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
Objective: The objective was to quantitatively and qualitatively examine the efficacy of DBT (e.g., decreasing life-threatening suicidal and parasuicidal acts, attrition, and depression) explicitly with borderline personality disorder (BPD) and using conservative assumptions and criteria, across treatment providers and settings. Method: Five…
Panos, Patrick T.; Jackson, John W.; Hasan, Omar; Panos, Angelea
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
University training clinics offer state-of-the-art treatment opportunities for clients, particularly for underserved and underinsured client populations. Little has been published regarding the implementation of Dialectical BehaviorTherapy (DBT) in settings such as a university training clinic, which may face challenges in utilizing such a…
Kerr, Patrick L.; Muehlenkamp, Jennifer J.; Larsen, Margo Adams
Dialectical behaviortherapy (DBT) has become a widely used treatment model for individuals with borderline personality disorder (BPD) and other individuals with significant emotion dysregulation problems. Despite its strong empirical support, DBT obviously does not have positive outcomes for all individuals. It is critical that cases of DBT…
Objective: The authors describe the first 6 months of a dialectical behaviortherapy (DBT) clinic operated by trainees in a general adult psychiatry residency program. The purpose of this report is to provide a model for the creation and maintenance of a formalized resident DBT clinic. Methods: Residents participated in the DBT clinic, attended a…
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.
Objective: The authors describe the use of dialectical behaviortherapy (DBT) in treating borderline personality disorder during psychiatry residency, and assess the status of DBT education within psychiatry residencies in the United States. Method: The authors present a patient with borderline personality disorder treated by a resident using DBT,…
Sharma, Binali; Dunlop, Boadie W.; Ninan, Philip T.; Bradley, Rebekah
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…
Dialectical behaviortherapy (DBT) was originally developed for chronically suicidal adults with borderline personality disorder (BPD) and emotion dysregulation. Randomized controlled trials (RCTs) indicate DBT is associated with improvements in problem behaviors, including suicide ideation and behavior, non-suicidal self-injury (NSSI), attrition,…
MacPherson, Heather A.; Cheavens, Jennifer S.; Fristad, Mary A.
Filling a tremendous need, this highly practical book adapts the proven techniques of dialectical behaviortherapy (DBT) to treatment of multiproblem adolescents at highest risk for suicidal behavior and self-injury. The authors are master clinicians who take the reader step by step through understanding and assessing severe emotional…
Miller, Alec L.; Rathus, Jill H.; Linehan, Marsha M.
Dialectical behaviortherapy (DBT) is an evidence-based treatment that is considered to be the standard of care in treating individuals with BPD, however there have been few published studies to identify the challenges and solutions for implementing DBT in community-based settings. The current study identified the barriers and solutions within a system-wide roll-out of DBT within a large, urban public health system encompassing both mental health and substance abuse treatment settings. Qualitative interviews were conducted with 19 clinicians receiving DBT training over a period of 13 months. A content analysis revealed three themes that were identified as challenges to the DBT implementation process including program development and recruitment of patients, a lack of administrative support or organizational investment in DBT, and time commitment of DBT. In order to transfer DBT into a public behavioral health system, investment from both clinic- and system-level administrators is required. Strategies to prevent drift, such as incorporating a train-the-trainer model, are discussed. PMID:23754686
Carmel, Adam; Rose, Monica Leila; Fruzzetti, Alan E
Dialectical behaviortherapy (DBT) has been shown to be effective in randomized controlled trials with women with borderline personality disorder and histories of chronic self-inflicted injury including suicide attempts. The present study is a pre-post replication of a comprehensive DBT program in a community mental health center for individuals…
Comtois, Katherine Anne; Elwood, Lynn; Holdcraft, Laura C.; Smith, Wayne R.; Simpson, Tracy L.
Dialectical behaviortherapy (DBT), an empirically supported treatment for adult women diagnosed with borderline personality disorder (BPD), has been increasingly adapted for use with adolescents across a variety of settings. This article describes a community-based application of DBT principles and strategies for adolescents and their families.…
Objective: At present, the most frequently investigated psychosocial intervention for borderline personality disorder (BPD) is dialectical behaviortherapy (DBT). We conducted a meta-analysis to examine the efficacy and long-term effectiveness of DBT. Method: Systematic bibliographic research was undertaken to find relevant literature from online…
Kliem, Soren; Kroger, Christoph; Kosfelder, Joachim
This study tested the feasibility of using a psychoeducational video recording to teach a behavioral skill from the Dialectical BehaviorTherapy (DBT; Linehan, 1993a, 1993b) skills training program to individuals meeting criteria for borderline personality disorder. A video presenting a DBT emotion-regulation skill was developed and the extent to…
Waltz, Jennifer; Dimeff, Linda A.; Koerner, Kelly; Linehan, Marsha M.; Taylor, Laura; Miller, Christopher
Approximately one third of adults with intellectual and developmental disabilities have emotion dysregulation and challenging behaviors (CBs). Although research has not yet confirmed that existing treatments adequately reduce CBs in this population, dialectical behaviortherapy (DBT) holds promise, as it has been shown to effectively reduce CBs in other emotionally dysregulated populations. This longitudinal single-group pilot study examined whether individuals with impaired intellectual functioning would show reductions in CBs while receiving standard DBT individual therapy used in conjunction with the Skills System (DBT-SS), a DBT emotion regulation skills curriculum adapted for individuals with cognitive impairment. Forty adults with developmental disabilities (most of whom also had intellectual disabilities) and CBs, including histories of aggression, self-injury, sexual offending, or other CBs, participated in this study. Changes in their behaviors were monitored over 4 years while in DBT-SS. Large reductions in CBs were observed during the 4 years. These findings suggest that modified DBT holds promise for effectively treating individuals with intellectual and developmental disabilities. PMID:23914278
This study evaluated the efficacy of methods of training community mental health providers (N=132) in dialectical behaviortherapy (DBT) distress tolerance skills, including (a) Linehan's (1993a) Skills Training Manual for Borderline Personality Disorder (Manual), (b) a multimedia e-Learning course covering the same content (e-DBT), and (c) a…
Dimeff, Linda A.; Woodcock, Eric A.; Harned, Melanie S.; Beadnell, Blair
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.
Inpatient dialectical behaviortherapy (DBT) is an effective treatment for borderline personality disorder (BPD), but often treatment is ended prematurely and predictors of dropout are poorly understood. We, therefore, studied predictors of dropout among 60 women with BPD during inpatient DBT. Non-completers had higher experiential avoidance and trait anxiety at baseline, but fewer life-time suicide attempts than completers. There was a trend for more anger-hostility and perceived stigma among non-completers. Experiential avoidance and anxiety may be associated with dropout in inpatient DBT. Low life-time suicidality and high anger could reflect a subtype at risk for discontinuation of inpatient treatment. PMID:18299116
Rüsch, Nicolas; Schiel, Sarah; Corrigan, Patrick W; Leihener, Florian; Jacob, Gitta A; Olschewski, Manfred; Lieb, Klaus; Bohus, Martin
Objective: The present study explored 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…
Bedics, Jamie D.; Atkins, David C.; Comtois, Katherine A.; Linehan, Marsha M.
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
Evidence suggests that heightened negative affectivity is a prominent feature of Borderline Personality Disorder (BPD) that often leads to maladaptive behaviors. Nevertheless, there is little research examining treatment effects on the experience and expression of specific negative emotions. Dialectical BehaviorTherapy (DBT) is an effective treatment for BPD, hypothesized to reduce negative affectivity (Linehan, 1993a). The present study analyzes secondary data from a randomized controlled trial with the aim to assess the unique effectiveness of DBT when compared to Community Treatment by Experts (CTBE) in changing the experience, expression, and acceptance of negative emotions. Suicidal and/or self-injuring women with BPD (n = 101) were randomly assigned to DBT or CTBE for one year of treatment and one year of follow-up. Several indices of emotional experience and expression were assessed. Results indicate that DBT decreased experiential avoidance and expressed anger significantly more than CTBE. No differences between DBT and CTBE were found in improving guilt, shame, anxiety, or anger suppression, trait, and control. These results suggest that DBT has unique effects on improving the expression of anger and experiential avoidance, whereas changes in the experience of specific negative emotions may be accounted for by general factors associated with expert therapy. Implications of the findings are discussed. PMID:24418652
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. Family members were involved in
Harriet Salbach-Andrae; Inga Bohnekamp; Ernst Pfeiffer; Ulrike Lehmkuhl; Alec L. Miller
This study examines the effectiveness of Mode Deactivation Therapy, (MDT) and Dialectical BehaviorTherapy, (DBT) in a Residential Treatment Center for adolescent males. All clients were admitted to the same Residential Treatment Center. Clients presented with physical aggression, suicidal ideation, with mixed personality disorders/traits. One…
Apsche, Jack A.; Bass, Christopher K.; Houston, Marsha-Ann
A strain of dibenzothiophene (DBT) biodegradation bacteria Gordonia sp. WQ-01 was subjected to He–Ne laser (632.8nm) irradiation to improve the degradation ability. Under the optimum condition of output power of 20mW for 15min, a positive mutant strain WQ-01A was acquired. Intrinsic DBT biodegradation kinetics by resting cells of the wild strain WQ-01 and its mutant strain WQ-01A in aqueous phase
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.
This series of papers was presented in a symposium on behaviortherapy. Each paper represents a separate study focusing on one aspect of behavior modification. The issue of reinforcement is prominant with regard to its type and source. Methods of self-reinforcement and older-peer modeling are studied. The suggestion that subjects who reinforce…
This case study presents a theoretical analysis of implementing mode deactivation therapy (MDT) (Apsche & Ward Bailey, 2003) family therapy with a 13 year old Caucasian male. MDT is a form of cognitive behavioraltherapy (CBT) that combines the balance of dialectical behaviortherapy (DBT) (Linehan, 1993), the importance of perception from…
This thesis examines how perturbing selected adversary capabilities in a design basis threat (DBT) may affect the assessment of a facility's security system performance. We found that using a strictly defined DBT to design and analytically test...
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)
The primary aim of this article is to describe modifications made to Dialectical BehaviorTherapy (DBT) for a predominantly ethnic minority population of persons living with HIV/AIDS with substance-use diagnoses and borderline personality disorder (BPD) or three features of BPD plus suicidality (i.e., the triply diagnosed). Despite the myriad…
Wagner, Elizabeth E.; Miller, Alec L.; Greene, Lori I.; Winiarski, Mark G.
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 article addresses training issues in behaviortherapy. Methods and skills that are most important for affecting changes in client behavior are identified, and the progress that has been made in demon- strating that these skills can be taught effectively are reviewed. Among the skills discussed are the decision-making skills used to identify problems, to select appropriate interventions, and to
Cognitive behavioraltherapy (CBT) can help many people deal with chronic back pain. ... Nonspecific back pain - cognitive behavioral; Backache - chronic - ... - back - chronic - cognitive behavioral; Chronic back pain - low - ...
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
This study demonstrates the process of learning and shaping of behavior which occurs during a program of therapy for individuals with hyperfunctional hoarse voice quality. First a therapy program delineating the techniques and criteria to be used was written. The program was presented during 16 individual half-hour sessions over an eight-week period to three clients known to have vocal nodules. The clients' responses were charted at various points from audiotape recordings of each therapy session using a modification of the Boone-Prescott analysis system, to obtain data to demonstrate the learning processes. It was concluded that: (1) the client's behaviors in this vocal rehabilitation program reflected a learning process; (2) facilitating techniques were used to modify or shape behavior through successive approximations to the terminal goal; (3) self-evaluation is an important factor needed to bring about successful changes in behavior; (4) analysis of client's behaviors in relation to the learning process can aid in evaluating the effectiveness of the facilitating techniques; and (5) from such evaluation intraclient and interclient program changes are derived hopefully resulting in a greater success rate and maximum benefits from time spent in therapy. PMID:950799
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
Dialectical behaviortherapy, developed by Linehan to treat borderline personality disorder (8, 9), is currently the most comprehensive and empirically validated affect regu- lation treatment. In light of preliminary evidence of posi- tive findings from the application of dialectical behaviortherapy to bulimia nervosa (10-12), we conducted a ran- domized controlled study comparing the outcome of 20 weeks of dialectical
Debra L. Safer; Christy F. Telch; D. W. Stewart Agras
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.
In this article, I am concerned with the ethical foundations of behaviortherapy, that is, with the normative ethics and the meta-ethics underlying behaviortherapy. In particular, I am concerned with questions concerning the very possibilty of providing an ethical justification for things done in the context of therapy. Because behavior therapists must be able to provide an ethical justification for various actions (if the need arises), certain meta-ethical views widely accepted by behavior therapists must be abandoned; in particular, one must give up ethical subjectivism, ethical skepticism, and ethical relativism. An additional task is to show how it is possible to provide a nonsubjective, nonskeptical, and nonrelativistic moral justification for an ethical statement. Although this is a monumental task, I provide a rough sketch of such a model, one that is congenial to the value judgments underlying behaviortherapy. PMID:11651139
... Research News From NIH BehavioralTherapy, Incentives Enhance Addiction Treatment Past Issues / Summer 2006 Table of Contents ... that people who are trying to end their addiction to marijuana can benefit from a treatment program ...
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.
The development of evidence-based treatments for anxiety disorders is a major achievement of clinical psychology, and cognitive behaviortherapy is the best-established and most widely used method. The first form of this therapy, behaviortherapy, was a combination of Pavlovian and Behavioristic ideas and methods and was particularly successful in reducing fears. The infusion of cognitive ideas in the late 1970s generated the wider and more flexible cognitive behaviortherapy that independent agencies in the United States and United Kingdom now recommend as the treatment of choice for most of the anxiety disorders. Remaining theoretical problems and clinical limitations need to be tackled. PMID:19086834
Very few studies have examined the role of cognitive behaviortherapy (CBT) in the outpatient treatment of anorexia nervosa. This study used a randomized, controlled design to evaluate a 12-month, manual based program of CBT, with behavioral family therapy as the comparison group. Twenty-five adolescents and young adults with anorexia nervosa, currently living with their families, were recruited into the
There are many specific treatment approaches for insomnia that fall under the general category of cognitive-behavioraltherapy\\u000a (CBT). Therapies in this area have common elements: patients gain more control on sleep by modifying their sleep-wake schedules,\\u000a learning relaxation skills, changing sleep-related habits, and\\/or learning to decrease worry about sleep. These skills can\\u000a be taught in different ways. The specific CBT
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
Treatment trials for psychogenic nonepileptic seizures (PNES) are few, despite the high prevalence and disabling nature of the disorder. We evaluated the effect of cognitive behavioraltherapy (CBT) on reduction of PNES. Secondary measures included psychiatric symptom scales and psychosocial variables. We conducted a prospective clinical trial assessing the frequency of PNES in outpatients treated using a CBT for PNES
W. Curt LaFrance Jr.; Ivan W. Miller; Christine E. Ryan; Andrew S. Blum; David A. Solomon; Joan E. Kelley; Gabor I. Keitner
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…
There are few published randomized controlled trials examining treatment for symptoms of bulimia nervosa (BN) in adolescents. Additionally, many adolescents presenting for treatment for BN symptoms endorse co-occurring mood disturbances, suicidality, and nonsuicidal self-injury (NSSI), and may not meet full Diagnostic and Statistical Manual-IV-Text Revision (DSM-IV-TR) diagnostic criteria for BN. In addition to the limited number of randomized controlled trials, published treatment studies of BN symptoms in adolescence do not specifically address the multiple comorbid symptoms that these adolescents often report. The purpose of this pilot study was to examine the feasibility and effectiveness of an outpatient dialectical behaviortherapy (DBT) program for adolescents with symptoms of BN, suicide attempts, and NSSI. Ten eligible participants enrolled in the study; 3 dropped within 4 weeks of initiating treatment. In addition to binge eating and suicidal behavior, participants also endorsed a number of other comorbid mood disorders and substance abuse. Seven participants completed 6 months of treatment and 6-month follow-up assessments. Treatment included access to a crisis management system, individual therapy, skills training, and a therapist consultation team. At posttreatment, participants had significantly reduced self-harm; (Cohen's d = 1.35), frequency of objective binge episodes (Cohen's d = .46), frequency of purging (Cohen's d = .66), and Global Eating Disorder Examination scores (Cohen's d = .64). At follow-up, 6 participants were abstinent of NSSI; 3 participants were abstinent from binge eating. At follow-up, treatment gains were maintained and enhanced. Results indicate that it is feasible to address multiple forms of psychopathology during the treatment of BN symptoms in this age-group. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:24773094
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
Constraint-induced (CI) therapy is a term given to a family of efficacious neurorehabilitation treatments including to date: upper extremity CI movement therapy, lower extremity CI movement therapy, pediatric CI therapy, and CI aphasia therapy. The purpose of this article is to outline the behavior analysis origins of CI therapy and the ways in…
There is a strong impetus in the psychosis research field to develop interventions that aim to prevent the onset of psychotic disorders. Over the past 15 years there has been a tremendous development in the work aimed at understanding the pre-psychotic period. More recently there has been a focus on developing and testing treatments both pharmacological and psychological that could potentially prevent or delay the onset of psychosis. One of the psychological treatments that has received the most attention is cognitive behavioraltherapy (CBT). Relatively few trials have been completed and this paper reviews the existing trials. Implications of these trials for the treatment of this early phase as well as for designing future studies are discussed. PMID:22239588
Addington, Jean; Marshall, Catherine; French, Paul
There is a wealth of data indicating the effectiveness of cognitive behavioraltherapy in the treatment of bulimia nervosa. However, the best evidence indicates a treatment success rate of 50%. The purpose of this paper is to briefly describe cognitive behavioral treatment of bulimia nervosa and to offer suggestions on how this therapy approach may be tailored to best serve
The 9 members of the Institute for Rational-Emotive Therapy’s International Training Standards and Review Committee (of which\\u000a Albert Ellis is currently one) predict the status of Rational Emotive BehaviorTherapy (REBT) after the death of Albert Ellis,\\u000a its progenitor. Most respondents addressed whether REBT will exist in its own right or be subsumed under the broad umbrella\\u000a of Cognitive Behavior
Stephen G. Weinrach; Albert Ellis; Raymond DiGiuseppe; Michael E. Bernard; Windy Dryden; Howard Kassinove; G. Barry Morris; Ann Vernon; Janet Wolfe
"A History of the BehavioralTherapies" (O'Donohue, et al., 2001) contains no description of psychological behaviorism (PB) and the role it played as one of the foundations of behaviortherapy. This article indicates some of the contributions made by PB that make the missing chapter and related phenomena a major aberration in science. (Contains 39…
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…
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
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
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) present significant problems with behavioral disinhibition that often negatively affect their peer relationships. Although behaviortherapies for ADHD have traditionally aimed to help parents and teachers better manage children's ADHD-related behaviors, therapy processes seldom use peer relationships to implement evidence-based behavioral principles. This article introduces Structured Dyadic BehaviorTherapy as a milieu for introducing effective behavioral techniques within a socially meaningful context. Establishing collaborative behavioral goals, benchmarking, and redirection strategies are discussed to highlight how in-session dyadic processes can be used to promote more meaningful reinforcement and change for children with ADHD. Implications for improving patient care, access to care, and therapist training are also discussed. PMID:24377401
Although cognitive behavioral spectrum approaches with individual children are plentiful and demonstrate effectiveness, cognitive behaviorally oriented clinicians are frequently left to their own devices when it comes to treating families. Cognitive behavioral family therapy is a relatively recent development and there are precious few reports of its clinical use. This article presents a conceptual foundation and clinical rubrics for the
Cognitive behaviortherapy (CBT) is a form of nonpharmacologic treatment. It is based on a model of chronic fatigue syndrome (CFS) that hypothesizes that certain cognitions and behavior may perpetuate symptoms and disability–that is, act as obstacles to recovery. Treatment emphasizes self-help and aims to help the patient to recover by changing these unhelpful cognitions and behavior. There is now
Objective To compare the effectiveness of a continence pessary to evidence-based behavioraltherapy for stress incontinence and to assess whether combined pessary and behavioraltherapy is superior to single-modality therapy. Methods Multi-site, randomized clinical trial (“Ambulatory Treatments for Leakage Associated with Stress Incontinence” (ATLAS)) randomized 446 women with stress incontinence to pessary, behavioraltherapy, or combined treatment. Primary outcome measures, at 3months, were Patient Global Impression of Improvement (PGI-I) and the stress incontinence subscale of the Pelvic Floor Distress Inventory (PFDI). A priori, to be considered clinically superior, combination therapy had to be better than both single-modality therapies. Outcomes measures were repeated at 6 and 12 months. Primary analyses used intention-to-treat approach. Results At 3 months, 40% of the pessary group and 49% of the behavioral group were “much better” or “very much better” on PGI-I (p=0.09). Compared to the pessary group, more women in the behavioral group reported having no bothersome incontinence symptoms (49% vs. 33%, p=0.006) and treatment satisfaction (75% vs. 63%, p=0.02). Combination therapy was significantly better than pessary on PGI-I (53%, p=0.02) and PFDI (44%, p=0.05), but not better than behavioraltherapy; it was therefore not superior to single-modality therapy. Group differences were not sustained to12 months on any measure, and patient satisfaction remained above 50% for all treatment groups. Conclusions Behavioraltherapy resulted in greater patient satisfaction and fewer bothersome incontinence symptoms than pessary at 3 months, but differences did not persist to 12 months. Combination therapy was not superior to single-modality therapy. PMID:20177294
In some recent articles we developed a new systematic approach to generate solvable rational extensions of primary translationally shape invariant potentials. In this generalized SUSY QM partnership, the DBT are built on the excited states Riccati-Schr\\"odinger (RS) functions regularized via specific discrete symmetries of the considered potential. In the present paper, we prove that this scheme can be extended in a multistep formulation. Applying this scheme to the isotonic oscillator, we obtain new towers of regular rational extensions of this potential which are strictly isospectral to it. We give explicit expressions for their eigenstates which are associated to the recently discovered exceptional Laguerre polynomials and show explicitely that these extensions inherit of the shape invariance properties of the original potential.
