months (sleep-related behavior modification and progressive muscle relaxation). All cases were assessed by Symptom Checklist 90 (SCL-90) and Pittsburgh Sleep Quality Index (PSQI) before and 2, 4, 6, 8, 10, and 12 weeks after treatment. Fifty-one patients in the treatment group and 47 patients in the control group completed the experiments. After treatment, the total mean scores were (1.94 ± 0.50/2.29 ± 0.31); scores of somatization, depression, anxiety, hostility, and additional items were (1.87 ± 0.58/2.56 ± 0.26), (2.25 ± 0.80/2.79 ± 0.50), (1.79 ± 0.26/2.37 ± 0.34), (1.71 ± 0.46/2.25 ± 0.43), and (1.91 ± 0.67/2.26 ± 0.59) in SCL-90, respectively. The total scores for PSQI were (12.63 ± 2.27/16.40 ± 2.16); scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, hypnotics, and daytime dysfunction which were (1.98 ± 0.76/2.57 ± 0.58), (1.75 ± 0.59/2.60 ± 0.50), (2.10 ± 0.50/2.62 ± 0.53), (2.06 ± 0.47/2.57 ± 0.54), (2.04 ± 0.69/2.45 ± 0.72), (1.02 ± 0.79/1.51 ± 0.98), and (1.69 ± 0.55/2.09 ± 0.58), respectively, were significantly lower in the treatment group compared with the control group. However, there were no significant differences in the scores of factors of obsessive-compulsive (2.26 ± 0.62/2.32 ± 0.38), interpersonal sensitivity (2.23 ± 0.64/2.43 ± 0.47), phobic anxiety (1.98 ± 0.62/2.01 ± 0.67), paranoid ideation (1.55 ± 0.43/1.69 ± 0.39), and psychoticism (1.57 ± 0.46/1.66 ± 0.49). The conclusion is that sleep-related behavior modification in combination with progressive muscle relaxation effectively improved the mental state and sleep quality of MHD patients with insomnia. PMID:24577747
The purpose of this study was to examine how an after-school Education-oriented Music Therapy (EoMT) program can impact students’ emotional and behavioral problems and academic competency. The study implemented a 16-week music therapy program using music activities and interventions to promote academic, social, and emotional skills. The Social Skills Rating System (Gresham & Elliott, 1990); which measures social skills, academic
The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the agitated behaviors and social interactions of older adults with dementia were examined using the Cohen-Mansfield Agitation Inventory and the Animal-Assisted Therapy Flow Sheet. In a pilot study, 15 nursing home residents with dementia participated in a daily AAT intervention for three weeks. Results showed statistically significant decreases
Contingency management (CM) rapidly reduces cocaine use, but its effects subside after treatment. Cognitive-behavioraltherapy (CBT) produces reductions months after treatment. Combined, the 2 might be complementary. One hundred ninety-three cocaine-using methadone-maintained outpatients were randomly assigned to 12 weeks of group therapy (CBT or a control condition) and voucher availability (CM contingent on cocaine-negative urine or noncontingent). Follow-ups occurred 3,
David H. Epstein; Wesley E. Hawkins; Lino Covi; Annie Umbricht; Kenzie L. Preston
Individuals with cancer are disproportionately affected by sleep disturbance and insomnia relative to the general population. These problems can be a consequence of the psychological, behavioral, and physical effects of a cancer diagnosis and treatment. Insomnia often persists for years and, when combined with already high levels of cancer-related distress, may place cancer survivors at a higher risk of future physical and mental health problems and poorer quality of life. The recommended first-line treatment for insomnia is cognitive behavioraltherapy for insomnia (CBT-I), a non-pharmacological treatment that incorporates cognitive and behavior-change techniques and targets dysfunctional attitudes, beliefs, and habits involving sleep. This article presents a comprehensive review of the literature examining the efficacy of CBT-I on sleep and psychological outcomes in cancer patients and survivors. The search revealed 12 studies (four uncontrolled, eight controlled) that evaluated the effects of CBT-I in cancer patients or survivors. Results suggest that CBT-I is associated with statistically and clinically significant improvements in subjective sleep outcomes in patients with cancer. CBT-I may also improve mood, fatigue, and overall quality of life, and can be successfully delivered through a variety of treatment modalities, making it possible to reach a broader range of patients who may not have access to more traditional programs. Future research in this area should focus on the translation of evidence into clinical practice in order to increase awareness and access to effective insomnia treatment in cancer care. PMID:24971014
Background: Infertility has been described as creating a form of stress leading to a variety of psychological problems. Both psychotherapy and pharmacotherapy are effective treatments for infertility stress. The aim of this study was to evaluate the effectiveness of cognitive behavioraltherapy along with fluoxetine for improvement infertility stress in infertile women. Materials and Methods: In a randomized controlled clinical trial, 89 infertile women with mild to moderate depression (Beck scores 10-47) were recruited into the following three groups: i. cognitive behaviortherapy (CBT), ii. antidepressant therapy, and iii. control group. Twenty-nine participants in the CBT method received gradual relaxation training, restructuring, and eliminating of negative automatic thoughts and dysfunctional attitudes to infertility for 10 sessions. Thirty participants in the pharmacotherapy group took 20 mg fluoxetine daily for 90 days. Thirty individuals in control group did not receive any intervention. All participants completed fertility problem inventory (FPI) and the Beck Depression Inventory (BDI) at the beginning and end of the study. We applied Chi-square paired t test, ANOVA and Turkey’s test to analyze the data. Results: The mean of the infertility stress scores in CBT, fluoxetine, and control groups at the beginning and end of the study were as follows, respectively: 3.5 ± 0.62 vs.2.7 ± 0.62 (p<0.05), 3.5 ± 0.53 vs.3.2 ± 4.4 (p<0.05), and 3.4 ± 0.55 vs. 3.5 ± 0.48. In CBT group, the mean scores of social concern, sexual concern, marital concern, rejection of child-free lifestyle, and need for parenthood decreased meaningfully compared to those before starting the therapy. But in fluoxetine group, mean score of women sexual concern out of those five main problems of infertility reduced significantly. Also, fluoxetine and CBT reduced depression compared to the control group. Conclusion: CBT improved the social concerns, sexual concerns, marital concerns, rejection of child-free lifestyle, and need for parenthood more than floxitine group. Thus, CBT was not only a reliable alternative to pharmacotherapy, but also superior to fluoxetine in resolving and reducing of infertility stress (Registration Number: IRCT2012061710048N1). PMID:24520487
The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV transmission risk behavior were assessed in a sample of 1,388 South Africans infected with HIV and receiving ART in 16 clinics in KwaZulu-Natal, South Africa. Results confirmed the assumptions of the IMB model and demonstrated that HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV transmission risk behavior in this population. Subanalyses confirmed these relationships for HIV transmission risk behavior overall and for HIV transmission risk behavior with partners perceived to be HIV-negative or HIV-status unknown. A consistent pattern of gender differences showed that for men, HIV prevention information and HIV prevention motivation may have direct links with HIV preventive behavior, while for women, the effects of HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV preventive behavior. These IMB model-based findings suggest directions for HIV prevention interventions with South African men and women living with HIV and on ART as an important component of overall strategies to contain South Africa’s generalized HIV epidemic. PMID:23477576
Kiene, Susan M.; Fisher, William A.; Shuper, Paul A.; Cornman, Deborah H.; Christie, Sarah; MacDonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D.