behavioraltherapy (CBT) has a rich history of alleviating the suffering associated with mental disorders to a greater or lesser degree by different treatment packages but are still fundamentally common therapeutic
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,…
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)
This document applies the Cognitive-Behavioral Approach to grief counseling and grief therapy. Although most people are able to work through their grief with support from family and friends, some people may not want to burden loved ones with their loss. Grief counseling or grief therapy is best used by those individuals who need the opportunity to…
Many psychotherapeutic approaches have been developed for depression, among which behavioral and cognitive therapies have shown their effectiveness. These short-term therapies quickly improve symptoms and reduce the relapse rate by around 30%. This article reviews the main studies of behavioral and cognitive therapy in depressed patients. The results are discussed in terms of acceptability, feasibility, and efficacy. The study protocols, psychiatric symptoms, and endpoints are described. There is now a need to identify which patients are most likely to respond to these treatments. PMID:21171253
statements. Carl Rogers is considered also a pioneer and highly influential researcher on process therapy research (Hill & Corbett, 1993). In 1957, Rogers and his students and colleagues developed measures to assess therapy processes and test Rogerian...]) .................................................................................... 37 3 Response Mode Rates by Student Therapists in the Present Study, and by Student Therapists, Career Counselors, Brief Psychodynamic Therapists, Rogers, Perls, Ellis, Mental Health Professionals (MH), and Radio Talk Show...
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
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…
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
Dissociative identity disorder and borderline personality disorder resemble each other in trauma histories and comorbidity. Each disorder is frequently comorbid with the other. Treatment outcome data for Dialectical BehaviorTherapy of borderline personality disorder and Trauma Model Therapy of dissociative identity disorder are reviewed. The author proposes a psychotherapy treatment study in which there are three subject groups and two treatment conditions. The subject groups are borderline personality disorder without dissociative identity disorder; dissociative identity disorder without borderline personality disorder; and both conditions present concurrently. Subjects would be randomized to receive Dialectical BehaviorTherapy or Trauma Model Therapy. Such a study could provide answers to controversies in the field about a better treatment approach for dissociative identity disorder and potentially could broaden and strengthen the indications for Dialectical BehaviorTherapy. PMID:16173357
Cognitive behaviortherapy (CBT), problem-solving therapy (PST), or treatment as usual (TAU) were compared in the management of suicide attempters. Participants completed the Beck Hopelessness Scale, Beck Scale for Suicidal Ideation, Social Problem-Solving Inventory, and Client Satisfaction Questionnaire at pre- and posttreatment. Both CBT and PST…
Background The desulphurization of dibenzothiophene (DBT), a recalcitrant thiophenic fossil fuel component by Serratia marcescens (UCP 1549) in order for reducing the Sulphur content was investigated. The Study was carried out establishing the growth profile using Luria Bertani medium to different concentrations of DBT during 120 hours at 28°C, and orbital Shaker at 150 rpm. Results The results indicated that concentrations of DBT 0.5, 1.0 and 2.0 mM do not affected the growth of the bacterium. The DBT showed similar Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MCB) (3.68 mM). The desulphurization of DBT by S. marcescens was used with 96 hours of growth on 2 mM of DBT, and was determined by gas chromatography (GC) and GC-mass spectrometry. In order to study the desulphurization process by S. marcescens was observed the presence of a sulfur-free product at 16 hours of cultivation. Conclusions The data suggests the use of metabolic pathway “4S” by S. marcescens (UCP 1549) and formed biphenyl. The microbial desulphurization process by Serratia can be suggest significant reducing sulphur content in DBT, and showed promising potential for reduction of the sulfur content in diesel oil. PMID:22583489
Constraint-induced (CI) therapy is a term given to a family of efficacious neurorehabilitation treatments including to date: upper extremity CI movement therapy, lower extremity CI movement therapy, pediatric CI therapy, and CI aphasia therapy. The purpose of this article is to outline the behavior analysis origins of CI therapy and the ways in which its procedures incorporate behavior analysis methods and principles. The intervention is founded on the concept of learned nonuse, a mechanism now empirically demonstrated to exist, which occurs after many different types of damage to the central nervous system (CNS). It results from the dramatic alteration of the contingencies of reinforcement that results from substantial CNS damage and leads to a greater deficit than is warranted by the actual damage sustained. CI therapy produces a countervailing alteration in the contingencies of reinforcement. The intervention has been used successfully to substantially improve motor deficits after stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, with cerebral palsy in a pediatric population, and for language impairment in poststroke aphasia. The protocol of CI therapy consists primarily of standard behavior-analytic methods. It produces a marked plastic brain change that is correlated with its therapeutic effect, and therefore provides an example of the way in which behavior change can contribute to a profound remodeling of the brain. CI therapy may be viewed as an example of behavioral neurorehabilitation. PMID:23449867
The purpose of this paper is to provide an overview of behavioral and cognitive treatment approaches in the management of pathological gambling disorders. Disappointingly, the literature to date contains only one controlled outcome study in which two differing behavioral techniques were compared. Although research in general has focussed on identifying the nature of cognitive distortions in gambling, findings from these
Therapies that rely on written materials, information, or procedures involving familiarity with the dominant culture (e.g., colloquialisms, history) often pose barriers to people who use another language, have low English literacy, or are less familiar with the dominant culture. All this applies deaf individuals. One of the most well-validated…
The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables…
Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M.
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…
Studies of patient adherence to health behavior programs, such as physical exercise, smoking cessation, and diet, have resulted in the formulation and validation of the Transtheoretical Model (TTM) of behavior change. Although widely accepted as a guide for the development of health behavior interventions, this model has not been applied to vocal rehabilitation. Because resolution of vocal difficulties frequently depends on a patient's ability to make changes in vocal and health behaviors, the TTM may be a useful way to conceptualize voice behavior change processes, including the patient's readiness for change. The purpose of this paper is to apply the TTM to the voice therapy process to: (1) provide an organizing framework for understanding of behavior change in voice therapy, (2) explain how treatment adherence problems can arise, and (3) provide broad strategies to improve treatment adherence. Given the significant role of treatment adherence in treatment outcome, considering readiness for behavior change should be taken into account when planning treatment. Principles of health behavior change can aid speech pathologists in such understanding and estimating readiness for voice therapy. PMID:18082367
Summary Studies of patient adherence to health behavior programs, such as physical exercise, smoking cessation, and diet, have resulted in the formulation and validation of the Transtheoretical Model (TTM) of behavior change. Although widely accepted as a guide for the development of health behavior interventions, this model has not been applied to vocal rehabilitation. Because resolution of vocal difficulties frequently depends on a patient’s ability to make changes in vocal and health behaviors, the TTM may be a useful way to conceptualize voice behavior change processes, including the patient’s readiness for change. The purpose of this paper is to apply the TTM to the voice therapy process to: (1) provide an organizing framework for understanding of behavior change in voice therapy, (2) explain how treatment adherence problems can arise, and (3) provide broad strategies to improve treatment adherence. Given the significant role of treatment adherence in treatment outcome, considering readiness for behavior change should be taken into account when planning treatment. Principles of health behavior change can aid speech pathologists in such understanding and estimating readiness for voice therapy. PMID:18082367
The literature contains few reports of behaviortherapy used to treat compulsive gamblers. Desensitization (Draft, 1970),electrical aversion (Goorney, 1968; Seager, 1969),and a multifaceted approach including faradic shock, covert sensitization, massed practice, and time-out (Cotler, 1971)have been reported with mixed results. The increasing interest of behavior therapists in cognitive-symbolic mediation is well documented (Bandura, 1969; Mahoney, 1974; Meichenbaum, 1976);however, there are
This study examined whether insomnia persisted after completion of cognitive behavioraltherapy (CBT) for PTSD and whether persistence of insomnia was associated with continuing nightmares, vigilance, depression, childhood abuse history, or having been traumatized in a sleep-related context. A retrospective analysis of posttreatment Clinician-Administered PTSD Scale (CAPS) data from 27 patients who no longer met PTSD diagnosis following CBT for
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
Eight experts in Rational Emotive BehaviorTherapy (REBT) provide personal examples of their own successes and failures in applying REBT to themselves. The experts actively talked to themselves both rationally and irrationally. Rational self-talk was more prevalent in the examples of how REBT was successfully used by the experts. (GCP)
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.
This article describes the application of cognitive-behavioraltherapy (CBT) to the treatment of rapid cycling bipolar disorder. Between 10% and 24% of bipolar patients experience a rapid cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood-stabilizing medications, rapid cyclers are…
The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioraltherapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…
Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence
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.
Although several studies have examined the efficacy of Acceptance Enhanced BehaviorTherapy (AEBT) for the treatment of trichotillomania (TTM) in adults, data are limited with respect to the treatment of adolescents. Our case series illustrates the use of AEBT for TTM in the treatment of two adolescents. The AEBT protocol (Woods & Twohig, 2008) is…
Fine, Kathi M.; Walther, Michael R.; Joseph, Jessica M.; Robinson, Jordan; Ricketts, Emily J.; Bowe, William E.; Woods, Douglas W.
The thrust of this review article is the impact of our professional and scientific writing on the reputation and growth of the field of behaviortherapy. How the field is being represented and how it is perceived depend largely on what is communicated to both the scientific and professional communities and the lay public. The writing must do justice to
Objective: A brief cognitive behavioraltherapy (CBT) group intervention was designed to treat comorbid anxiety, depression, and low self-esteem and self-efficacy in adults with ADHD. It was hypothesised that participants would gain knowledge about ADHD, experience a reduction in comorbid symptoms, and benefit from the supportive aspect of group…
The involvement of the hypothalamic dopaminergic pathway in the treatment of anorexia nervosa (AN) was evaluated by monitoring the serum prolactin (PRL) levels in 10 adolescent anorectic females. 5 patients were treated by behaviortherapy program and 5 were treated with pimozide, an antidopaminergic drug. The study was conducted for a period of 20 weeks. Elevation of PRL levels was
Abraham Weizman; Sam Tyano; Henricus Wijsenbeek; Menashe Ben David
Recently, considerable attention has been given to the cognitive processes entailed in mourning. There has been a growing understanding that the death of a loved one forces individuals to restructure and rebuild previously held assumptions about the self and the world. On the basis of this conceptualization of grief as a period of meaning reconstruction, cognitive-behavioraltherapy seems a fitting
Trauma Focused Cognitive BehavioralTherapy (TF CBT) Consultation Calls Deepen your TF CBT practice the clinician is using TF-CBT, discussion of strategies to engage the child/adolescent and his/her caregiver, and ways to implement the TF-CBT components effectively. This is a proven method to help integrate practice
Advanced Trauma Focused Cognitive BehavioralTherapy (TF CBT) In collaboration with the National on supporting clinicians to build upon basic skills in implementing TF-CBT through interactive small group: incorporating gradual exposure into all TF-CBT components; developing the trauma narrative; implementing
Trauma Focused Cognitive BehavioralTherapy (TF CBT) 2 Day Training Trauma-Focused Cognitive participating in treatment. This two day workshop will provide clinicians with training in how to provide TF-CBT Training / Training Fee $225 Pre-Training Requirement: Participants must complete TF-CBT Web course before
Many university students suffer from test anxiety that is severe enough to impair performance. Given mixed efficacy results of previous cognitive-behaviortherapy (CBT) trials and a theoretically driven rationale, an acceptance-based behaviortherapy (ABBT) approach was compared to traditional CBT (i.e., Beckian cognitive therapy; CT) for the…
Brown, Lily A.; Forman, Evan M.; Herbert, James D.; Hoffman, Kimberly L.; Yuen, Erica K.; Goetter, Elizabeth M.
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
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…
Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behaviortherapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the stan- dard exposure in social phobia, especially
E. Klinger; S. Bouchard; P. Legeron; S. Roy; F. Lauer; I. Chemin; P. Nugues
Objections to Rational Emotive BehaviorTherapy (REBT) may be based on the predominance of the personality type in the counseling profession dubbed "tender mindedness." The dichotomy between the "tough minded" and the "tender minded" may suggest the reasons for its acceptance among some and rejection by others. The author examines common…
Burkholderia fungorum DBT1 is a bacterial strain isolated from an oil refinery discharge and capable of transforming dibenzothiophene, phenanthrene, naphthalene, and fluorene. In order to evaluate the influence of a policyclic aromatic hydrocarbon (PAH)-transforming bacterial strain on the phytoremediation of organic contaminants, B. fungorum DBT1 was inoculated into hybrid poplar (Populus deltoides×Populus nigra). The poplar plants were grown for 18-wk with or without naphthalene, phenanthrene, fluorene and dibenzothiophene (488mgkg(-1) soil each) in non-sterile sand-peat substrate. Evidences were gained that B. fungorum DBT1 was present in high concentration in poplar root tissues (2.9-9.5×10(3)CFUg(-1)), while the strain was not detected in stem, leaves and rhizosphere. When poplar was planted in uncontaminated substrate, the infection caused negative effects on biomass index, leaves and stem dry weight, without showing however any disease symptoms. On the other hand, plants inoculated with the strain DBT1 resulted in better tolerance against the toxic effects of PAHs, in terms of root dry weight. Although the presence of plants acted as the main effective treatment for PAH dissipation (82-87%), the inoculum with DBT1 strain lead to the highest PAH abatement (up to 99%). In the present study, an environmental isolate with proper metabolic features was demonstrated to be possibly suitable as a poplar endophyte for improving microbe-assisted phytoremediation in PAH contaminated matrices. PMID:23706896
In this article, we suggest that the long-term effective- ness of cognitive-behaviortherapy (CBT) may be en- hanced by going beyond symptoms at the cognitive level (i.e., intellectual meanings) and expanding thera- peutic focus to the underlying, implicit emotional mean- ings. Following a discussion of the state-of-the-art view on emotion in CBT, we present empirical, theoretical, and clinical evidence from
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 "experimental neuroses", shown by his students M.N. Eroféeva and N.R. Shenger-Krestovnikova to be produced and eliminated through the principles of conditioning and counterconditioning. In this article, the Pavlovian origins of behaviortherapy are assessed, and the relevance of conditioning principles to modern behaviortherapy are analyzed. It is shown that Pavlovian conditioning represents far more than a systematic basic learning paradigm. It is also an essential theoretical foundation for the theory and practice of behaviortherapy. PMID:9382243
Cognitive behaviortherapy (CBT) is an evidence-based intervention for individuals with serious mental illness and potentiates standard medication management. Americans receiving publicly funded treatment for serious mental illnesses have limited access to CBT and hence we need to devise innovative ways of providing access to this important intervention. We present a case of a man who had severe disability, was medication resistant, and diagnosed with Obsessive Compulsive Disorder and Major Depressive Disorder. After being home bound for many years he was provided CBT utilizing his existing case manager as a therapy extender. The specific roles of the primary therapist and case manager as well as the improvement in quality of life of the individual are delineated. This case report opens up the possibility of further studying case managers as therapy extenders for treating serious mental illnesses. PMID:23828035
Pinninti, Narsimha R; Schmidt, Lisa T; Snyder, Richard P
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
Aim To examine the efficacy of two adolescent drug abuse treatments: individual cognitive behavioraltherapy (CBT) andmultidimensionalfamilytherapy(MDFT).Design A2(treatmentcondition)x4(time)repeated-measuresintent- to-treat randomized design. Data were gathered at baseline, termination, 6 and 12 months post-termination. Analyses used latent growth curve modeling. Setting Community-based drug abuse clinic in the northeastern United States. Participants A total of 224 youth, primarily male (81%), African American (72%),
Howard A. Liddle; Gayle A. Dakof; Ralph M. Turner; Craig E. Henderson; Paul E. Greenbaum
Attempts to apply cognitive-behavioraltherapy (CBT) to treat patients in the early stage of psychosis, including those with First-Episode Psychosis (FEP) and those with an At-Risk Mental State (ARMS), have recently attracted considerable attention. Such CBT for FEP focuses on promoting the recovery process and relapse prevention, although evidence on its efficacy is currently limited. Further, studies on CBT for ARMS have not consistently demonstrated its effectiveness. Some reports affirm the effectiveness of CBT in FEP prevention, while others claim that the treatment leads to no compelling difference in comparison to nonspecific treatment such as supportive therapy and treatment as usual. It is evident that psychosocial interventions play a fundamental role in the treatment of early stages of psychosis. Therapeutic approaches based on CBT have been applied to various cases: however, further research is necessary in order to produce more concrete results and obtain the evidence needed to approve this method. PMID:23789321
Objective: To describe an adapted version of dialectical behaviortherapy for adolescents with bipolar disorder. Method: The dialectical behaviortherapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months)…
Goldstein, Tina R.; Axelson, David A.; Birmaher, Boris; Brent, David A.