Background Attention bias for socially threatening information, an empirically supported phenomenon, figures prominently in models of social phobia. However, all published studies examining this topic to date have relied on group means to describe attention bias patterns; research has yet to examine potential subgroups of attention bias among individuals with social phobia (e.g., vigilant or avoidant). Furthermore, almost no research has examined how attention biases in either direction may predict change in symptoms as a result of treatment. Methods This study (N=24) compared responses to cognitive behavioraltherapy (CBT) for social phobia between individuals with avoidant and vigilant biases for threatening faces at pretreatment. Results Participants with avoidant biases reported significantly and clinically higher symptom levels at posttreatment than did those with vigilant biases. Conclusions These findings suggest that an avoidant attention bias may be associated with reduced response to CBT for social phobia. PMID:21308888
Co-occurring posttraumatic stress disorder (PTSD) is prevalent in addiction treatment programs and a risk factor for negative outcomes. Although interventions have been developed to address substance use and PTSD, treatment options are needed that are effective, well tolerated by patients, and potentially integrated with existing program services. This paper describes a cognitive behavioraltherapy (CBT) for PTSD that was adapted from a treatment for persons with severe mental illnesses and PTSD in community mental health settings. The new adaptation is for patients in community addiction treatment with co-occurring PTSD and substance use disorders. In this study, 5 community therapists delivered the CBT for PTSD. Outcome data are available on 11 patients who were assessed at baseline, post-CBT treatment, and at a 3-month follow-up post-treatment. Primary outcomes were substance use, PTSD severity, and retention, of which all were favorable for patients receiving the CBT for PTSD. PMID:19395179
McGovern, Mark P.; Lambert-Harris, Chantal; Acquilano, Stephanie; Xie, Haiyi; Alterman, Arthur I.; Weiss, Roger D.
This article reviews the brief strategic family therapy (BSFT; J. Szapocznik, M. A. Scopetta, & O. E. King, 1978, The effect and degree of treatment comprehensiveness with a Latino drug abusing population. In D. E. Smith, S. M. Anderson, M. Burton, N. Gotlieb, W. Harvey, & T. Chung, Eds, A multicultural view of drug abuse, pp. 563–573, Cambridge, MA: G. K. Hall & J. Szapocznik, M. A. Scopetta, & O. E. King, 1978, Theory and practice in matching treatment to the special characteristics and problems of Cuban immigrants, Journal of Community Psychology, 6, 112–122.) approach to treating adolescent drug abuse and related problem behaviors. The treatment intervention is reviewed, including specialized features such as engagement of difficult families. Empirical evidence supporting the BSFT approach is presented. We then illustrate ways in which clinicians can use the model with troubled families whose adolescents may be at risk for drug use and HIV. Finally, future directions for BSFT research are described. PMID:23936750
Szapocznik, Jose; Schwartz, Seth J.; Muir, Joan A.; Brown, C. Hendricks
State mental health systems are actively seeking to disseminate empirically supported treatment approaches to improve the outcomes of adults with serious mental illnesses. However, many of these interventions have not been studied within public mental health settings. Cognitive behavioraltherapy (CBT) has been shown to be effective for major depression in well-controlled trials, but its effectiveness in public mental health settings is less known. The present study examines the feasibility of dissemination of CBT in the Texas public mental health system. Seven clinicians were trained by a CBT expert and supervised for 5 months, during which time their skills approached competency levels of therapists in randomized controlled trials. Forty clients were treated during the therapists' training phase, attending an average of ten sessions and experiencing a significant reduction in depressive symptoms. Study results are compared with previously published studies of CBT. PMID:20162373
Although strong evidence supports cognitive-behavioraltherapy for late-life depression and depression in racial and ethnic minorities, there are no empirical studies on the treatment of depression in older sexual minorities. Three distinct literatures were tapped to create a depression treatment protocol for an older gay male. Interventions were deduced from the late-life depression literature, culturally adapted CBT protocols for racial minorities, and the emerging social and developmental psychological theories for lesbian, gay, and bisexual populations. Specific treatment interventions, processes, and outcomes are described to illustrate how these literatures may be used to provide more culturally appropriate and effective health care for the growing, older sexual minority population. PMID:23144559