Based primarily on studies that employ Pavlovian fear conditioning, extinction of conditioned fear has been found to be mediated by N-methyi-D-aspartate (NMDA) receptors in the amygdala and medial prefrontal cortex. This led to the discovery that an NMDA partial agonist, D-cycloserine, could facilitate fear extinction when given systemically or locally into the amygdala. Because many forms of cognitive behavioraltherapy depend on fear extinction, this led to the successful use of D-cycloserine as an adjunct to psychotherapy in patients with so-called simple phobias (fear of heights), social phobia, obsessive-compulsive behavior, and panic disorder. Data in support of these conclusions are reviewed, along with some of the possible limitations of D-cycloserine as an adjunct to psychotherapy. PMID:22275851
Context Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes. Objective To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant others to simultaneously treat PTSD symptoms and enhance relationship satisfaction) with a wait-list condition. Design, Setting, and Participants Randomized controlled trial of heterosexual and same-sex couples (n=40 couples; n=80 individuals) in which one partner met criteria for PTSD according to the Clinician-Administered PTSD Scale, conducted from 2008 to 2012 in a Department of Veterans Affairs outpatient hospital setting in Boston, Massachusetts, and a university-based research center in Toronto, Ontario, Canada. Symptoms of PTSD, comorbid conditions, and relationship satisfaction were collected by blinded assessors at baseline, at mid treatment (median, 8.00 weeks [range, 1.71–20.43 weeks] after baseline), and at posttreatment (median, 15.86 weeks [range, 7.14–38.57 weeks] after baseline). An uncontrolled 3-month follow-up (median, 38.21 weeks [range, 28.43–50.57 weeks] after baseline) was also completed. Intervention Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n=20) or were placed on a wait list for the therapy (n=20). Main Outcome Measures Clinician-rated PTSD symptom severity was the primary outcome and was assessed with the Clinician-Administered PTSD Scale. Intimate relationship satisfaction, assessed with the Dyadic Adjustment Scale, patient- and partner-rated PTSD symptoms, and comorbid symptoms were secondary outcomes. Results PTSD symptom severity (score range, 0–136) was significantly more improved in the couple therapy condition than in the wait-list condition (mean change difference, ?23.21; 95% CI, ?37.87 to ?8.55). Similarly, patients’ intimate relationship satisfaction (score range, 0–151) was significantly more improved in couple therapy than in the wait-list condition (mean change difference, 9.43; 95% CI, 0.04–18.83). The time×condition interaction effect in the multilevel model predicting PTSD symptoms (t37.5=?3.09; P =.004) and patient-reported relationship satisfaction (t68.5=2.00; P=.049) revealed superiority of the couple therapy compared with the wait list. Treatment effects were maintained at 3-month follow-up. Conclusion Among couples in which one partner was diagnosed as having PTSD, a disorder-specific couple therapy, compared with a wait list for the therapy, resulted in decreased PTSD symptom severity and patient comorbid symptom severity and increased patient relationship satisfaction. Trial Registration clinicaltrials.gov Identifier: NCT00669981 PMID:22893167
Monson, Candice M.; Fredman, Steffany J.; Macdonald, Alexandra; Pukay-Martin, Nicole D.; Resick, Patricia A.; Schnurr, Paula P.
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
Individual randomized controlled trials (RCTs) of habit reversal training and a Comprehensive Behavioral Intervention for Tics (collectively referred to as behaviortherapy, BT) have demonstrated efficacy in reducing tic severity for individuals with Tourette Syndrome and Chronic Tic Disorders (collectively referred to as TS), with no examination of treatment moderators. The present meta-analysis synthesized the treatment effect sizes (ES) of BT relative to comparison conditions, and examined moderators of treatment. A comprehensive literature search identified eight RCTs that met inclusion criteria, and produced a total sample of 438 participants. A random effects meta-analysis found a medium to large ES for BT relative to comparison conditions. Participant mean age, average number of therapy sessions, and the percentage of participants with co-occurring attention deficit hyperactivity disorder (ADHD) were found to moderate treatment effects. Participants receiving BT were more likely to exhibit a treatment response compared to control interventions, and identified a number needed to treat (NNT) of three. Sensitivity analyses failed to identify publication bias. Overall, BT trials yield medium to large effects for TS that are comparable to treatment effects identified by meta-analyses of antipsychotic medication RCTs. Larger treatment effects may be observed among BT trials with older participants, more therapeutic contact, and less co-occurring ADHD. PMID:24398255
McGuire, Joseph F; Piacentini, John; Brennan, Erin A; Lewin, Adam B; Murphy, Tanya K; Small, Brent J; Storch, Eric A
Objective: The purpose of this review was to assess the clinical significance of cognitive-behavioraltherapy for bulimia nervosa using the reliable change index and nor- mative comparison analyses. Method: Fifteen treatment outcome studies using either indi- vidual or group cognitive-behavioraltherapy for bulimia nervosa were selected for inclusion. Results: Results suggest that cognitive-behavioraltherapy for bulimia nervosa produces clinically significant
Jennifer D. Lundgren; Sharon Danoff-Burg; Drew A. Anderson
Behaviors that chronically activate the hypothalamic-pituitary-adrenal (HPA) axis and/or suppress the hypothalamic-pituitary-thyroidal (HPT) axis disrupt the hypothalamic-pituitary-gonadal axis in women and men. Individuals with functional hypothalamic hypogonadism typically engage in a combination of behaviors that concomitantly heighten psychogenic stress and increase energy demand. Although it is not widely recognized clinically, functional forms of hypothalamic hypogonadism are more than an isolated disruption of gonadotropin-releasing hormone (GnRH) drive and reproductive compromise. Indeed, women with functional hypothalamic amenorrhea display a constellation of neuroendocrine aberrations that reflect allostatic adjustments to chronic stress. Given these considerations, we have suggested that complete neuroendocrine recovery would involve more than reproductive recovery. Hormone replacement strategies have limited benefit because they do not ameliorate allostatic endocrine adjustments, particularly the activation of the adrenal and the suppression of the thyroidal axes. Indeed, the rationale for the use of sex steroid replacement is based on the erroneous assumption that functional forms of hypothalamic hypogonadism represent only or primarily an alteration in the hypothalamic-pituitary-gonadal axis. Potential health consequences of functional hypothalamic amenorrhea, often termed stress-induced anovulation, may include an increased risk of cardiovascular disease, osteoporosis, depression, other psychiatric conditions, and dementia. Although fertility can be restored with exogenous administration of gonadotropins or pulsatile GnRH, fertility management alone will not permit recovery of the adrenal and thyroidal axes. Initiating pregnancy with exogenous means without reversing the hormonal milieu induced by chronic stress may increase the likelihood of poor obstetrical, fetal, or neonatal outcomes. In contrast, behavioral and psychological interventions that address problematic behaviors and attitudes, such as cognitive behaviortherapy (CBT), have the potential to permit resumption of full ovarian function along with recovery of the adrenal, thyroidal, and other neuroendocrine aberrations. Full endocrine recovery potentially offers better individual, maternal, and child health. PMID:17308138
Objective: Randomized comparisons of acceptance-based treatments with traditional cognitive behavioraltherapy (CBT) for anxiety disorders are lacking. To address this gap, we compared acceptance and commitment therapy (ACT) to CBT for heterogeneous anxiety disorders. Method: One hundred twenty-eight individuals (52% female, mean age = 38, 33%…
Arch, Joanna J.; Eifert, Georg H.; Davies, Carolyn; Vilardaga, Jennifer C. Plumb; Rose, Raphael D.; Craske, Michelle G.
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…
Cognitive behavioraltherapy (CBT) for psychological disorders is becoming increasingly popular on the Internet. However, when using this workstation approach, components such as training and learning relaxation skills, problem solving, exposure exercises, and sleep management guidance must be done in the domestic environment. This paper describes design concepts for providing spatially explicit CBT with mobile phones. We reviewed and analyzed a set of treatment manuals to distinguish elements of CBT that can be improved and supported using mobile phone applications. The key advantage of mobile computing support in CBT is that multimedia can be applied to record, scale, and label anxiety-provoking situations where the need arises, which helps the CBT clients formulate and convey their thoughts and feelings to relatives and friends, as well as to therapists at subsequent treatment sessions. PMID:17911881
Cognitive behavioraltherapy (CBT), an umbrella term that includes a diverse group of treatments, is defined by a strong commitment to empiricism. While CBT has a robust empirical base, areas for improvement remain. This article reviews the status of the current empirical base and its limitations, and presents future directions for advancement of the field. Ultimately, studies are needed that will identify the predictors, mediators, and moderators of treatment response in order to increase knowledge on how to personalize interventions for each client and to strengthen the impact of CBT. Efforts to advance the dissemination and implementation of CBT, innovative approaches such as practice-oriented research, and the advantages of incorporating new and existing technologies, are discussed as well. PMID:25689506
Tinnitus is defined as auditory perception without external sound. There is currently no cure for tinnitus. Cognitive behavioraltherapy (CBT) is a tinnitus treatment that addresses the affected individual's reaction to tinnitus. It aims not to eliminate auditory perception as sound but to reduce or correct one's negative response to tinnitus. CBT identifies negative automatic thought and then evaluates its validity with the patient. It also aims to change negative automatic thought to more positive and realistic thought. In this way, tinnitus sufferers can function well despite the presence of tinnitus. Many studies have supported the efficacy of CBT for treating tinnitus. A meta-analysis of CBT for tinnitus also concluded that CBT is effective in treating tinnitus. Thus, CBT is considered a good option for treating tinnitus. We herein discuss the use of CBT for tinnitus with a literature review. PMID:24653916
The current study investigates the comparative effects of sensory-integration therapy and behavioral interventions on rates of self-injurious behavior (SIB) in a 9-year-old boy with diagnosis of autism. A functional analysis was conducted to identify the variables maintaining the self-injurious behavior. This analysis demonstrated that SIB was…
Extended the findings from previous meta-analytic work by comparing the effectiveness of behavioral parent-training (BPT) and cognitive-behavioraltherapy (CBT) for youth with antisocial behavior problems. Youth demographic variables were also examined as potential moderators of the effectiveness of these 2 types of interventions. Thirty BPT…
McCart, Michael R.; Priester, Paul E.; Davies, W. Hobard; Azen, Razia
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
The self psychological understanding of masochism differs from traditional views in that it perceives masochistic behaviors as maladaptive attempts to experience vitalization, greater self-esteem and self-cohesiveness. Motivational systems theory may be especially useful in understanding the purposes served by masochistic behavior. Masochistic behavior in interpersonal relations is of particular importance to group therapy. Such behavior serves to maintain a relationship
Summary Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive BehavioralTherapy for Insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to (1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, (2) discuss measurement issues, and (3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts. PMID:23602124
Matthews, Ellyn E.; Arnedt, J. Todd; McCarthy, Michaela S.; Cuddihy, Leisha J.; Aloia, Mark S.
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 *…
Purpose: The purpose of this article is to present an exploration of some of the issues surrounding adherence to vocal behavioral change in voice therapy within the context of Motivational Interviewing (MI) and to explore MI's potential for integration into voice therapy (MI-adapted voice therapy). MI is a style of interpersonal communication in…
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…
The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioraltherapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…
Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.
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…
Objective: To examine potential differential responses in men and women to cognitive behaviortherapy for posttraumatic stress disorder (PTSD). Method: Fifty-two men and 56 women diagnosed with PTSD participated in randomized controlled trials of cognitive behaviortherapy for PTSD. Participants were randomly allocated to either (a) exposure-only…
Anorexia nervosa has been approached by a variety of therapeutic regimens. These regimens have addressed themselves to either the underlying psychological problems or the eating disorder. By integrating behaviortherapy and psychotherapy, the author proposes a treatment plan which addresses both problems simultaneously. Psychotherapy and behaviortherapy are theoretically integrable; their integration produces a treatment consistent with the dynamics underlying
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
This article reviews behaviortherapies, motivational interviewing interventions, and combined behavioral-psychosocial therapies across 34 peer-reviewed publications. Studies were included if they involved youth with alcohol and other drug (AOD) use, included measures of AOD outcomes, and used controlled research designs with a control or comparison condition. The level of empirical support of the interventions was evaluated using established guidelines. The article determined that behaviortherapies were "probably efficacious," and motivational interviewing interventions easily met the criteria for "promising." Because of small sample sizes, combined behavioral-psychosocial therapies marginally met the criteria for "promising." The findings from this article underscore the value of individual and group behaviortherapies and motivational interviewing in helping reduce mild to serious AOD use among adolescents. PMID:20682219
Burnout is a globally increasing illness, and as a result, many forms of burnout therapy have arisen. The use of digital games can be psychotherapeutically effective because they can transform exercises that are by themselves unattractive into intrinsically motivated action. This pilot study aims to test whether a specially designed game contributes to patients learning desired behavior and achieving other specific therapeutic goals in an online cognitive-behavioraltherapy (CBT)-based burnout treatment context. In total, 101 participants took part in the experiment, under four conditions: (a) Game+Therapy, (b) Therapy Only, (c) Game Only, and (d) No Game+No Therapy. Pre- and postmeasures were taken online. Results showed that the two therapy conditions (Game+Therapy and Therapy Only) showed a greater decrease in complaints and disengagement, and a stronger increase in coping skills than the nontherapy conditions (Game Only and No Game+No Therapy). As expected, the Game+Therapy condition outperformed the Therapy Only condition on combined improvement measures of burnout symptoms. However, analyses of individual measures showed no effects. It can be cautiously concluded that the therapeutic digital game may be a useful tool when embedded in a therapeutic burnout treatment program and is probably more efficient than CBT, as it is used in current practice. PMID:25684611
Zielhorst, Thomas; van den Brule, Daphne; Visch, Valentijn; Melles, Marijke; van Tienhoven, Sam; Sinkbaek, Helle; Schrieken, Bart; Tan, Eduard S-H; Lange, Alfred
Background Despite high rates of post-cardiac surgery depression, studies of depression treatment in this population have been limited. Objective To evaluate early cognitive behavioraltherapy (CBT) in a home environment in patients recovering from cardiac surgery. Methods From July 2006 through October 2009, we conducted a randomized controlled trial and enrolled 808 patients who were screened for depressive symptoms using the Beck Depression Inventory (BDI) in the hospital and one month later. Patients were interviewed using the Structured Clinical Interview for DSM-IV (SCID-I); those who met criteria for clinical depression (n=81) were randomized to CBT (n=45) or usual care (UC; n=36). After completion of the UC period, 25 individuals were offered later CBT (UC+CBT). Results Main outcomes (depressive symptoms [BDI] and clinical depression [SCID-I]) were evaluated after 8 weeks using intention-to-treat principles and linear mixed models. In the CBT group compared to the UC group, there was greater decline in BDI scores (?=1.41 [95% CI 0.81–2.02], p = <.001) and greater remission of clinical depression (29 [64%] vs. 9 [25%], number need to treat, 2.5 [95% CI, 1.7–4.9], p < .001). Compared to the early CBT group, (median time from surgery to CBT = 45.5 days) the later UC+CBT group (median time from surgery to CBT = 122 days) also experienced a reduction in BDI scores, but the group x time effect was smaller (?=0.79 [95% CI 0.101.47], p = .03) and remission rates between the two groups did not differ. Conclusions Early home CBT is effective in depressed post-cardiac surgery patients. Early treatment is associated with greater symptom reduction than similar therapy given later after surgery. PMID:22635060
Doering, Lynn V.; Chen, Belinda; Cross, Rebecca; Magsarili, Marise C.; Nyamathi, Adey; Irwin, Michael R.
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.
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
Because no studies of psychotherapy treatments for night eating syndrome (NES) have been published, we conducted a pilot study of a 10-session cognitive behaviortherapy (CBT) for NES. Twenty-five patients (19 female, 6 male) were screened and comprehensively assessed before being enrolled. At each visit, patients completed the Night Eating Symptom Scale (NESS), were weighed, and number of awakenings and the number of nocturnal ingestions and daily caloric intake were calculated from weekly food and sleep records. Mixed model regression analyses [of the data] showed significant decreases in caloric intake after dinner (35.0% to 24.9%); number of nocturnal ingestions (8.7 to 2.6 per week); weight (82.5 to 79.4 kg); and NESS score (28.7 to 16.3; all p values <0.0001). Number of awakenings per week, depressed mood, and quality of life also improved significantly (p values <.02). This first clinical trial of CBT for NES shows significant improvements in the core aspects of NES and weight reduction, suggesting the need for a controlled treatment trial. PMID:20405767
Allison, Kelly C; Lundgren, Jennifer D; Moore, Reneé H; O'Reardon, John P; Stunkard, Albert J
Tourette's disorder, also called Tourette syndrome (TS), is characterized by motor and vocal tics that can cause significant impairment in daily functioning. Tics are believed to be due to failed inhibition of both associative and motor cortico-striato-thalamo-cortical pathways. Comprehensive Behavioral Intervention for Tics (CBIT), which is an extension of Habit Reversal Therapy (HRT), teaches patients to become more aware of sensations that reliably precede tics (premonitory urges) and to initiate competing movements that inhibit the occurrence of tics. In this study, we used functional magnetic resonance imaging (fMRI) to investigate the neural changes associated with CBIT treatment in subjects with TS. Eight subjects with TS were matched with eight healthy controls in gender, education, age, and handedness. Subjects completed the Visuospatial Priming (VSP) task, a measure of response inhibition, during fMRI scanning before and after CBIT treatment (or waiting period for controls). For TS subjects, we found a significant decrease in striatal (putamen) activation from pre- to post-treatment. Change in VSP task-related activation from pre- to post-treatment in Brodmann's area 47 (the inferior frontal gyrus) was negatively correlated with changes in tic severity. CBIT may promote normalization of aberrant cortico-striato-thalamo-cortical associative and motor pathways in individuals with TS. PMID:25444535
Deckersbach, Thilo; Chou, Tina; Britton, Jennifer C; Carlson, Lindsay E; Reese, Hannah E; Siev, Jedidiah; Scahill, Lawrence; Piacentini, John C; Woods, Douglas W; Walkup, John T; Peterson, Alan L; Dougherty, Darin D; Wilhelm, Sabine
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…
Objective: To examine the relationship between cognitive and behavioral changes associated with cognitive behavioraltherapy (CBT) and treatment response in an intensive partial hospital (PH) setting. Methods: Study participants were 105 patients with mood disorders receiving treatment in a private psychiatric PH setting. The flexible treatment model used evidence-based CBT interventions adapted to the PH context, with emphases on psychoeducation
Michael S. Christopher; Timothy J. Neary; Karen L. Jacob; Edmund C. Neuhaus; Lauren A. Fiola
Moderately obese volunteers were randomly assigned to two treatment conditions (behaviortherapy or behaviortherapy plus aerobic exercise) and two posttreatment conditions (no further contact or a multicomponent maintenance program). Clients in the aerobic exercise condition lost significantly more weight than those who received behaviortherapy…
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 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 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
Women with breast cancer who were suffering from treatment-related menopausal symptoms experienced symptom relief with cognitive behavioraltherapy, physical exercise, or both, according to a Dutch study published October 8, 2012, in the Journal of Clinical Oncology.
Two cases of integrated cognitive behavioraltherapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option. PMID:25706067
van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wim; Schoevers, Robert A
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
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
ABSTRACT The purpose of this study was to examine the effectiveness of individualized music therapy protocols in decreasing the duration of instances of elevated levels of maladaptive emotionally regulative behaviors in ...
The main objective of this review was to compare the effectiveness of cognitive-behavioraltherapy and contingency management for cocaine dependence. Contingency management alone reliably reduced cocaine use during active treatment in all cited trials, whereas the positive effect of cognitive-behavioraltherapy emerged after treatment in 3 of 5 trials. Synergistic effects of the combination of contingency management plus cognitive-behavioraltherapy are shown in 2 trials, but another 3 trials found no additive effects. Positive, rapid, and enduring effects on cocaine use are reliably seen with contingency management interventions, whereas measurable effects of cognitive-behavioraltherapy emerge after treatment and are not as reliable as effects with contingency management. PMID:24074193
Farronato, Nadine S; Dürsteler-Macfarland, Kenneth M; Wiesbeck, Gerhard A; Petitjean, Sylvie A
We present a ternary blend-based bulk heterojunction ITO/PEDOT:PSS/PFO-DBT: MEH-PPV:PC71BM/LiF/Al photodetector. Enhanced optical absorption range of the active film has been achieved by blending two donor components viz. poly[2,7-(9,9-di-octyl-fluorene)-alt-4,7-bis(thiophen-2-yl)benzo-2,1,3-thiadiazole] (PFO-DBT) and poly(2-methoxy-5(2'-ethylhexyloxy) phenylenevinylene (MEH-PPV) along with an acceptor component, i.e., (6,6)-phenyl-C71 hexnoic acid methyl ester. The dependency of the generation rate of free charge carriers in the organic photodetector (OPD) on varied incident optical power density was investigated as a function of different reverse biasing voltages. The photocurrent showed significant enhancement as the intensity of light impinging on active area of OPD is increased. The ratio of Ilight to Idark of fabricated device at -3 V was ~3.5 × 10(4). The dynamic behaviour of the OPD under on/off switching irradiation revealed that sensor exhibits quick response and recovery time of ?800 ms and 500 ms, respectively. Besides reliability and repeatability in the photoresponse characteristics, the cost-effective and eco-friendly fabrication is the added benefit of the fabricated OPD. PMID:25574936
We present a ternary blend-based bulk heterojunction ITO/PEDOT:PSS/PFO-DBT:MEH-PPV:PC71BM/LiF/Al photodetector. Enhanced optical absorption range of the active film has been achieved by blending two donor components viz. poly[2,7-(9,9-di-octyl-fluorene)-alt-4,7-bis(thiophen-2-yl)benzo-2,1,3-thiadiazole] (PFO-DBT) and poly(2-methoxy-5(2?-ethylhexyloxy) phenylenevinylene (MEH-PPV) along with an acceptor component, i.e., (6,6)-phenyl-C71 hexnoic acid methyl ester. The dependency of the generation rate of free charge carriers in the organic photodetector (OPD) on varied incident optical power density was investigated as a function of different reverse biasing voltages. The photocurrent showed significant enhancement as the intensity of light impinging on active area of OPD is increased. The ratio of Ilight to Idark of fabricated device at ?3 V was ?3.5 × 104. The dynamic behaviour of the OPD under on/off switching irradiation revealed that sensor exhibits quick response and recovery time of <800 ms and 500 ms, respectively. Besides reliability and repeatability in the photoresponse characteristics, the cost-effective and eco-friendly fabrication is the added benefit of the fabricated OPD. PMID:25574936
\\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
Older adults (3 men, 4 women, aged 55 to 68 years) with chronic sleep-maintenance insomnia were treated sequentially with relaxation therapy (RT) and then with a cognitive–behavioraltherapy (CBT) specifically designed for alleviating sleep maintenance problems. Sleep diaries and an objective measure of sleep, the sleep assessment device, showed only modest improvements in measures of wake time after sleep onset,
Jack D. Edinger; Timothy J. Hoelscher; Gail R. Marsh; Steven Lipper; Martin Ionescu-Pioggia
The present study investigated the effectiveness of music therapy for dementia patients using endo- crinological 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 ther- apy was performed twice a week for 8 consecutive weeks (16 sessions). As a result, total scores on the
Applied behavioral-systems family therapy model to lower socioeconomic status juvenile offenders. Compared 27 delinquents, court-referred to in-home time-unlimited family therapy, to 27 lower-risk delinquents who received only probation. Examined number and severity of offenses during 30 months following group assignment. Found delinquents in…
Objective: This study examined (a) duration of generalized anxiety disorder (GAD) as a moderator of cognitive behavioraltherapy (CBT) versus its components (cognitive therapy and self-control desensitization) and (b) increases in dynamic flexibility of anxious symptoms during the course of psychotherapy as a mediator of this moderation. Degree of…
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.
and conduct therapy sessions using CBT Ability to increase independence in treatment planning and intervention Understanding of Cognitive-Behavioral interventions and treatments for depression and anxiety Understanding with increasing skill and experience in CBT Ability to evaluate client progress as therapy proceeds Ability
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
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
Background: Behaviortherapy [exposure and response prevention (ERP)] and cognitive therapy (CT) have proven effective in the treatment of obsessive-compulsive disorder. Direct comparisons between these treatment modalities have exposed no differences in efficacy. However, very little research has been conducted into the differences between the change processes in ERP and CT. This investigation is a first attempt to study change
Gideon E. Anholt; Pieter Kempe; Else de Haan; Patricia van Oppen; Danielle C. Cath; Johannes H. Smit
Background: To determine whether sleep quality and fatigue associated with breast cancer adjuvant chemotherapy treatments can be improved with behavioraltherapy (BT) (Individua- lized Sleep Promotion Plan (ISPPr)) including modified stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. Methods: Randomized-controlled trial based on Piper Integrated Fatigue Model, 219 stages I-IIIA breast cancer patients. Prior to the initial chemotherapy
Ann M. Berger; Brett R. Kuhn; Lynne A. Farr; James C. Lynch; Sangeeta Agrawal; Julie Chamberlain; Susanna G. Von Essen
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, discharge, and 6-month follow-up. Observational ratings of adherence and competence were collected on
Aaron Hogue; Craig E. Henderson; Sarah Dauber; Priscilla C. Barajas; Adam Fried; Howard A. Liddle
Social changes and developments in medical science prompted mental health professionals to adopt new roles in relation to their self-disclosure practices. The physician-patient relationship has balanced on a different level, promoting the equity and the autonomy of the second. The contemporary patient is better informed, asks more questions and requires more answers. The boundaries between "professional" and "personal" are less strict and patients believe that they have a right to know whether the personal experiences (educational, clinical, research) of their therapists enable them to understand and help them. Although the latest version of the American Psychological Association's Ethics Code (APA, 2002) offers no explicit guidance on therapist self-disclosure, it incorporates an implicit message that therapists can no longer choose non-disclosure without having considered the issue carefully. Non-disclosure is no longer the easy answer, as it may affect adversely the therapeutic relationship and the therapeutic effect. These new circumstances prompted representatives of all psychotherapeutic orientations to reconsider traditional positions on therapist self-disclosure, to adapt to the diverse needs of the patients and the modern requirements of the therapeutic process and to define the framework within which its conduct is not only safe but also effective. This review attempts to describe the concept of therapist self-disclosure and its use and its functions in Cognitive-BehavioralTherapy, following a history of the term in other major therapeutic schools (psychoanalytic, client-centered and systemic). As the focus of any psychotherapy is the patient himself, we added reports of patients' experiences by their therapists' disclosures. Those descriptions reveal clearly not only the benefits of therapist self-disclosure but also the dangers posed by improper use. Finally, we attempt to set a framework in the form of proposals, as these result from existing empirical and theoretical research. As therapists will inevitably be confronted with the issue of self-disclosure in their careers, they will have to make decisions on if, what, when, why, to whom, and how to disclose. These guidelines aspire to be of help to therapists so they can use self-disclosure efficiently and ethically and to minimize potential risks. PMID:25630546
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
This year-long course is designed to provide participants with an understanding of how cognitive and behavioral models can be used in conceptualizing and treating behavioral and emotional disorders among youth. We will review vulnerability factors for child psychopathology, and will examine how cognitive-behavioral models can be used to guide both prevention and treatment programs. Our goal is practical - to
The primary purpose of this study was to investigate consistency in clinicians' behaviors during two voice therapy sessions. The secondary purpose was to examine relationships between ratings of clinicians' and clients' behaviors. Each clinician (n = 7) was observed working with two different clients. Two experienced evaluators, using the Adjective Checklist and five-point semantic differential scales, rated clinicians and clients. Results indicated that 6 of 10 aspects of therapy studied were found to be relatively inconsistent, with the pace of therapy being the least stable. Ratings of individual clinician traits (e.g., favorable, unfavorable, intraception) were the most stable. PMID:8293067
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…
Objectives: In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Methods: Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. Results: The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider’s qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Conclusion: Adequate management and quality control of CAM providers is thought to involve both education and legislation.
Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young
The report documents the theoretical basis and application of massage therapy, with six students who exhibited self-injurious behaviors (SIB), in two studies. The first study investigated the relationship between physical and/or emotional stress and self-abusive behavior in five severely mentally impaired students. Subjects received two to three…
This study examined predictive relations between 9 therapist behaviors and client involvement in manual-guided, cognitive-behavioraltherapy for adolescent depression. Analyses included 42 adolescents who met criteria for a depressive disorder (major depressive disorder, dysthymic disorder, or adjustment disorder with depressed mood) and who were…
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:…
Kanter, Jonathan W.; Baruch, David E.; Gaynor, Scott T.
After describing a social learning formulation of the male alcoholic's marriage, this paper reviews the few studies of behavioral marital therapy (BMT) for alcoholics and their wives. Although none of these studies are as rigorous as one might wish and many of them are merely case studies, a review of the literature shows that behavioral marital…
Olfactory reference syndrome (ORS) is characterized by a preoccupation with the belief that one's body emits a foul odor. Cognitive behavioraltherapy (CBT) was used to treat a woman in her 50s who presented in our outpatient anxiety disorders specialty clinic with ORS, accompanied by embarrassment, shame, distress, avoidance behavior, and social…
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.
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.
Twenty children with autism, ages 3 to 6 years, received either massage therapy or reading attention by their parents for 15 minutes daily for one month. Evaluation suggested that children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they…
Escalona, Angelica; Field, Tiffany; Singer-Strunck, Ruth; Cullen, Christy; Hartshorn, Kristen
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…
Objective: To describe the elements of a manual-based cognitive-behavioraltherapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. Method: The CBT-SP was developed using a risk reduction and relapse prevention approach and…
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…
Argues that Alcoholics Anonymous (AA) and Rational Emotive BehaviorTherapy (REBT) share important rational objectives and numerous cognitive-behavioral methods. Both emphasize a philosophical shift as a principal ingredient for change. Provides definitions of rationality and spirituality and explains how REBT and smart recovery are spiritual…
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…
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…
To examine changes in dyadic communication, as well as links between communication and long-term relationship outcomes, 134 distressed couples randomly assigned to either Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) or Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) were observed in video-recorded interactions. Observers rated discussions of relationship problems at 3 time points (pre-therapy, post-therapy, 2-year follow-up) and relationship outcomes (i.e., treatment response and relationship stability) were measured at a 5-year follow-up. Consistent with previous examinations of individual partner communication (K.J.W. Baucom et al., 2011; Sevier et al., 2008), TBCT produced greater improvements from pre-therapy to post-therapy (d = 0.27-0.43) and superior communication at post-therapy (d = 0.30-0.37). However, IBCT produced greater improvements from post-therapy to 2-year follow-up (d = 0.32-0.39). Both levels of, and changes in, dyadic communication were associated with relationship outcomes, even when controlling for individual communication. Our findings lend additional support for theoretical and practical differences between these two therapies and the utility of assessment at the level of the couple. Furthermore, they contribute to a broader pattern of findings in which relationship outcomes are more consistently linked with constructive communication than with destructive communication. PMID:25549210
Baucom, Katherine J W; Baucom, Brian R; Christensen, Andrew
Cognitive-behavioral techniques have a great deal to offer in the prevention and remediation of upper extremity cumulative trauma disorder (CTD) in the workplace In relation to prevention, cognitive-behavioral methods offer promise as adjuncts to educational programs and ergonomic practices that aim to increase workers' use of safe work postures, movements, and procedures. Cognitive-behaviortherapy (CBT) is also an important component
The impact of a modified dialectical behaviortherapy and problem-solving model is examined on the work environment of a patient\\u000a with an obsessive-compulsive personality disorder (OCPD). A case study is presented examining the impact this client's OCPD\\u000a behavior in the work environment and on his subordinates. Discussed are interventions that were useful in treating a motivated\\u000a patient employing cognitive-behavioral models
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…
Maladaptive aggression in adolescents is an increasing public health concern. Cognitive BehaviorTherapy (CBT) is one of the most common and promising treatments of aggression. However, there is a lack of information on predictors of treatment response regarding CBT. Therefore, a meta-analysis was performed examining the role of predictors on treatment response of CBT. Twenty-five studies were evaluated (including 2,302 participants; 1,580 boys and 722 girls), and retrieved through searches on PubMed, PsycINFO and EMBASE. Effect sizes were calculated for studies that met inclusion criteria. Study population differences and specific CBT characteristics were examined for their explanatory power. There was substantial variation across studies in design and outcome variables. The meta-analysis showed a medium treatment effect for CBT to reduce aggression (Cohen'd = 0.50). No predictors of treatment response were found in the meta-analysis. Only two studies did examine whether proactive versus reactive aggression could be a moderator of treatment outcome, and no effect was found of this subtyping of aggression. These study results suggest that CBT is effective in reducing maladaptive aggression. Furthermore, treatment setting and duration did not seem to influence treatment effect, which shows the need for development of more cost-effective and less-invasive interventions. More research is needed on moderators of outcome of CBT, including proactive versus reactive aggression. This requires better standardization of design, predictors, and outcome measures across studies. PMID:25138144
Smeets, Kirsten C; Leeijen, Anouk A M; van der Molen, Mariët J; Scheepers, Floor E; Buitelaar, Jan K; Rommelse, Nanda N J
This paper reflects an attempt to chronicle the events, articles, and hearings which concerned the application of behavior technology in adult prison systems between January 1, 1973 and November 1, 1974. The events of this time period are viewed by the author as demanding the attention of behavior therapists, legislators, correctional officials,…
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…
Preschool children received twice-weekly massages for five weeks. Compared to control children, the massaged children had better behavior ratings on mood state, vocalization, activity, and cooperation following massage on day one and throughout the study. Teachers rated their behavior more optimally, and their parents rated them as having less…
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 goal of this paper is to report on the typology, frequency, and duration of intersession calls placed by outpatient eating disorder clients to their therapists. Participants were 17 women, offered DBT after-hours telephone coaching adapted for individuals with eating disorders. Results indicated that clients used telephone coaching primarily…
Limbrunner, Heidi M.; Ben-Porath, Denise D.; Wisniewski, Lucene
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, Angélica M; Nascimento, Antônio L; Fontenelle, Leonardo F
The first circadian-relevant kinase to be identified was DOUBLE-TIME (DBT) in Drosophila, a homolog of vertebrate CKI?, which regulates the progressive phosphorylation and stability of PERIOD (PER) proteins in animals. A negative feedback loop wherein PER directly inhibits the transcriptional activity of the CLOCK-CYCLE (CLK-CYC) heterodimer is central to the generation of molecular rhythms and normal progression of the clock in Drosophila. We show that DBT activity is required for the phase-specific hyperphosphorylation of CLK in vivo, an event that correlates with times of maximal repression in per RNA levels. The ability of DBT to hyperphosphorylate CLK, enhance its degradation, and evoke modest inhibition of CLK-dependent transactivation from circadian promoter elements was directly shown in cultured Drosophila cells. Intriguingly, DBT seems to function in close partnership with the PER-relevant protein phosphatase 2A, resulting in dynamic equilibrium between hypo- and hyperphosphorylated isoforms of CLK. This balancing mechanism might act to stabilize the limiting levels of CLK against stochastic fluctuations minimizing the propagation of “molecular noise” in the feedback circuitry. Also, the subcellular localization of CLK was altered from predominately nuclear to strong cytoplasmic staining in the presence of PER. These results suggest that, in contrast to mammalian clocks, circadian transcriptional inhibition in Drosophila involves displacement of the positive factors from chromatin. These results also demonstrate that DBT can target both negative and positive factors in circadian feedback loops and support a conserved role for dynamic regulation of reversible phosphorylation in directly modulating the activities of circadian transcription factors. PMID:16603629
Over the past 40 years, clinical treatment protocols for anorexia nervosa have evolved from being primarily behavioral-based to cognitive-based. Although treatment methods for anorexia nervosa have changed, there is little research to support the use of any particular method over another. The scarce research data that exist on the long-term outcomes of both behaviorally and cognitively-based treatment methods indicate poor
While Rational Emotive Behaviour Therapy (REBT) highlights the norm of people's dogmatic, fanatical, and rigid religious beliefs,\\u000a it has always favoured several aspects of Zen-Buddhism as a modus vivendi. Scientifically-based REBT and wisdom-oriented Zen have more in common than one might think at first sight. In this chapter,\\u000a I, Albert Ellis and Maurits Kwee show how REBT and Zen have
Important aspects of Kabat-Zinn’s mindfulness-based stress reduction (MBSR) are compared, point-by-point, with Albert Ellis’ Rational Emotive BehaviorTherapy (REBT). There are some significant differences, since REBT does not advocate meditation as part of the therapy, and MBSR does not include disputing of irrational beliefs. But the similarities are even more striking, especially in the stress on self-acceptance, and in not
\\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
The authors sought to examine short- and mid-term effectiveness of a group cognitive–behavioraltherapy (CBT) in pathological gambling (PG) and to analyze predictors of therapy outcome. Two hundred ninety PG patients participated in the current study, all diagnosed on the basis of Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria, and were given manualized outpatient group CBT (16
Susana Jiménez-Murcia; Eva M. Álvarez-Moya; Roser Granero; M. Neus Aymami; Monica Gómez-Peña; Nuria Jaurrieta; Bibiana Sans; Jaume Rodriguez-Marti; Julio Vallejo
Cognitive-behavioraltherapy (CBT) is an evidence-based psychotherapy which leads to recovery in over 50% of patients with depression and anxiety disorders. It is, therefore, the first-line treatment for those disorders. In April 2010 we began a beacon project, called "Increasing Access for Psychological Therapies" (IAPT), in Chiba, Japan. In the Chiba IAPT project, we lead the cognitive-behavioraltherapy training and provide individual CBT supervision, based on the system of IAPT in the UK. It is important to differentiate between counseling services and psychiatric services under the Medical Practitioners Act. To improve mental health in Japan, we will establish national standards for certification of clinical professionals trained in the science and art of CBT, and develop a law related to national licensing of cognitive-behavioral therapists. PMID:21702132
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
This study examined the association between relationship satisfaction and drinking urges among women who participated in alcohol behavioral individual therapy (ABIT) and Alcohol Behavioral Couples Therapy (ABCT). Relationship satisfaction and drinking urges were not related on a daily level, but urges were related to mean levels of relationship satisfaction and this association was moderated by treatment condition and time in treatment. Women with higher relationship satisfaction had fewer drinking urges, and women in ABCT with higher relationship satisfaction experienced greater reductions in urges during treatment. These findings suggest that ABCT may target the association between relationship satisfaction and drinking urges. PMID:24187430
Owens, Mandy D.; Hallgren, Kevin A.; Ladd, Benjamin O.; Rynes, Kristina; McCrady, Barbara S.; Epstein, Elizabeth
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…
Treatment for pathological gambling is in its infancy. Several cognitive and behavioral interventions have shown promise, but high attrition and relapse rates suggest that gamblers requesting treatment are not uniformly committed to change. This article describes an exploratory study with 9 severe pathological gamblers--in their majority horse…
Wulfert, Edelgard; Blanchard, Edward B.; Freidenberg, Brian M.; Martell, Rebecca S.