Research has demonstrated the effectiveness of both individual and group cognitive behaviortherapy (CBT) programs for social anxiety disorder (SAD) with patients in many countries. The present preliminary study reports the effectiveness of individual CBT for Japanese patients with SAD. Fifteen outpatients diagnosed with SAD completed an individual CBT program of six 50-min sessions with several components, including cognitive restructuring to modify cost and probability bias, repeated speech exposure, and homework about idiosyncratic anxiety-provoking situations. The results show that SAD symptoms improved after completion of the program. Large effect sizes were found for cognitive factors of SAD. In addition, repeated speech exposure was highly effective for improving the self-perception of subjective anxiety. The present findings suggest that an individual CBT program can be effective for reducing SAD symptoms with Japanese patients. PMID:24219020
Understanding the onset and course of sudden gains in treatment provides clinical information to the patient and clinician, and encourages clinicians to strive for these sudden clinical gains with their patients. This study characterizes the occurrence of sudden gains with Behavioral Activation (BA; Martell, Addis, & Jacobson, 2001), and the extent to which pre-treatment dysfunctional depressive thinking predicts sudden gains during treatment. We enrolled a sample of adults (n = 42) between ages 18–65 diagnosed with primary Major Depressive Disorder. All participants completed a 16-week course of BA, with clinical and self-report assessments at pre-, mid- and post-treatment. Results indicated that sudden gain and non-sudden gain participants showed differential improvement across treatment. No significant effects emerged for the dysfunctional cognitive style as a predictor of sudden gain status. Sudden gains may result from interaction of non-specific factors with the BA techniques implemented during early phases of therapy. PMID:22336434
The term childhood traumatic grief (CTG) is being increasingly used to refer to the particular reaction in children that may follow the death of a loved one during a traumatic event. The goal of this case study is to describe the theoretical argument and framework for, as well as a clinical example of, cognitive-behavioraltherapy (CBT) for CTG. We present a case of a five-year-old boy whose father, a firefighter, died in the line of duty at the World Trade Center on September 11, 2001. This specific case will highlight the steps of CBT for CTG, the value of assessment during the therapeutic process, and the need to consider developmental and family factors in treatment. PMID:15371061
Brown, Elissa J; Pearlman, Michelle Y; Goodman, Robin F
Among the challenges facing the mental health field are the dissemination and implementation of evidence-based practices. The present study investigated the relationships between inner context variables (i.e., adopter characteristics and individual perceptions of intra-organizational factors) and two implementation outcomes-independently rated therapist fidelity on a performance-based role-play (i.e., adherence and skill) and self-reported penetration of cognitive behavioraltherapy for youth anxiety following training. A significant relationship was found between inner context variables and fidelity. Specifically, adopter characteristics were associated with adherence and skill; individual perceptions of intra-organizational factors were associated with adherence. Inner context variables were not associated with penetration. Future directions are discussed. PMID:24202067
We conducted a two-phase study to develop and evaluate the psychometric properties of an instrument to identify barriers to Cognitive BehavioralTherapy (CBT) homework completion in a depressed sample. In Phase I, we developed an item pool by interviewing 20 depressed patients and 20 CBT therapists. In Phase II, we created and administered a draft instrument to 56 people with depression. Exploratory Factor Analysis revealed a 2-factor oblique solution of “Patient Factors” and “Therapy/Task Factors.” Internal consistency coefficients ranged from .80 to .95. Temporal stability was demonstrated through Pearson correlations of .72 (for the therapist/task subscale) to .95 (for the patient subscale) over periods of time that ranged from 2 days to 3 weeks. The patient subscale was able to satisfactorily classify patients (75 to 79 %) with low and high adherence at both sessions. Specificity was .66 at both time points. Sensitivity was .80 at sessions B and .77 at session C. There were no consistent predictors of assignment compliance when measured by the Assignment Compliance Rating Scale (Primakoff, Epstein, & Covi, 1986). The Rating Scale and subscale scores did, however, correlate significantly with assignment non-compliance (.32 to .46). PMID:24049556
Callan, Judith A.; Dunbar-Jacob, Jacqueline; Sereika, Susan M.; Stone, Clement; Fasiczka, Amy; Jarrett, Robin B.; Thase, Michael E.