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…
Implemented a behavioral treatment program for obesity using an interactive microcomputer system small enough to be carried by subjects. Subjects receiving the computer-assisted treatment lost approximately 2.5 times as much weight as controls and their rate of weight loss equaled that for more elaborate behavioral treatments. (MCF)
This article examines the effectiveness of Mode Deactivation Family Therapy (MDT) in an outpatient setting as compared to Treatment as Usual (TAU). MDT is an evidence-based psychotherapy and has been shown to be effective treating adolescents with a variety of problems involving emotional disorder, physical and sexual aggression, as well as…
Apsche, Jack A.; Bass, Christopher K.; Houston, Marsha-Ann
This study investigates individual and group cognitive—behavioral interventions in decreasing psychological symptoms and enhancing the psychological status of Iranian prison inmates. A random sample of 180 males is placed in three equal groups: an individual cognitive—behavioraltherapy (CBT) group, an individual and group CBT group, and a control group. General Health Questionnaire, Symptom Checklist-90— Revised, and diagnostic interviews based on
Mohammad Khodayarifard; Mohsen Shokoohi-Yekta; Gregory E. Hamot
Many disaster survivors suffer from postdisaster distress regardless of whether or not they meet criteria for specific psychiatric\\u000a diagnoses. Cognitive BehaviorTherapy for Postdisaster Distress (CBT-PD), a ten-session manualized intervention, was developed\\u000a to address a range of cognitive, emotional, and behavioral reactions to disaster. Trained community-based therapists provided\\u000a CBT-PD to adult survivors of Hurricane Katrina as part of InCourage, a
Jessica L. Hamblen; Fran H. Norris; Siobhan Pietruszkiewicz; Laura E. Gibson; April Naturale; Claudine Louis
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…
The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioraltherapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be…
McDonagh, Annmarie; Friedman, Matthew; McHugo, Gregory; Ford, Julian; Sengupta, Anjana; Mueser, Kim; Demment, Christine Carney; Fournier, Debra; Schnurr, Paula P.
Antidepressant medication is considered the current standard for severe depression, and cognitive therapy is the most widely investigated psychosocial treatment for depression. However, not all patients want to take medication, and cognitive therapy has not demonstrated consistent efficacy across trials. Moreover, dismantling designs have suggested that behavioral components may account for the efficacy of cognitive therapy. The present study tested
Sona Dimidjian; Steven D. Hollon; Keith S. Dobson; Karen B. Schmaling; Robert J. Kohlenberg; Michael E. Addis; Robert Gallop; Joseph B. McGlinchey; David K. Markley; Jackie K. Gollan; David C. Atkins; David L. Dunner; Neil S. Jacobson
Objective: The objectives of the current study were to ascertain feasibility and acceptability of directly delivering a cognitive-behavioraltherapy (CBT) group intervention for inattentive children in a school setting, to examine the reliability of the RATE-C Questionnaires that accompany the program, and to determine whether they can be used to…
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.
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
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.
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…
Shirk, Stephen R.; Gudmundsen, Gretchen; Kaplinski, Heather Crisp; McMakin, Dana L.
Minimizing depression in residential aged care facilities is a formidable challenge but doing so may improve quality of life and protect against dementia. A pilot project with residents with cognitive decline and concurrent depression tested the suitability of a faith-based cognitive behavioraltherapy (CBT) intervention in reducing participant levels of depression, offering promising results. PMID:22359836
Obsessive-compulsive disorder (OCD) is a prevalent, chronic and disabling anxiety disorder. Despite the efficacy and strength of pharmacologic interventions for OCD, medications are not always well accepted or effective, making an efficacious psychosocial alternative especially attractive. Cognitive-behavioraltherapy (CBT) has been established as an effective treatment for adult OCD, yet access to such treatment is limited, especially in rural areas.
Joseph A. Himle; Daniel J. Fischer; Jordana R. Muroff; Michelle L. Van Etten; Laura M. Lokers; James L. Abelson; Gregory L. Hanna
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.
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…
The current study evaluated cognitive-behavioraltherapy (CBT) for adolescent depression delivered in health clinics and counseling centers in four high schools. Outcomes were benchmarked to results from prior efficacy trials. Fifty adolescents diagnosed with depressive disorders were treated by eight doctoral-level psychologists who followed a…
Shirk, Stephen R.; Kaplinski, Heather; Gudmundsen, Gretchen
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.
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
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
In this article, we describe a pilot study that investigated the effectiveness of group cognitive behavioraltherapy (CBT) for auditory hallucinations. Eleven inpatients with either chronic schizophrenia or schizoaffective disorder participated in 2 CBT groups of differing treatment duration (i.e., 7 versus 20 sessions). The results showed that…
Pinkham, Amy E.; Gloege, Andrew T.; Flanagan, Steven; Penn, David L.
This study investigated the effectiveness of Rational-emotive behaviortherapy in the treatment of adult victims of childhood sexual abuse. A sample of 42 women, seeking help for their psychological distress associated with childhood sexual abuse, was selected by means of an assessment interview and the Trauma Sympton Checklist, and randomly assigned to a treatment (n=28) and a delayed treatment control
The purpose of this article is to provide specific guidelines for child-centered play therapists to set behavioral outcome goals to effectively work with families and to meet the demands for accountability in the managed care environment. The child-centered play therapy orientation is the most widely practiced approach among play therapists who…
Post, Phyllis B.; Ceballos, Peggy L.; Penn, Saundra L.
Sixty-four headache sufferers were allocated randomly to cognitive-behavioraltherapy (CBT), temporal pulse amplitude (TPA) biofeedback training, or waiting-list control. Fifty-one participants (14M/37F) completed the study, 30 with migraine and 21 with tension-type headache. Treatment consisted of 8, 1-hour sessions. CBT was highly effective,…
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 experienced significantly slower symptom improvement than youths in
V. Robin Weersing; Satish Iyengar; David J. Kolko; Boris Birmaher; David A. Brent
Few studies have examined treatments for complicated grief—a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive?behavioraltherapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of complicated grief were allocated to 1 of 3 treatment conditions: (a) a condition
Paul A. Boelen; Jos de Keijser; Marcel A. van den Hout; Jan van den Bout
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.
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 patients (n = 12) with persistent
Lisa A. Uebelacker; Risa B. Weisberg; Ryan Haggarty; Ivan W. Miller
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.
Cognitive-behavioraltherapy (CBT) and pharmacotherapy demonstrate efficacy across the anxiety disorders, but recognition of their limitations has sparked interest in combining modalities to maximize benefit. This article reviews the empirical literature to examine whether combining treatments influences efficacy of either monotherapy.We conducted a comprehensive literature search of published randomized trials that compared combined treatment with pharmacologic or CBT monotherapies. Ten
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
Objective: Few treatments for somatization have been proven effective. In the past decade, however, clinical trials of cognitive-behavioraltherapy (CBT) have been promising. Our aim was to critically review and synthesize the evidence from these trials. Methods: A search of the Medline database from 1966 through July 1999 was conducted to identify controlled trials designed to evaluate the efficacy of
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
BACKGROUND: Empirical support for cognitive behavioraltherapy (CBT) for treating Japanese patients with major depression is lacking, therefore, a feasibility study of CBT for depression in Japanese clinical settings is urgently required. FINDINGS: A culturally adapted, 16-week manualized individual CBT program for Japanese patients with major depressive disorder was developed. A total of 27 patients with major depression were enrolled
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…
Objective: This study examined the feasibility, acceptability, and effects of Camp Cope-A-Lot (CCAL), a computer-assisted cognitive behavioraltherapy (CBT) for anxiety in youth. Method: Children (49; 33 males) ages 7-13 (M = 10.1 [plus or minus] 1.6; 83.7% Caucasian, 14.2% African American, 2% Hispanic) with a principal anxiety disorder were…
Compared panic control treatment (PCT), behaviortherapy for panic disorders, with alprazolam medication, placebo, and waiting-list control groups. Percentage of clients (N=57) completing study who were free of panic attacks following PCT was 87 percent, compared with 50 percent for alprazolam, 36 percent for placebo, and 33 percent for…
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.
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,…
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…
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.
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
The purpose of this study is to adapt and pilot test a group Cognitive-BehavioralTherapy (CBT) model which has been proven to be effective in treating depression in Puerto Rican adolescents, to treat depressive symptoms and improve glycemic control in adolescents with diabetes. Eleven adolescents aged 13-16 participated in a 12 session group CBT intervention. Indicators of outcome effects (depressive
Cognitive-behavioraltherapy (CBT) interventions are often used as adjunct treatments with standard medical care to help patients with chronic illnesses better manage their pain and distress or improve function. We review the primary assumptions and the four essential components that underlie all CBT interventions. We then examine the outcomes produced by CBT interventions for patients with two chronic illnesses for
Laurence A Bradley; Nancy L Mckendree-Smith; Leanne R Cianfrini
BACKGROUND: Cognitive model of panic disorder have proposed that panic attacks result from the catastrophic misinterpretation of certain bodily sensations. Cognitive-BehavioralTherapy (CBT) for panic disorder aims to change these catastrophic cognitions. CBT intervention successfully caused reduction of catastrophic cognitions and symptomatic improvement in the majority of cases. However there are some patients who fail to modify their catastrophic cognitions
The Treatment for Adolescents With Depression Study (TADS) was designed to compare the relative and combined effectiveness of cognitive behaviortherapy (CBT) and fluoxetine, each of which had demonstrated efficacy in carefully controlled single-site studies. Models of CBT from these efficacy studies served as the foundation for the TADS…
Clinical Practice Guidelines for depression and anxiety recommend cognitive-behavioraltherapy (CBT) as an equivalent and sometimes more effective treatment than medication. The limited research investigating CBT for anxiety and depression in epilepsy demonstrates mixed results. Described here is a pilot project using an existing group CBT intervention for symptoms of depression and\\/or anxiety, CBT Basics II, in patients with epilepsy.
S. Macrodimitris; J. Wershler; M. Hatfield; B. Backs-Dermott; K. Mothersill; C. Baxter; S. Wiebe
Objective: The health consequences of tobacco smoking disproportionately affect African Americans, but research on whether efficacious interventions can be generalized to this population is limited. This study examined the efficacy of group-based cognitive-behavioraltherapy (CBT) for smoking cessation among African Americans. Method: Participants…
Webb, Monica S.; de Ybarra, Denise Rodriguez; Baker, Elizabeth A.; Reis, Isildinha M.; Carey, Michael P.
Individuals with intellectual disabilities (ID) often display mental health symptoms that may benefit from psychotherapy. In this pilot study, a newly designed cognitive behavioraltherapy (CBT) group treatment targeting mood difficulties was provided to 8 adults with mild-borderline ID. Assessment occurred at pretreatment, posttreatment, and 4…
Ghafoori, Bita; Ratanasiripong, Paul; Holladay, Christina
Background: Bipolar disorder (BD) is a common disorder that results in significant psychosocial impairment, including diminished quality of life and functioning, despite aggressive pharmacotherapy. Psychosocial interventions that target functional factors could be beneficial for this population, and we hypothesized that the addition of group cognitive behavioraltherapy (CBT) to maintenance pharmacotherapy would improve functioning and quality of life. Methods: Patients
Irene Patelis-Siotis; L. Trevor Young; Janine C. Robb; Michael Marriott; Peter J. Bieling; Linda C. Cox; Russell T. Joffe
In January 2001, Accreditation Council of Graduate Medical Education accredited general psychiatry training programs were charged with the requirement to train residents in cognitive-behavioraltherapy (CBT) to a level of competence. Programs were given the responsibility to delineate standards for trainees, to determine measures of competence,…
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
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…
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
Objective: To explore pretreatment and short-term improvement variables as potential moderators and predictors of 12-month follow-up outcome of unsupported online computerized cognitive behavioraltherapy (CCBT), usual care, and CCBT combined with usual care for depression. Method: Three hundred and three depressed patients were randomly allocated…
de Graaf, L. Esther; Hollon, Steven D.; Huibers, Marcus J. H.
In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive BehavioralTherapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing a…
van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike
Sleep disturbance is common in dialysis patients and is associated with the development of enhanced inflammatory responses. Cognitive-behavioraltherapy is effective for sleep disturbance and reduces inflammation experienced by peritoneal dialysis patients; however, this has not been studied in hemodialysis patients. To determine whether alleviation of sleep disturbance in hemodialysis patients also leads to less inflammation, we conducted a randomized
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
We evaluated the changes in taste responsiveness of anorexia nervosa (AN) patients during behaviortherapy. Taste responsiveness of AN patients was lower at admission when compared to controls but it improved significantly over the course of treatment (p < 0.01). Taste responsiveness improved prior to increase in body weight. No significant correlation was noted between weight gain and improvement in
In chronic fatigue syndrome (CFS), facilitating, initiating, and perpetuating factors are distinguished. Although somatic factors might have initiated symptoms in CFS, they do not explain the persistence of fatigue. Cognitive behaviortherapy (CBT) for CFS focuses on factors that perpetuate and prolong symptoms. Recently it has been shown that,…
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…
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 compare the outcomes of naturalistic CBT delivered by trainee
Nicholas R. Forand; Susan Evans; Dean Haglin; Baruch Fishman
Insomnia is a pervasive problem for many patients suffering from medical and psychiatric conditions. Even when the comorbid disorders are successfully treated, insomnia often fails to remit. In addition to compromising quality of life, untreated insomnia may also aggravate and complicate recovery from the comorbid disease. Cognitive behaviortherapy for insomnia (CBT-I) has an established efficacy for primary insomnia, but
Cognitive behaviortherapy (CBT) is a common em- pirically supported intervention (1) that is effective in 40%-60% of patients with unipolar depression (2). Know- ing which patients are likely to benefit from CBT could in- crease the response rate and, through targeted referrals, decrease costs. CBT involves, among other skills, learning to interrupt automatic sustained emotional processing (e.g., elaboration, rumination)
Greg J. Siegle; Cameron S. Carter; Michael E. Thase
Cognitive behavioraltherapy (CBT) is widely regarded as the treatment of choice for bulimia nervosa (BN), with previous reviews of the CBT outcome literature claiming an approximate 40%–50% recovery rate. Most of these reviews have focused on reductions of binge eating and purging; however, the cognitive model of BN that underlies the CBT approach identifies three additional symptoms as central
Schizophrenia is one of the most devastating psychiatric illnesses. There has been a tremendous worldwide research and clinical effort into early intervention for psychosis. However, despite significant improvement in symptoms after a first episode, there is no corresponding quality improvement in function for many individuals. Thus, increased attention has been given to psychological intervention in particular cognitive behavioraltherapy (CBT)
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…
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
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
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
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
A study was conducted to determine the effect of behaviortherapy on personality disorders when treatment focused on an Axis I diagnosis of obsessive-compulsive disorder (OCD). Twenty-one patients diagnosed with OCD participated. At pretest, the mean number of personality disorders was approximately four, whereas the posttest number was approximately three. Analyses suggest that this change, although apparently small, is clinically
Dean McKay; Fugen Neziroglu; John Todaro; Jose A. Yaryura-Tobias
Cognitive-behavioraltherapy (CBT) and pharmacotherapy with serotonin reuptake inhibitors (SRIs) are established monotherapies for obsessive-compulsive disorder (OCD), yet research on their combined efficacy is lacking. Practicing psychologists who treat OCD are thus unable to say definitively whether exposure and ritual prevention would be more successful with concomitant SRI pharmacotherapy. The authors explored this issue in a clinical sample of 56
Martin E. Franklin; Jonathan S. Abramowitz; Lori A. Zoellner; Norah C. Feeny
Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioraltherapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…
Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.
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…
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
There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioraltherapy and other well-researched cognitive interventions. The purpose of this article is to describe the…
This literature review explores the potential impact of Rational Emotive BehaviorTherapy (REBT) on teacher efficacy and student achievement. Research conducted to date, focusing on increasing teacher efficacy and student achievement, has produced mixed results. Teachers continue to think, emote, and behave in unhelpful ways. REBT appears to…
Trauma-Focused Cognitive BehavioralTherapy (TF-CBT) 2 Day TF-CBT Training Thursday & Friday May 3, and in a variety of settings. This two day workshop will provide clinicians with training in how to provide TF-CBT and to implement this model. Pre-Training Recommendation: Participants are strongly encouraged to complete the TF-CBT
Objective: Many studies have confirmed the efficacy of cognitive behavioraltherapy (CBT) as a treatment for depression. However, the mechanism of CBT for depression reduction is still not well understood. This study explored the mechanism of CBT from the perspective of individuals' problem-solving appraisal. Method: A one-group pretest-posttest…
This study compared the effects of a higher dose of cognitive behavioraltherapy (CBT) for panic disorder versus CBT for panic disorder combined with “straying” to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic
Michelle G. Craske; Todd J. Farchione; Laura B. Allen; Velma Barrios; Milena Stoyanova; Raphael Rose
Trauma Focused Cognitive BehavioralTherapy (TF CBT) 2 Day Training Spring 2013 Trauma participating in treatment. This two day workshop will provide clinicians with training in how to provide TF-CBT Training / Training Fee $225 Pre-Training Requirement: Participants must complete TF-CBT Web course before
Although several theories exist to describe why patients improve in cognitive-behavioraltherapy (CBT), in only a limited number of studies has CBT skill acquisition been examined, particularly among patients with complex clinical profiles. Thus, the overarching aim of this research was to develop a tool to measure patients' use of CBT skills,…
Jacob, Karen L.; Christopher, Michael S.; Neuhaus, Edmund C.
Background: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioraltherapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or…
Wood, Jeffrey J.; Drahota, Amy; Sze, Karen; Har, Kim; Chiu, Angela; Langer, David A.
The goals of these two studies were to assess the acceptability and feasibility as well as to gather preliminary efficacy data on a modified combination cognitive behavioral (CBT) and attachment based family therapy (ABFT) for adolescents (ages 12–18), with the primary diagnosis of generalized (GAD), social phobia (SP), and separation (SAD) anxiety disorders. In Phase I, CBT was modified for
Objective: This study assessed a Web-based cognitive-behavioraltherapy (CBT) for maladaptive perfectionism, investigating perfectionism, anxiety, depression, negative automatic thoughts, and perceived stress. Participants: Participants were undergraduate students defined as maladaptive perfectionists through a screening questionnaire at an urban…
Depression and anxiety are the most common mental health disorders seen in clinical practice and they are highly comorbid. Cognitive behavioraltherapy (CBT) has been demonstrated as an effective treatment for both depression and anxiety but is often not available to all individuals who could benefit from it. This paper investigates the…
Hamilton, Kate E.; Wershler, Julie L.; Macrodimitris, Sophie D.; Backs-Dermott, Barb J.; Ching, Laurie E.; Mothersill, Kerry J.
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…
Safir, Marilyn P.; Wallach, Helene S.; Bar-Zvi, Margalit
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…
Wallach, Helene S.; Safir, Marilyn P.; Bar-Zvi, Margalit
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…
Background: In order to develop Stepped Care trauma-focused cognitive behavioraltherapy (TF-CBT), a definition of early response/non-response is needed to guide decisions about the need for subsequent treatment. Objective: The purpose of this article is to (1) establish criterion for defining an early indicator of response/non-response to the…
Salloum, Alison; Scheeringa, Michael S.; Cohen, Judith A.; Storch, Eric A.
Alternatives for Families: A Cognitive-BehavioralTherapy (AF-CBT) is an evidence-based treatment for families with children aged 5 to 15 years who have been affected by verbal and physical aggression in the family. AF-CBT was designed to address risks for exposure to emotional and physical aggression as well as common clinical consequences of…
Herschell, Amy D.; Kolko, David J.; Baumann, Barbara L.; Brown, Elissa J.
Because anxiety is the most common mental health disorder diagnosed in children, early intervention is crucial for fundamental coping. Although cognitive-behavioraltherapy (CBT) is the preferred treatment method for this affective disorder, instruction for children needs to be specific for them to successfully acquire and implement essential CBT…
Kearny, Regina; Pawlukewicz, Justine; Guardino, Mary
The outcome of a sequential treatment strategy that included cognitive behavioraltherapy (CBT) in the prevention of major depressive disorder relapse among 46 youths is examined. Results show that youths under the antidepressant medication management plus relapse prevention CBT treatment was at lower risk for relapse than those under the…
Kennard, Betsy D.; Emslie, Graham J.; Mayes, Taryn L.; Nightingale-Teresi, Jeanne; Nakonezny, Paul A.; Hughes, Jennifer L.; Jones, Jessica M.; Tao, Rongrong; Stewart, Sunita M.; Jarrett, Robin B.
Since the early 1990s, cognitive behavioraltherapy (CBT) has been increasingly used as an adjunctive treatment for psychotic disorders. This paper describes the CBT of three cases, each at a different stage of psychotic disorder: at-risk mental state, first-episode psychosis, and chronic psychotic disorder. For the at-risk mental state, treatment…
Valmaggia, Lucia R.; Tabraham, Paul; Morris, Eric; Bouman, Theo K.
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 patients (n = 12) with persistent symptoms of depression, despite antidepressant medication treatment. Ten of 12 participants completed 10 sessions of therapy over the course of 4 months, and all endorsed high levels of treatment satisfaction. Participants' depression scores declined significantly over time, and 75% of participants experienced at least 50% change on a self-report measure of depression symptoms. There were trends for social functioning, pain, and general health perceptions to improve over time. These results highlight the acceptability and feasibility of adapting behaviortherapy for primary care, and support the continuation of this research. PMID:19282506
Uebelacker, Lisa A; Weisberg, Risa B; Haggarty, Ryan; Miller, Ivan W
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, we used a treatment development model to adapt behaviortherapy for primary care patients (n = 12) with persistent symptoms of depression, despite antidepressant medication treatment. Ten of 12 participants completed 10 sessions of therapy over the course of 4 months, and all endorsed high levels of treatment satisfaction. Participants' depression scores declined significantly over time, and 75% of participants experienced at least 50% change on a self-report measure of depression symptoms. There were trends for social functioning, pain, and general health perceptions to improve over time. These results highlight the acceptability and feasibility of adapting behaviortherapy for primary care, and support the continuation of this research. PMID:19282506
Uebelacker, Lisa A.; Weisberg, Risa; Haggarty, Ryan; 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.
This randomized clinical trial compared the relative efficacy of individual (child) cognitive-behavioraltherapy (ICBT), family cognitive-behavioraltherapy (FCBT), and a family-based education/support/attention (FESA) active control for treating anxiety disordered youth ages 7-14 years (M = 10.27). Youth (N = 161; 44% female; 85% Caucasian, 9%…
Kendall, Philip C.; Hudson, Jennifer L.; Gosch, Elizabeth; Flannery-Schroeder, Ellen; Suveg, Cynthia
Alcoholics Anonymous (AA) and behaviortherapy have been characterized as having opposing views of alcoholism. This article describes theoretical foundations, view of the change process, and treatment practices of AA and behaviortherapy. Theoretical and practice perspectives on integration of the two models are examined, and advantages and…
Cognitive therapy for psychosis has developed over the past 30 years from initial case studies, treatment manuals, pilot randomized controlled studies to fully powered and methodologically rigorous efficacy and, subsequently, effectiveness trials. Reviews and meta-analyses have confirmed the benefits of the interventions. Considered appraisal by government and professional organizations has now led to its inclusion in international treatment guidelines for schizophrenia. Patients consistently ask for access to psychotherapeutic interventions, and it is slowly becoming available in many European countries and other parts of the world, eg, US and the People's Republic of China. However, it remains unacceptably difficult to access for the vast majority of people with psychosis who could benefit from it. Psychosis affects people in the prime of their lives and leads to major effects on their levels of distress, well-being, and functioning, and also results in major costs to society. Providing effective interventions at an early stage has the potential to reduce the high relapse rates that occur after recovery from first episode and the ensuing morbidity and premature mortality associated with psychosis. PMID:25733937
Cognitive therapy for psychosis has developed over the past 30 years from initial case studies, treatment manuals, pilot randomized controlled studies to fully powered and methodologically rigorous efficacy and, subsequently, effectiveness trials. Reviews and meta-analyses have confirmed the benefits of the interventions. Considered appraisal by government and professional organizations has now led to its inclusion in international treatment guidelines for schizophrenia. Patients consistently ask for access to psychotherapeutic interventions, and it is slowly becoming available in many European countries and other parts of the world, eg, US and the People’s Republic of China. However, it remains unacceptably difficult to access for the vast majority of people with psychosis who could benefit from it. Psychosis affects people in the prime of their lives and leads to major effects on their levels of distress, well-being, and functioning, and also results in major costs to society. Providing effective interventions at an early stage has the potential to reduce the high relapse rates that occur after recovery from first episode and the ensuing morbidity and premature mortality associated with psychosis. PMID:25733937
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
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
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with dream enactment often involving violent or potentially injurious behaviors during REM sleep that is strongly associated with synucleinopathy neurodegeneration. Clonazepam has long been suggested as the first-line treatment option for RBD. However, evidence supporting melatonin therapy is expanding. Melatonin appears to be beneficial for the management of RBD with reductions in clinical behavioral outcomes and decrease in muscle tonicity during REM sleep. Melatonin also has a favorable safety and tolerability profile over clonazepam with limited potential for drug-drug interactions, an important consideration especially in elderly individuals with RBD receiving polypharmacy. Prospective clinical trials are necessary to establish the evidence basis for melatonin and clonazepam as RBD therapies. PMID:25454845
McGrane, Ian R; Leung, Jonathan G; St Louis, Erik K; Boeve, Bradley F
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.
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…
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…
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.
Cognitive-behavioraltherapy (CBT) was compared to a combination of aerobic\\/anaerobic exercise therapy (ET) for the treatment of elevated levels of body image disturbance in college females. CBT consisted of a modification of the 1987 Butters and Cash procedure that was tailored for group intervention; ET consisted of weightlifting and aerobic dancing. Using a counterbalancing procedure, the same therapists conducted both
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.
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
Williams syndrome (WS) is genetic neurodevelopmental disorder with a well-characterized cognitive and behavioral phenotype. Research has consistently demonstrated high rates of psychopathology in this population; however, little research has examined the use of empirically-supported psychosocial interventions in those with WS. The current case study reports on the use of Habit Reversal Therapy (HRT) to treat multiple body-focused repetitive behaviors in a child with WS. Although HRT is a well-established cognitive-behavioral intervention for body-focused repetitive behaviors, it has been infrequently used in populations with developmental disabilities. An etiologically-informed approach was used to adapt HRT to fit the known behavioral and cognitive phenotype of WS. Results suggest that HRT may be beneficial for this population. Modified treatment elements are described and future research areas highlighted. PMID:24357918
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 CBT + LT, or a minimal contact/delayed LT control (MCDT; LT following 6 weeks of monitoring). CBT, LT, and CBT + LT significantly and comparably improved depression severity relative to MCDT in intent-to-treat and completer samples. CBT + LT (73%) had a significantly higher remission rate than MCDT (20%). Using prospectively measured summer mood status to estimate the "functional" population, CBT + LT also had a significantly larger proportion of participants with clinically significant change over treatment compared with MCDT. The LT condition outcomes virtually replicated results from prior trials. CBT, alone or combined with LT, holds promise as an efficacious SAD treatment and warrants further study. If replicated, CBT + LT's remission rate would represent a clinically meaningful improvement over the 53% observed across LT studies. PMID:17563165
Rohan, Kelly J; Roecklein, Kathryn A; Tierney Lindsey, Kathryn; Johnson, Leigh G; Lippy, Robert D; Lacy, Timothy J; Barton, Franca B
Forty-eight children (M age?=?4.8 years) infected with HIV/AIDS and living in the Dominican Republic were randomly assigned to a massage therapy or a play session control group. The children in the massage therapy group received two weekly 20-min massages for 12 weeks; the children in the control group participated in a play session (coloring, playing with blocks) for the same duration and length as the massage therapy group. Overall, the children in the massage therapy group improved in self-help abilities and communication, suggesting that massage therapy may enhance daily functioning for children with HIV/AIDS. Moreover, the HIV infected children who were six or older also showed a decrease in internalizing behaviors; specifically depressive/anxious behaviors and negative thoughts were reduced. Additionally, baseline assessments revealed IQ equivalence below normal functioning for 70% of the HIV infected children and very high incidences of mood problems (depression, withdrawn) for 40% of the children and anxiety problems for 20% of the children, suggesting the need for better monitoring and alternative interventions in countries with limited resources to improve cognition and the mental health status of children infected with HIV/AIDS. PMID:18830444
Although recent research suggests that individual cognitive behavioraltherapy (CBT) may be an effective treatment for female sexual dysfunctions, we have little information regarding predictors of treatment response. The goal of the current study was to assess the degree to which pre-treatment relationship satisfaction predicted treatment response to cognitive behavioral sex therapy. Women with sexual dysfunction (n = 31, M age = 28 years, 77.4 % Caucasian) receiving cognitive-behavioral sex therapy with or without ginkgo biloba, as part of a wider randomized clinical trial, were assessed pre- and post-treatment using validated self-report measures of sexual satisfaction, sexual distress, sexual functioning, and relationship satisfaction. Pre-treatment relationship satisfaction predicted changes in sexual satisfaction and distress, but not sexual functioning. Women with higher relationship satisfaction at intake experienced larger gains in sexual satisfaction and distress over the course of treatment. Pre-treatment relationship satisfaction also moderated the association between changes in sexual functioning and changes in sexual distress, such that improved functioning was associated with decreased distress only for women entering therapy with high relationship satisfaction. These findings suggest that, for women with low relationship satisfaction before entering treatment, improvement in sexual functioning may not be enough to alleviate their sexual distress. PMID:22588577
Stephenson, Kyle R; Rellini, Alessandra H; Meston, Cindy M
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
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
Couple therapy – across a number of different theoretical approaches – has been shown to be an effective treatment for a variety of individual and relationship difficulties. Moreover, recent studies have demonstrated that the effects of several approaches last at least two to five years after the end of treatment. However, couple therapy has a critical limitation: most distressed couples – including those that eventually divorce – do not seek couple therapy. Thus, while we recognize there are notable advances in the treatment approaches described in this special section, we argue that traditional approaches to couple therapy need to be supplemented by alternative interventions before we can make a profound, population-level impact on relationship distress and divorce. To this end, we translated Integrative Behavioral Couple Therapy into a self-help, web-based program - www.OurRelationship.com. Through a combination of tailored feedback, filmed illustrations, and interactive education, the online program first helps couples identify a core problem in their relationship. The program then assists partners in coming to a new and more accurate understanding of the problem they jointly identified and subsequently brings them together in a structured conversation to share their new understandings with each other. Finally, based on this shared conceptualization, the program supports couples in making concrete changes in their relationship. In this article, we discuss the rationale for the program, describe the core components of the website, and illustrate these components with a case example. Relative advantages and disadvantages compared to traditional couple therapy are presented. PMID:25408094
Doss, Brian D.; Benson, Lisa A.; Georgia, Emily J.; Christensen, Andrew
Cognitive behavioraltherapy (CBT) has been shown to be highly effective in the treatment of health anxiety. However, little is known about the effectiveness of group CBT in the treatment of health anxiety. The current study is the largest study that has investigated the effectiveness of combined individual and group CBT for patients with the diagnosis of hypochondriasis (N=80). Therapy outcomes were evaluated by several questionnaires. Patients showed a large improvement on these primary outcome measures both post-treatment (Cohen's d=0.82-1.08) and at a 12-month follow-up (Cohen's d=1.09-1.41). Measures of general psychopathology and somatic symptoms showed significant improvements, with small to medium effect sizes. Patients with more elevated hypochondriacal characteristics at therapy intake showed a larger therapy improvement, accounting for 7-8% of the variance in therapy outcome. CBT group therapy has therefore been shown to be an appropriate and cost-effective treatment for health anxiety. PMID:25589453
Inadequate sleep among adolescents frequently contributes to obesity and reduced academic performance, along with symptoms of anxiety, depression, fatigue, and attention deficits. The etiological bases of sleep quality has been associated with both stress and sleep habits. These problems tend to be especially important for adolescents with diabetes as the effects of poor sleep complicate health outcomes. This case example concerns a 14-year-old adolescent girl with a history of type I diabetes and stress-related sleep difficulties. Treatment included cognitive-behavioral methods and hypnotic relaxation therapy. Results of this case example and other controlled research suggest that hypnotic relaxation therapy is well accepted, results in good compliance, and serves as a useful adjunctive to cognitive-behavioral intervention for sleep problems. PMID:20865769
This case series describes the development of a novel psychotherapeutic intervention for older adolescents and adults with anorexia nervosa (AN). Emotion acceptance behaviortherapy (EABT) is based on a model that emphasizes the role of anorexic symptoms in facilitating avoidance of emotions. EABT combines standard behavioral interventions that are central to the clinical management of AN with psychotherapeutic techniques designed to increase emotion awareness, decrease emotion avoidance, and encourage resumption of valued activities and relationships outside the eating disorder. Five patients with AN aged 17-43 years were offered a 24-session manualized version of EABT. Four patients completed at least 90% of the therapy sessions, and three showed modest weight gains without return to intensive treatment. Improvements in depressive and anxiety symptoms, emotion avoidance, and quality of life also were observed. These results offer preliminary support for the potential utility of EABT in the treatment of older adolescents and adults with AN. PMID:20721894