This article reviews the current state of empirical research on the purported "new wave" of cognitive behavioraltherapy (CBT). A particular emphasis is given to mindfulness-based treatments and acceptance and commitment therapy (ACT). Mindfulness-based approaches and ACT are evaluated with regard to their efficacy and comparison with traditional CBT. Deviations from CBT are explained within the context of theory, specifically in terms of the role of cognitions. These differences, however, are not irreconcilable in requiring a separate classification of "new wave" treatments. While subtle and important differences on the theoretical and procedural level might exist, available data do not favor one treatment over another, and do not suggest differential mechanisms of action that warrant a dramatic separation from the CBT family of approaches. Instead, the "new wave" treatments are consistent with the CBT approach, which refers to a family of interventions rather than a single treatment. Thus, the term "new wave" is potentially misleading because it is not an accurate reflection of the contemporary literature. PMID:20599141
In recent years, a growing number of behavior therapists have expressed concern over the current state of the behavioraltherapy movement. Some of the major problems raised center on current overload and fractionization, the lack of a coherent overall picture, the loss of identity, and the influx of cognitivism. In an attempt to enhance understanding of the factors responsible for the current crises in the behaviortherapy field, the author provides a historical overview of the behavioral movement from its original conception to its current state. An argument is made that the solution to the afore-mentioned problems resides in the readoption of the underlying philosophy of science that originally gave birth and purpose to the field. PMID:10363350
This preliminary investigation examined the efficacy of a game-based cognitive-behavioraltherapy group program for elementary school-aged children who have experienced sexual abuse. Treatment aimed to improve: (a) internalizing symptoms, (b) externalizing behaviors, (c) sexually inappropriate behaviors, (d) social skills deficits, (e) self-esteem problems, and (f) knowledge of healthy sexuality and self-protection skills. Results indicate that game-based cognitive-behavioraltherapy was effective
Justin R. Misurell; Craig Springer; Warren W. Tryon
Social anxiety disorder (SAD) frequently co-occurs with substance use disorders (SUDs). Although the efficacy of separate\\u000a cognitive behavioral treatments for each disorder has been widely documented, there is a dearth of studies investigating treatment\\u000a outcome for patients with co-existing SAD and SUDs. This paper presents preliminary data from a pilot study that investigated\\u000a whether cognitive behavioral group therapy—modified to explicitly
Aims To evaluate the changes over time in quality and quantity of coping skills acquired following cognitive behavioraltherapy (CBT), and examine potential mediating effects on substance use outcomes. Design A randomized controlled trial (RCT) evaluating the effectiveness of a computerized version of CBT (CBT4CBT) as an adjunct to standard outpatient treatment over an 8-week period. Setting Data were collected from individuals seeking treatment for substance dependence in an outpatient community setting. Participants Fifty-two substance abusing individuals (50% African American), with an average age of 42 years, and a majority reporting cocaine as their primary drug of choice. Measurements Participants’ responses to behavioral role-plays of situations associated with high risk for drug and alcohol use were audio-taped and independently rated to assess their coping responses. Findings There were statistically significant increases in mean ratings of the quality of participants’ coping responses for those assigned to CBT4CBT compared to treatment as usual, and these differences remained significant three months after treatment completion. Moreover, quality of coping responses mediated the effect of treatment on participants’ duration of abstinence during the follow-up period. Conclusions These findings suggest that assignment to the computerized CBT program improved participants’ coping skills, as measured by independent ratings of a role playing task. It is also the first study to test and support quality of coping skills acquired as a mediator of the effect of CBT for substance use. PMID:20854334
Kiluk, Brian D.; Nich, Charla; Babuscio, Theresa; Carroll, Kathleen M.
Background: Emotion-focused cognitive behavioraltherapy (ECBT) is a new form of CBT with emotion regulation components. This form of treatment is suggested to be employed to improve dysregulation of anxiety and other kind of emotions in anxious children. This study observed and compared the effectiveness of CBT and ECBT on anxiety symptoms; sadness and anger management; and cognitive emotion regulation strategies in children with separation anxiety disorder (SAD). Materials and Methods: This study is a randomized clinical trial. Subjects were 30 children from 9 to 13-years-old (15 girls and 15 boys) with diagnosis of SAD, being randomly assigned to CBT, ECBT, and control groups (five girls and five boys in each group). Subject children in CBT group participated in 10-h weekly sessions within Coping Cat manual; whereas, subject children in ECBT group contributed in 12-h weekly sessions within ECBT. The control group received no treatment. The Screen for Child Anxiety Related Emotional Disorders (SCARED; child and parent forms), Children's Emotion Management Scale (CEMS; anger and sadness forms), and Cognitive Emotion Regulation Questionnaire (CERQ) tests administered to all subjects in pretest, posttest, and the follow-up measurement (3 months later). Analysis of covariance (ANCOVA) repeated measure and Kruskal-Wallis were applied to analyze data by Statistical Package for Social Sciences (SPSS) software package (v. 20). Results: CBT and ECBT; demonstrated no significant difference in reducing separation anxiety and total anxiety symptoms from parent and children's reports. ECBT effectively increased anger coping and decreased negative cognitive strategies and dysregulation of anger in children, both in posttest and follow-up. Also, ECBT reduced sadness dysregulation and increased sadness coping, though these significant advantages were lost in 3 months later follow-up. CBT reduced negative cognitive strategies in follow-up and increased sadness coping in posttest. None of treatments affected on anger and sadness inhibition and positive cognitive coping in separation anxious children. Conclusion: ECBT, in comparison with CBT; effectively improved emotion regulation strategies in children with separation anxiety. PMID:24949029
Objective: To examine the efficacy of exposure-based cognitive-behavioraltherapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD). Method: A total of 71…
Piacentini, John; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Peris, Tara; Wood, Jeffrey J.; McCracken, James
This article presents results of a randomized controlled trial examining the efficacy of Parent–Child Interaction Therapy (PCIT) for treating disruptive behaviors of young children (ages 3 to 6) with mental retardation (MR) and comorbid oppositional defiant disorder. Thirty families were randomly assigned to an immediate treatment (IT) or waitlist (WL) control group. Results indicated that IT mothers interacted more positively
THE PRESENT STUDY WAS DESIGNED TO DETERMINE WITHIN GROUP PLAY THERAPY--(1) THE COMBINATION OF EXPERIENCES WHICH PRODUCE THE GREATEST CHANGE IN BEHAVIORS AND THE EMOTIONAL STATE, AND (2) WHETHER TREATMENT INCLUDING TANGIBLE REWARDS PRODUCE MORE CHANGE THAN TREATMENT EXCLUDING THEM. THE 11 THIRD-GRADE BOYS REFERRED BY TEACHERS BECAUSE OF THEIR SHY,…
Depression affects at least 11 million Americans per year and costs the U.S. economy an estimated 44 billion dollars annually. Comprehensive review of the existing sci- entific evidence suggests that psychotherapy, particularly cognitive behaviortherapy (CBT), is at least as effective as medication in the treatment of depression, even if severe (Antonuccio, Danton, & DeNelsky, 1995). These conclusions hold for
David O. Antonuccio; Michael Thomas; William G. Danton
This study evaluated the effects of alcohol-focused spouse involvement and behavioral couples therapy (BCT) in group drinking reduction treatment for male problem drinkers. Sixty-four male clients and their female partners were randomly assigned to 1 of 3 conditions: treatment for problem drinkers only (PDO), couples alcohol-focused treatment, or…
Follow-up data across 2 years were obtained on 130 of 134 couples who were originally part of a randomized clinical trial comparing traditional versus integrative behavioral couple therapy (TBCT vs. IBCT; A. Christensen et al., 2004). Both treatments produced similar levels of clinically significant improvement at 2 years posttreatment (69% of…
Christensen, Andrew; Atkins, David C.; Yi, Jean; Baucom, Donald H.; George, William H.