Inadequate sleep among adolescents frequently contributes to obesity and reduced academic performance, along with symptoms of anxiety, depression, fatigue, and attention deficits. The etiological bases of sleep quality has been associated with both stress and sleep habits. These problems tend to be especially important for adolescents with diabetes as the effects of poor sleep complicate health outcomes. This case example concerns a 14-year-old adolescent girl with a history of type I diabetes and stress-related sleep difficulties. Treatment included cognitive–behavioral methods and hypnotic relaxation therapy. Results of this case example and other controlled research suggest that hypnotic relaxation therapy is well accepted, results in good compliance, and serves as a useful adjunctive to cognitive–behavioral intervention for sleep problems. PMID:20865769
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, José; Zarate, Monica; Duff, Johnathan; Muir, Joan
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
The case of a 59-year-old woman psychiatrically hospitalized with comorbid insomnia, suicidal ideation, and generalized anxiety disorder is presented. Pharmacologic therapies were unsuccessful for treating insomnia prior to and during hospitalization. Intensive sleep deprivation was initiated for 40 consecutive hours followed by a recovery sleep period of 8 hours. Traditional components of cognitive behavioraltherapy for insomnia (CBTi), sleep restriction, and stimulus control therapies, were initiated on the ward. After two consecutive nights with improved sleep, anxiety, and absence of suicidal ideation, the patient was discharged. She was followed in the sleep clinic for two months engaging in CBTi. Treatment resulted in substantial improvement in her insomnia, daytime sleepiness, and anxiety about sleep. Sleep deprivation regimens followed by a restricted sleep recovery period have shown antidepressant effects in depressed patients. Similar treatment protocols have not been investigated in patients with pharmacotherapy refractory insomnia and generalized anxiety disorder. Citation: Breitstein J, Penix B, Roth BJ, Baxter T, Mysliwiec V. Intensive sleep deprivation and cognitive behavioraltherapy for pharmacotherapy refractory insomnia in a hospitalized patient. J Clin Sleep Med 2014;10(6):689-690. PMID:24932151
Breitstein, Joshua; Penix, Brandon; Roth, Bernard J.; Baxter, Tristin; Mysliwiec, Vincent
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
Six children (aged 9 to 13) diagnosed with a childhood anxiety disorder were treated with an 18-session, family-based cognitive-behavioraltherapy that was evaluated using assessments from multiple sources and a multiple-baseline (2, 4, and 6 weeks) across-cases design. Diagnoses, parent and teacher reports, and child self-reports assessed outcome. Changes in diagnostic status, standardized parent- and teacher-report measures, and parent and
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
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 attempted to examine the causal relationships among changes in automatic thoughts, dysfunctional attitudes, and depressive symptoms in a 12-week group cognitive behaviortherapy (GCBT) program for depression. In all, 35 depressed patients attending the GCBT program were monitored with the Automatic Thoughts Questionnaire, Dysfunctional Attitudes Scale, and Beck Depression Inventory at the pre-treatment, 4th and 8th sessions,
This paper offers an overview using cognitive-behaviortherapy (CBT) within a school system. In addition to providing services\\u000a to individual students, this article provides an overview of implementing CBT into a system of school-wide mental health services.\\u000a Interventions are discussed at three levels—universal school-wide interventions, target interventions with at-risk students,\\u000a and intensive interventions with students in need. Examples of specific
Ray W. Christner; Elizabeth Forrest; Jessica Morley; Elana Weinstein
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
Glutamatergic N-methyl-d-aspartate (NMDA) receptor hypofunction has been proposed as a mechanism underlying psychosis. d-cycloserine, a partial agonist at the glycine site of the NMDA receptor, enhances learning in animal models, although tachyphylaxis develops with repeated dosing. Once-weekly dosing of d-cycloserine produces persistent improvement when combined with cognitive behavioraltherapy (CBT) in anxiety disorders. Delusional beliefs can be conceptualized as a
Jennifer D. Gottlieb; Corinne Cather; Meghan Shanahan; Timothy Creedon; Eric A. Macklin; Donald C. Goff
We systematically reviewed empirical studies that investigated the use of cognitive-behavioraltherapy (CBT) for premenstrual\\u000a syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Our multi-database search identified seven published empirical reports.\\u000a Three were identified as randomized controlled trials (RCTs). The methods utilized to investigate therapeutic efficacy of\\u000a CBT in these studies varied widely from case reports to RCTs with pharmacotherapy comparison
M. Kathleen B. Lustyk; Winslow G. Gerrish; Shelley Shaver; Shaunie L. Keys
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
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
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 integration for both children. The results are discussed in terms of the challenges of evaluating sensory-integration-based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important. PMID:23060661
Addison, Laura R; Piazza, Cathleen C; Patel, Meeta R; Bachmeyer, Melanie H; Rivas, Kristi M; Milnes, Suzanne M; Oddo, Jackie
Background Ovarian cancer has the highest mortality rate of all gynaecologic cancers. Faced with poor prognoses, stressful treatment effects and a high likelihood of recurrence, survivors must confront significant physical and psychological morbidities that negatively impact health-related quality of life. Frequently reported side effects include cancer-related fatigue, peripheral neuropathy, and psychological distress. Exercise and cognitive behavioraltherapy interventions have counteracted such adverse effects in other cancer populations. Objective To investigate the feasibility and benefits of a 24-week home-based exercise intervention, coordinated with 12 weeks of cognitive behavioraltherapy (two sessions per month), developed for two types of patients diagnosed with epithelial ovarian cancer: 1) those undergoing primary treatment with adjuvant chemotherapy after primary surgery; 2) those on surveillance after completing treatment within the last 2 years. Methods Participants were recruited from the Gynaecologic Oncology Clinic. Eligible participants completed baseline assessments and were provided with home-based exercise equipment. Cognitive behavioraltherapy was provided every other week for patients via telephone. Assessments were completed at baseline (T1), 3 months (T2) and 6 months (T3). Results 19 of the 46 eligible patients approached were enrolled, with 7 patients in the treatment group and 12 in the surveillance group. There was a significant within group increase in peak VO2 from baseline to 6 months: F(2,16)?=?5.531, p?=?0.015, partial ?2?=?0.409. Conclusion The combined 6-month exercise-cognitive behavioraltherapy intervention was associated with significant increases in aerobic fitness in epithelial ovarian cancer patients assessed. These improvements were similar regardless of whether the patient was receiving chemotherapy or under surveillance. PMID:23557323
This study demonstrated that therapeutic empathy has a moderate-to-large causal effect on recovery from depression in a group of 185 patients treated with cognitive–behavioraltherapy (CBT). The authors simultaneously estimated the reciprocal effect of depression severity on therapeutic empathy and found that this effect was quite small. In addition, homework compliance had a separate effect on clinical recovery, over and
Cognitive-behavioraltherapy (CBT) for anxiety disorders in youth has been evaluated in randomized clinical trials and found\\u000a to be an efficacious treatment. Studies have investigated the effects of increased parental\\/family involvement in treatment.\\u000a In the majority of these studies, however, parental involvement is synonymous with maternal involvement leaving the role of\\u000a fathers unknown. Studies including parents in treatment have yet
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 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
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 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, cognitive restructuring, and anxiety management. CBT-hypnosis comprised the CBT components
Richard A. Bryant; Michelle L. Moulds; Rachel M. Guthrie; Reginald D. V. Nixon
ObjectiveThis pilot study evaluated outcomes for a modified 12-session protocol of cognitive-behavioraltherapy for childhood traumatic grief (CBT-CTG) conducted between March 2004 and October 2005. CTG is an emerging condition characterized by a combination of posttraumatic stress and unresolved grief symptoms. This two-module treatment model consisting of sequential trauma- and grief-focused components was shortened from a previously presented 16-session protocol.
JUDITH A. COHEN; ANTHONY P. MANNARINO; VIRGINIA R. STARON
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.
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
Objectives To determine and compare costs of a nurse-administered behavioral intervention for pregnant substance users that integrated motivational enhancement therapy with cognitive behavioraltherapy (MET-CBT) to brief advice (BA) administered by an obstetrical provider. Both interventions were provided concurrent with prenatal care. Methods We conducted a micro-costing study that prospectively collected detailed resource utilization and unit cost data for each of the two intervention arms (MET-CBT and BA) within the context of a randomized controlled trial. A three-step approach for identifying, measuring and valuing resource utilization was used. All cost estimates were inflation adjusted to 2011 U.S. dollars. Results A total of 82 participants received the MET-CBT intervention and 86 participants received BA. From the societal perspective, the total cost (including participants’ time cost) of the MET-CBT intervention was $120,483 or $1,469 per participant. In contrast, the total cost of the BA intervention was $27,199 or $316 per participant. Personnel costs (nurse therapists and obstetric providers) for delivering the intervention sessions and supervising the program composed the largest share of the MET-CBT intervention costs. Program set up costs, especially intervention material design and training costs, also contributed substantially to the overall cost. Conclusions Implementation of an MET-CBT program to promote drug abstinence in pregnant women is associated with modest costs. Future cost effectiveness and cost benefit analyses integrating costs with outcomes and benefits data will enable a more comprehensive understanding of the intervention in improving the care of substance abusing pregnant women. PMID:24760017
Xu, Xiao; Yonkers, Kimberly A.; Ruger, Jennifer P.
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
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
The conduct problems of children with callous-unemotional (CU) traits (i.e., lack of empathy, lack of guilt/lack of caring behaviors) are particularly resistant to current behavioral interventions, and it is possible that differential sensitivities to punishment and reward may underlie this resistance. Children with conduct problems and CU (CPCU) are less responsive to behavioral punishment techniques (e.g., time-out), whereas reward techniques (e.g., earning points for prizes or activities) are effective for reducing conduct problems. This study examined the efficacy of modified behavioral interventions, which de-emphasized punishment (Condition B) and emphasized reward techniques (Condition C), compared with a standard behavioral intervention (Condition A). Interventions were delivered through a summer treatment program over 7 weeks with an A-B-A-C-A-BC-A design to a group of 11 children (7-11 years; 91% male). All children were diagnosed with either oppositional defiant disorder or conduct disorder, in addition to attention-deficit hyperactivity disorder. Results revealed the best treatment response occurred during the low-punishment condition, with rates of negative behavior (e.g., aggression, teasing, stealing) increasing over the 7 weeks. However, there was substantial individual variability in treatment response, and several children demonstrated improvement during the modified intervention conditions. Future research is necessary to disentangle treatment effects from order effects, and implications of group treatment of CPCU children (i.e., deviancy training) are discussed. PMID:25022772
Miller, Natalie V; Haas, Sarah M; Waschbusch, Daniel A; Willoughby, Michael T; Helseth, Sarah A; Crum, Kathleen I; Coles, Erika K; Pelham, William E
The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioraltherapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be more effective than PCT and WL in decreasing PTSD and related symptoms.
Annmarie McDonagh; Matthew Friedman; Gregory McHugo; Julian Ford; Anjana Sengupta; Kim Mueser; Christine Carney Demment; Debra Fournier; Paula P. Schnurr; Monica Descamps
Carbamazepine (Tegretol), an anticonvulsant medication, was evaluated within a double blind, placebo controlled, single subject experimental design to assess its effectiveness for reducing self-injury and disruptive Tourette's-like behavior presented by an 11-year-old girl with mild mental retardation and suspected partial complex seizure disorder. Results of the study showed self-injury, growling noises, and facial grimacing as completely suppressed following treatment with
Rowland P. Barrett; James B. Payton; Jennifer E. Burkhart
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…
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.
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
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…
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
This 9-week study was designed to determine whether a commercial cognitive-behavioral training program could effectively reduce overt aggression behavior in Chinese young male violent offenders. Sixty-six participants were randomly assigned to receive routine intervention alone (control group) or routine intervention plus Williams LifeSkills Training (WLST group) in a 1:1 ratio. The primary outcome was change scores on the Modified Overt Aggression Scale (MOAS) from baseline to one week following end of training. Secondary outcomes were change scores on the Barratt Impulsiveness Scale-11 (BIS-11) and Cook-Medley Hostility Scale (CMHS). There were significant between-group differences in change of MOAS total score (P?.001) and all sub-scores (Ps?.01) except aggression against property. Between-group differences were also observed in change of BIS-11 and CMHS total score (Ps?0.05). All results favored the WLST group. These findings suggest WLST has the potential to be an effective intervention to reduce overt aggressive behavior in young male violent offenders. PMID:24375428
Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioraltherapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment. PMID:21159328
Behavioraltherapy is an essential part of the overall strategy for treating obesity. Successes are most evident in short-term treatment, whereas the value of the long-term approach is more difficult to assess due to a lack of adequate data. The aims of behavior-modifying measures are improving eating habits and nutritional awareness, increasing physical activity, and improving strategies for coping with psychological and social consequences. At the focus of behavioral therapeutic techniques aimed at combatting obesity is self-observation supported by stimulus-control techniques, reinforcement techniques, and help with cognitive restructuring. Furthermore, patients learn how to avoid relapse. Success over the long-term can be improved by active follow-up measures and depends, among other things, on adequate quality control. The appropriate approaches to therapeutic programs must be made transparent both to the patient involved and concerned professionals. PMID:11697287
Objective: Cognitive-behavioraltherapy (CBT) is the best established treatment for binge-eating disorder (BED) but does not produce weight loss. The efficacy of behavioral weight loss (BWL) in obese patients with BED is uncertain. This study compared CBT, BWL, and a sequential approach in which CBT is delivered first, followed by BWL (CBT + BWL).…
Grilo, Carlos M.; Masheb, Robin M.; Wilson, G. Terence; Gueorguieva, Ralitza; White, Marney A.
Stimulus equivalence is a behavioral approach to analyzing the "meaning" of stimulus sets and has an implication for clinical psychology. The formation of three-member (A --> B --> C) stimulus equivalence classes was used to investigate the effects of three different sets of sample and comparison stimuli on emergent behavior. The three stimulus sets were composed of Rational-Emotive BehaviorTherapy (REBT)-related words, non-REBT emotionally charged words, and a third category of neutral words composed of flower labels. Sixty-two women and men participated in a modified matching-to-sample experiment. Using a mixed cross-over design, and controlling for serial order effects, participants received conditional training and emergent relationship training in the three stimulus set conditions. Results revealed a significant interaction between the formation of stimulus equivalence classes and stimulus meaning, indicating consistently biased responding in favor of reaching criterion responding more slowly for REBT-related and non-REBT emotionally charged words. Results were examined in the context of an analysis of the importance of stimulus meaning on behavior and the relation of stimulus meaning to behavioral and cognitive theories, with special appraisal given to the influence of fear-related discriminative stimuli on behavior. PMID:9696110
Plaud, J J; Gaither, G A; Weller, L A; Bigwood, S J; Barth, J; von Duvillard, S P
Objective To determine whether a brief intervention for children with functional abdominal pain and their parents' responses to their child's pain resulted in improved coping 12 months later. Design Prospective, randomized, longitudinal study. Setting Families were recruited during a 4-year period in Seattle, WA and Morristown, NJ. Participants 200 children with persistent functional abdominal pain and their parents. Interventions A 3-session social learning and cognitive behavioraltherapy intervention or an education and support intervention. Main outcome measures Child symptoms and pain coping responses were monitored using standard instruments, as was parental response to child pain behavior. Data were collected at baseline and after treatment (1 week and 3, 6, and 12 months after treatment). This article reports the 12-month data. Results Relative to children in the education and support group, children in the social learning and cognitive behavioraltherapy group reported greater baseline to 12-month follow-up decreases in gastrointestinal symptom severity (estimated mean difference = -0.36, CI = -0.63, -0.01) and greater improvements in pain coping responses (estimated mean difference = 0.61, CI = 0.26, 1.02). Relative to parents in the education and support group, parents in the social learning and cognitive behavioraltherapy group reported greater baseline to 12-month decreases in solicitous responses to their child's symptoms (estimated mean difference = -0.22, CI = -0.42, -0.03) and greater decreases in maladaptive beliefs regarding their child's pain (estimated mean difference = -0.36, CI = -0.59, -0.13). Conclusions Results suggest long-term efficacy of a brief intervention to reduce parental solicitousness and increasing coping skills. This strategy may be a viable alternative for children with functional abdominal pain. Trial registration ClinicalTrials.gov Identifier #NCT00494260 PMID:23277304
Levy, Rona L.; Langer, Shelby L.; Walker, Lynn S.; Romano, Joan M.; Christie, Dennis L.; Youssef, Nader; DuPen, Melissa M.; Ballard, Sheri A.; Labus, Jennifer; Welsh, Ericka; Feld, Lauren D.; Whitehead, William E.
In this article the procedure of selection of physiological parameters for optoelectronic system supporting behavioraltherapy of autistic children is proposed. Authors designed and conducted an experiment in which a group of 30 health volunteers (16 females and 14 males) were examined. Under controlled conditions people were exposed to a stressful situation caused by the picture or sound (1kHz constant sound, which was gradually silenced and finished with a shot sound). For each of volunteers, a set of physiological parameters were recorded, including: skin conductance, heart rate, peripheral temperature, respiration rate and electromyography. The selected characteristics were measured in different locations in order to choose the most suitable one for the designed therapy supporting system. The bio-statistical analysis allowed us to discern the proper physiological parameters that are most associated to changes due to emotional state of a patient, such as: skin conductance, temperatures and respiration rate. This allowed us to design optoelectronic sensors network for supporting behavioraltherapy of children with autism.
Landowska, A.; Karpienko, K.; Wróbel, M.; Jedrzejewska-Szczerska, M.