This study examines the use of cognitive-behavioraltherapy (CBT) for the treatment of separation anxiety disorder (SAD) in a six-year-old boy who was having at least one panic attack a day. It uses a four-phased program that includes a psychoeducational approach. The outcome studies demonstrated how CBT shows promise as a treatment modality with…
Research shows poor decision making in adolescents who self-harm and a positive correlation between decision-making abilities and duration since last self-harm episode. This exploratory study investigated whether decision making in self-harming adolescents could be improved through treatment with a novel cognitive behaviortherapy (CBT). It also…
Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive-behavioraltherapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory-II, Six-Item Hamilton Rating Scale…
McBride, Carolina; Atkinson, Leslie; Quilty, Lena C.; Bagby, R. Michael
Objective: In this study, the authors examined the feasibility and effectiveness of training community therapists to deliver cognitive behaviortherapy (CBT) for depression. Method: Participants were therapists (n = 12) and clients (n = 116; mean age = 41 years, 63% women) presenting for treatment of depression at a not-for-profit and designated…
Simons, Anne D.; Padesky, Christine A.; Montemarano, Jeremy; Lewis, Cara C.; Murakami, Jessica; Lamb, Kristen; DeVinney, Sharon; Reid, Mark; Smith, David A.; Beck, Aaron T.
Relatively little is known about the efficacy of clinically inexperienced student therapists carrying out cognitive behaviortherapy (CBT) under supervision during a professional, psychologist training program. The current study evaluated this by collecting pre- and post-treatment data on 591 consecutive patients receiving treatment at the…
Objective: This study tested the comparative effectiveness of modified behavioral self-control therapy (MBSCT) and naltrexone (NTX), as well as the added benefit of combining the 2, in problem drinking men who have sex with men (MSM) seeking to reduce but not quit drinking. Method: Participants (N = 200) were recruited and urn randomized to 1 of 2…
Morgenstern, Jon; Kuerbis, Alexis N.; Chen, Andrew C.; Kahler, Christopher W.; Bux, Donald A., Jr.; Kranzler, Henry R.
Objective: To examine the relative efficacy of intensive versus weekly cognitive-behavioraltherapy (CBT) for children and adolescents with obsessive-compulsive disorder (OCD). Method: Forty children and adolescents with OCD (range 7-17 years) were randomized to receive 14 sessions of weekly or intensive (daily psychotherapy sessions) family-based…
Storch, Eric A.; Geffken, Gary R.; Merlo, Lisa J.; Mann, Giselle; Duke, Danny; Munson, Melissa; Adkins, Jennifer; Grabill, Kristen M.; Murphy, Tanya K.; Goodman, Wayne K.
Objective: To examine the efficacy of a developmentally appropriate parent-child cognitive behavioraltherapy (CBT) protocol for anxiety disorders in children ages 4-7 years. Method: Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were…
Hirshfeld-Becker, Dina R.; Masek, Bruce; Henin, Aude; Blakely, Lauren Raezer; Pollock-Wurman, Rachel A.; McQuade, Julia; DePetrillo, Lillian; Briesch, Jacquelyn; Ollendick, Thomas H.; Rosenbaum, Jerrold F.; Biederman, Joseph
The present study investigated the impact of comorbidity over and above the impact of symptom severity on treatment outcome of Cognitive BehavioralTherapy for children with anxiety disorders. Children (aged 8-12, n = 124) diagnosed with an anxiety disorder were treated with a short-term CBT protocol. Severity was assessed with a composite measure…
Liber, Juliette Margo; van Widenfelt, Brigit M.; van der Leeden, Adelinde J. M.; Goedhart, Arnold W.; Utens, Elisabeth M. W. J.; Treffers, Philip D. A.
Objective: Research has focused on 2 different approaches to answering the question, "Which clients will respond to cognitive behavioraltherapy (CBT) for depression?" One approach focuses on rates of symptom change within the 1st few weeks of treatment, whereas the 2nd approach looks to pretreatment client variables (e.g., hopelessness) to…
Objective: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioraltherapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method: A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57%…
Goldin, Philippe R.; Ziv, Michal; Jazaieri, Hooria; Werner, Kelly; Kraemer, Helena; Heimberg, Richard G.; Gross, James J.
This article presents results of a randomized controlled trial examining the efficacy of Parent-Child Interaction Therapy (PCIT) for treating disruptive behaviors of young children (ages 3 to 6) with mental retardation (MR) and comorbid oppositional defiant disorder. Thirty families were randomly assigned to an immediate treatment (IT) or waitlist…
Brief intensive cognitive-behavioraltherapy (CBT) using exposure and response prevention significantly improves obsessive-compulsive disorder (OCD) symptoms in as little as 4 weeks. However, it has been thought that much longer treatment was needed to produce the changes in brain function seen in neuroimaging studies of OCD. We sought to elucidate the brain mediation of response to brief intensive CBT for
Sanjaya Saxena; E Gorbis; J O'Neill; S K Baker; M A Mandelkern; K M Maidment; S Chang; N Salamon; A L Brody; J M Schwartz; E D London
Body image change is an important component of the treatment of eating disorders, and cognitive behavioral body image therapy has substantial empirical support as efficacious in the improvement of body image difficulties and disorders. Most evidence comes from randomized, controlled, outcome studies and does not examine effectiveness for persons with clinical eating disorders in the context of “usual care” settings.
In this paper, we present a client with panic disorder and agoraphobia who relapses following a full course of cognitive behavioraltherapy (CBT). To frame the client's treatment, the major components of CBT for panic disorder with or without agoraphobia (PD/A) are reviewed. Likely reasons for the treatment's failure and strategies for improving…
Background: Children with high-functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety. Anxiety can adversely impact functioning across school, home and community environments. Cognitive behavioraltherapies (CBT) are frequently used with success for children with anxiety symptoms. Modified CBT interventions…
Reaven, Judy; Blakeley-Smith, Audrey; Culhane-Shelburne, Kathy; Hepburn, Susan
The purpose of this study was to assess the cognitive skills of children with autism spectrum disorders (ASD) thought to be necessary for Cognitive BehavioralTherapy (CBT). Forty children with ASD and forty age-matched typically developing children between the ages of 7-12 years participated. Groups were comparable with regard to nonverbal IQ,…
Lickel, Athena; MacLean, William E., Jr.; Blakeley-Smith, Audrey; Hepburn, Susan
Objective: To provide preliminary estimates of the effectiveness of cognitive-behavioraltherapy (CBT) in treating pediatric obsessive-compulsive disorder (OCD) of the pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS) subtype. Method: Seven children with OCD of the PANDAS subtype (range 9-13 years) were treated…
Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Mann, Giselle; Adkins, Jennifer; Merlo, Lisa J.; Duke, Danny; Munson, Melissa; Swaine, Zoe; Goodman, Wayne K.
Pathological gambling is a widespread problem with major implications for society and the individual. There are effective treatments, but little is known about the relative effectiveness of different treatments. The aim of this study was to test the effectiveness of motivational interviewing, cognitive behavioral group therapy, and a no-treatment control (wait-list) in the treatment of pathological gambling. This was done
Per Carlbring; Jakob Jonsson; Henrik Josephson; Lars Forsberg
Background Behavioral family systems therapy (BFST) for adolescents with diabetes has improved family relationships and communication, but effects on adherence and metabolic con- trol were weak. We evaluated a revised intervention, BFST for diabetes (BFST-D). Methods One hundred and four families were randomized to standard care (SC) or to 12 sessions of either an educational support group (ES) or a
Tim Wysocki; Michael A. Harris; Lisa M. Buckloh; Deborah Mertlich; Amanda Sobel Lochrie; Alexandra Taylor; Michelle Sadler; Nelly Mauras; Neil H. White
This study examined the relationships between acceptance of the treatment rationale (ATR), homework compliance, and change during cognitive-behavioraltherapy (CBT) for depression. By evaluating the associations between these variables over time it was possible to compare competing theories of change in CBT. Clients meeting criteria for major depression (N = 150) were assessed longitudinally for their reaction to the treatment
This case study describes a developmentally delayed 4-year-old and examines behavioral changes that occurred in occupational therapy using sensory integration (SI) techniques. The use of play observation to measure change following SI treatment is discussed, and the relevance of qualitative methodologies to collecting data on play is demonstrated.…