Mucopolysaccharidosis type VII (MPS VII; Sly syndrome) is one of a group of lysosomal storage diseases that share many clinical features, including mental retardation and hearing loss. Lysosomal storage in neurons of the brain and the associated behavioral abnormalities characteristic of a murine model of MPS VII have not been shown to be corrected by either bone marrow transplantation or gene therapy. However, intravenous injections of recombinant beta-glucuronidase initiated at birth reduce the pathological evidence of disease in MPS VII mice. In this study we present evidence that enzyme replacement initiated at birth improved the behavioral performance and reduced hearing loss in MPS VII mice. Enzyme-treated MPS VII mice performed similarly to normal mice and significantly better than mock- treated MPS VII mice in every phase of the Morris Water Maze test. In addition, the auditory function of treated MPS VII mice was dramatically improved, and was indistinguishable from normal mice. These data indicate that some of the learning, memory, and hearing deficits can be prevented in MPS VII mice if enzyme replacement therapy is initiated early in life. These data also provide functional correlates to the biochemical and histopathological improvements observed after enzyme replacement therapy. PMID:9525982
O'Connor, L H; Erway, L C; Vogler, C A; Sly, W S; Nicholes, A; Grubb, J; Holmberg, S W; Levy, B; Sands, M S
The state of the art for treatment efficacy studies now requires manual guided treatments and tests of therapist adherence. This report provides findings regarding adherence assessment of therapists participating in an investigation of treatment matching in adolescent substance abusers. The Group Sessions Rating Scale (GSRS), a group-therapy process measure, was studied to determine its appropriateness for assessing group treatment of adolescents with a) substance use disorders (SUD), b) interrater reliability, c) internal consistency, and d) ability to discriminate the active ingredients of cognitive-behavioraltherapy (CBT) from interactional therapy (IT). Interrater reliabilities were moderate to high, with those for CBT generally higher than those for IT. Internal consistency of CBT items was moderate, whereas those of IT were moderately high. Discriminability between the two treatment modalities was high. The frequency of active ingredients was generally therapy-specific: high for the relevant and low for the nonrelevant therapeutic modality items. The GSRS was found to be effective in the measurement of treatment process in adolescents with SUD. PMID:9680041
Kaminer, Y; Blitz, C; Burleson, J A; Kadden, R M; Rounsaville, B J
Cognitive-behavioraltherapy (CBT), which encompasses exposure with response prevention (ERP) and cognitive therapy, has demonstrated efficacy in the treatment of obsessive-compulsive disorder (OCD). However, the samples studied (reflecting the heterogeneity of OCD), the interventions examined (reflecting the heterogeneity of CBT), and the definitions of treatment response vary considerably across studies. This review examined the meta-analyses conducted on ERP and cognitive therapy (CT) for OCD. Also examined was the available research on long-term outcome associated with ERP and CT. The available research indicates that ERP is the first line evidence based psychotherapeutic treatment for OCD and that concurrent administration of cognitive therapy that targets specific symptom-related difficulties characteristic of OCD may improve tolerance of distress, symptom-related dysfunctional beliefs, adherence to treatment, and reduce drop out. Recommendations are provided for treatment delivery for OCD in general practice and other service delivery settings. The literature suggests that ERP and CT may be delivered in a wide range of clinical settings. Although the data are not extensive, the available research suggests that treatment gains following ERP are durable. Suggestions for future research to refine therapeutic outcome are also considered. PMID:25613661
McKay, Dean; Sookman, Debbie; Neziroglu, Fugen; Wilhelm, Sabine; Stein, Dan J; Kyrios, Michael; Matthews, Keith; Veale, David
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
Purpose Family caregivers of persons with dementia (PWD) may receive caregiver training because of logistical constraints and privacy concerns. This study evaluated the effectiveness of an online intervention for family caregivers of PWD in improving their self-efficacy in managing behavioral and psychological symptoms of dementia (BPSD), and their emotion well-being. Subjects and methods A total of 36 family caregivers of people with dementia participated in a 9-week online intervention based on the cognitive behavioraltherapy model. Outcomes of the intervention were measured by the Chinese version of the Neuropsychiatric Inventory Questionnaire and two domains of the Revised Scale for Caregiving Self-Efficacy. Wilcoxon signed rank tests were used to compare the change in outcome variables. Results The severity of BPSD of PWD and BPSD-related distress in family caregivers showed a statistically significant reduction after the intervention. Subgroup analysis showed self-efficacy in controlling upsetting thoughts significantly improved in caregivers of PWD at moderate to severe stages. Conclusion Online cognitive behavioraltherapy for family caregivers reduced BPSD of PWD and the related distress in their caregivers. PMID:24748781
Hypotheses predicting how cognitive behavioraltherapy (CBT) would change the daily pattern of mood and sleep in a patient with cyclothymia were formulated based on circadian processes. Using a prospective single-case experimental design, the patient provided mood ratings every 4 hours and sleep reports daily for 49 weeks, including a 4-week baseline, a 20-session CBT intervention, and a follow-up period. Improvements in mood during and after therapy were accounted for by reduced daily mood variability and extended sleep. The patient's energy at different times of day was explained by adjusting the endogenous rhythm in a mathematical circadian model. Treatment of cyclothymia and related bipolar disorders may be enhanced by integrating understanding of circadian mood regulation into CBT treatment. PMID:18324665
The primary aim of the study was to investigate dysfunctional beliefs in the form of inflated responsibility (IR) and thought action fusion (TAF) as predictive and mediating variables in individual (n=33) and group (n=37) cognitive behavioraltherapy (CBT) for obsessive compulsive disorder (OCD). IR and TAF declined significantly during CBT, and the decline was positively associated with change in OCD symptoms. However, when controlling for change in depressive symptoms, only change in IR remained significantly associated with OCD symptom change. The moral subtype of TAF predicted poorer treatment outcome, but only in group CBT. Both treatments produced a similar amount of change in the dysfunctional beliefs. The results provide some, preliminary evidence that IR, but not TAF, may be specifically involved in the change mechanisms of both individual and group CBT for OCD, although the design of the study with pre- and post-therapy measurements only does not allow for a causal mediator analysis. PMID:21232914
Jónsson, Hjalti; Hougaard, Esben; Bennedsen, Birgit E
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 fearful situations (F. H. Wilhelm & W. T. Roth, 1998). However, due to the constraints imposed by virtual reality (VR), we hypothesized that VR exposure to fearful situations would activate the BIS alone. To test this hypothesis, a VR free-standing elevator simulation was presented to participants selected for high and low fear of heights. As predicted, the high-anxious group strongly responded electrodermally (effect size d = 1.53), but showed only minimal HR elevations during exposure (d = 0.12), and little other cardiovascular or respiratory changes. The low-anxious control group showed little electrodermal and HR reactivity (d = 0.28 and 0.12). A comparison with data from a previous study demonstrated that this pattern was in stark contrast to the large electrodermal and cardiovascular response observed during situational in-vivo exposure outside the laboratory. We conclude that the BIS, but not BAS, is selectively activated during VR exposure, causing discordance between self-report and commonly used physiological measures of anxiety. Results are discussed within the framework of E. B. Foa & M. J. Kozak's (1986) emotional processing theory of fear modification, suggesting different mechanisms underlying VR and in-vivo exposure treatments. PMID:16167191
Wilhelm, Frank H; Pfaltz, Monique C; Gross, James J; Mauss, Iris B; Kim, Sun I; Wiederhold, Brenda K
Objective This study used prospective, observational methods to evaluate six features of therapist behavior as predictors of homework adherence in cognitive-behavioraltherapy (CBT) for adolescent depression, with the goal of identifying therapist strategies with the potential to improve adolescent adherence. Therapist behaviors were expected to interact with initial levels of client resistance or adherence to predict subsequent homework completion. Method Participants were 50 referred adolescents (33 females, 54% ethnic minority) ages 14–18 (M=15.9) meeting diagnostic criteria for a depressive disorder, and without co-morbid psychotic disorder, bipolar disorder, autism spectrum disorder, intellectual disability, or concurrent treatments. Therapist homework-related behaviors were coded from audiotapes of Sessions 1 and 2 and used to predict adolescents’ homework adherence, coded from audiotapes of Sessions 2 and 3. Results Several therapist behaviors were predictive of subsequent homework adherence, particularly for initially resistant or non-adherent adolescents. Stronger homework rationale and greater time allocated to explaining homework in Session 1 predicted greater adherence at Session 2, particularly for initially resistant adolescents. Stronger rationale and eliciting reactions/troubleshooting obstacles in Session 2 predicted greater adherence at Session 3, particularly for adolescents who were less adherent to prior homework. Conclusions Strategies such as providing a strong rationale, allocating more time to assigning homework, and eliciting reactions/troubleshooting obstacles may be effective ways to bolster homework adherence among initially less engaged, depressed teens. PMID:23237021
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,…
Although behavioral couples therapy (BCT) has considerable support in treating alcohol use disorder (AUD), studies have not examined BCT for dual problem couples in which both partners have current AUD. This study compared outcomes after BCT for dual problem couples (n = 20) with outcomes for single problem couples in which only one partner had AUD (n = 386). Results showed that dual problem and single problem couples did not differ significantly on degree of improvement in abstinence following BCT. A case example illustrates the application of BCT when both partners have a current AUD. PMID:23264718
Assessment of awareness for those with disorders of consciousness is a challenging undertaking, due to the complex presentation of the population. Debate surrounds whether behavioral assessments provide greatest accuracy in diagnosis compared to neuro-imaging methods, and despite developments in both, misdiagnosis rates remain high. Music therapy may be effective in the assessment and rehabilitation with this population due to effects of musical stimuli on arousal, attention, and emotion, irrespective of verbal or motor deficits. However, an evidence base is lacking as to which procedures are most effective. To address this, a neurophysiological and behavioral study was undertaken comparing electroencephalogram (EEG), heart rate variability, respiration, and behavioral responses of 20 healthy subjects with 21 individuals in vegetative or minimally conscious states (VS or MCS). Subjects were presented with live preferred music and improvised music entrained to respiration (procedures typically used in music therapy), recordings of disliked music, white noise, and silence. ANOVA tests indicated a range of significant responses (p???0.05) across healthy subjects corresponding to arousal and attention in response to preferred music including concurrent increases in respiration rate with globally enhanced EEG power spectra responses (p?=?0.05–0.0001) across frequency bandwidths. Whilst physiological responses were heterogeneous across patient cohorts, significant post hoc EEG amplitude increases for stimuli associated with preferred music were found for frontal midline theta in six VS and four MCS subjects, and frontal alpha in three VS and four MCS subjects (p?=?0.05–0.0001). Furthermore, behavioral data showed a significantly increased blink rate for preferred music (p?=?0.029) within the VS cohort. Two VS cases are presented with concurrent changes (p???0.05) across measures indicative of discriminatory responses to both music therapy procedures. A third MCS case study is presented highlighting how more sensitive selective attention may distinguish MCS from VS. The findings suggest that further investigation is warranted to explore the use of music therapy for prognostic indicators, and its potential to support neuroplasticity in rehabilitation programs. PMID:24399950
O’Kelly, Julian; James, L.; Palaniappan, R.; Taborin, J.; Fachner, J.; Magee, W. L.
Assessment of awareness for those with disorders of consciousness is a challenging undertaking, due to the complex presentation of the population. Debate surrounds whether behavioral assessments provide greatest accuracy in diagnosis compared to neuro-imaging methods, and despite developments in both, misdiagnosis rates remain high. Music therapy may be effective in the assessment and rehabilitation with this population due to effects of musical stimuli on arousal, attention, and emotion, irrespective of verbal or motor deficits. However, an evidence base is lacking as to which procedures are most effective. To address this, a neurophysiological and behavioral study was undertaken comparing electroencephalogram (EEG), heart rate variability, respiration, and behavioral responses of 20 healthy subjects with 21 individuals in vegetative or minimally conscious states (VS or MCS). Subjects were presented with live preferred music and improvised music entrained to respiration (procedures typically used in music therapy), recordings of disliked music, white noise, and silence. ANOVA tests indicated a range of significant responses (p???0.05) across healthy subjects corresponding to arousal and attention in response to preferred music including concurrent increases in respiration rate with globally enhanced EEG power spectra responses (p?=?0.05-0.0001) across frequency bandwidths. Whilst physiological responses were heterogeneous across patient cohorts, significant post hoc EEG amplitude increases for stimuli associated with preferred music were found for frontal midline theta in six VS and four MCS subjects, and frontal alpha in three VS and four MCS subjects (p?=?0.05-0.0001). Furthermore, behavioral data showed a significantly increased blink rate for preferred music (p?=?0.029) within the VS cohort. Two VS cases are presented with concurrent changes (p???0.05) across measures indicative of discriminatory responses to both music therapy procedures. A third MCS case study is presented highlighting how more sensitive selective attention may distinguish MCS from VS. The findings suggest that further investigation is warranted to explore the use of music therapy for prognostic indicators, and its potential to support neuroplasticity in rehabilitation programs. PMID:24399950
O'Kelly, Julian; James, L; Palaniappan, R; Taborin, J; Fachner, J; Magee, W L
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.
Early identification and treatment of social anxiety disorder (SAD) is critical to prevent development of a chronic course of symptoms, persistent functional impairment, and progressive psychiatric comorbidity. A small but growing literature supports the effectiveness of cognitive behaviortherapy (CBT) for anxiety disorders, including SAD, in adolescence. The present randomized controlled trial evaluated the efficacy of group vs. individual CBT for adolescents with generalized SAD in relation to an educational/supportive psychotherapy that did not contain specific CBT elements. All three treatments were associated with significant reductions in symptoms and functional impairment, and in improved social skills. No differences between treatments emerged on measures of symptoms, but the CBT conditions demonstrated greater gains on behavioral measures. The implications of the findings are discussed. PMID:18653310
Herbert, James D.; Gaudiano, Brandon A.; Rheingold, Alyssa A.; Moitra, Ethan; Myers, Valerie H.; Dalrymple, Kristy L.; Brandsma, Lynn L.
The authors applied cognitive-behavioraltherapy (CBT) for depression using the Healthy Management of Reality treatment manual. This 16-week group treatment comprised four 4-week modules: thoughts (cognitive restructuring), activities (behavioral activation), people (interpersonal skills training), and health (addresses physical health and depression). They illustrated the use of the culture-sensitive treatment manuals by way of the member characteristics and clinical process of a Spanish-language CBT group for depression. They highlighted the challenges and satisfactions of working with a Spanish-speaking population in the public sector, and focused on how culture and socioeconomic status influence patients, and how to adapt treatment to these factors. Last, they demonstrated how technological advances integrate with culture-sensitive, evidence-based treatments to better serve this population and reduce disparities. PMID:20549680
Aguilera, Adrian; Garza, Monica J; Muñoz, Ricardo F
The authors applied cognitive-behavioraltherapy (CBT) for depression using the Healthy Management of Reality treatment manual. This 16-week group treatment comprised four 4-week modules: thoughts (cognitive restructuring), activities (behavioral activation), people (interpersonal skills training), and health (addresses physical health and depression). They illustrated the use of the culture-sensitive treatment manuals by way of the member characteristics and clinical process of a Spanish-language CBT group for depression. They highlighted the challenges and satisfactions of working with a Spanish-speaking population in the public sector, and focused on how culture and socioeconomic status influence patients, and how to adapt treatment to these factors. Last, they demonstrated how technological advances integrate with culture-sensitive, evidence-based treatments to better serve this population and reduce disparities. PMID:20549680
Aguilera, Adrian; Garza, Monica J.; Muñoz, Ricardo F.
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.
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 problems and emotional processing. Eighty-three primarily White participants (mean age = 37) with a
Michelle G. Newman; Louis G. Castonguay; Thomas D. Borkovec; Aaron J. Fisher; James F. Boswell; Lauren E. Szkodny; Samuel S. Nordberg
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 center. Self- and peer-report measures of family-centered behavior, critical thinking ability, listening/interactive communication skill, and clinical behavior were collected before and after an 11-month facilitated, collaborative group mentorship intervention. Significant pre-post changes associated with intervention were found on 9 of 12 outcome measures, including information provision, respectful treatment, self-confidence, and listening and clinical skill. Changes were not found on the more trait-like variables of open-mindedness, interpersonal sensitivity, and interpersonal skill. Experienced therapists had higher scores than new therapists on most variables, including family-centered behavior, listening skill, and clinical skill. Implications regarding the utility of mentorship programs in children's rehabilitation centers are discussed. PMID:20950057
This study examined individual and family characteristics that predicted early positive change in the context of Multisystemic Therapy (MST). Families (n = 185; 65% male; average youth age 15 years) receiving MST in community settings completed assessments at the outset of treatment and 6-12 weeks into treatment. Early positive changes in youth antisocial behavior were assessed using the caregiver report on the Child Behavior Checklist Externalizing Behaviors subscale and youth report on the Self-Report Delinquency Scale. Overall, families showed significant positive changes by 6-12 weeks into treatment; these early changes were maintained into midtreatment 6-12 weeks later. Families who exhibited clinically significant gains early in treatment were more likely to terminate treatment successfully compared with those who did not show these gains. Low youth internalizing behaviors and absence of youth drug use predicted early positive changes in MST. High levels of parental monitoring and low levels of affiliation with deviant peers (mechanisms known to be associated with MST success) were also associated with early positive change. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:24866967
Stress and hypothalamic–pituitary–adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age=15) receiving Multisystemic Therapy (MST). To examine the differential relationship of cortisol with various types of stressors, self-report measures assessed lifetime stress, current episodic stress, and daily hassles. Morning and afternoon cortisol samples were collected to examine whether the relationship between stress and treatment outcome depended on the youth’s biological stress levels. Regression analyses indicated that awakening cortisol levels moderated the relationship between daily hassles and externalizing behaviors at post-treatment. More specifically, higher levels of daily hassles predicted worse outcomes only among adolescents with high levels of morning cortisol. In addition, lifetime stressors and afternoon measures of cortisol interacted to predict changes in caretaker reports of externalizing problems and youth arrests following treatment; lifetime stressors were positively associated with externalizing behavior when adolescents had low levels of afternoon cortisol. Implications for theory and future directions for evidence-based treatment are discussed. PMID:22350278
Psychosis used to be thought of as essentially a biological condition unamenable to psychological interventions. However, more recent research has shown that positive symptoms such as delusions and hallucinations are on a continuum with normality and therefore might also be susceptible to adaptations of the cognitive behavioraltherapies found useful for anxiety and depression. In the context of a model of cognitive, emotional, and social processes in psychosis, the latest evidence for the putative psychological mechanisms that elicit and maintain symptoms is reviewed. There is now good support for emotional processes in psychosis, for the role of cognitive processes including reasoning biases, for the central role of appraisal, and for the effects of the social environment, including stress and trauma. We have also used virtual environments to test our hypotheses. These developments have improved our understanding of symptom dimensions such as distress and conviction and also provide a rationale for interventions, which have some evidence of efficacy. Therapeutic approaches are described as follows: a collaborative therapeutic relationship, managing dysphoria, helping service users reappraise their beliefs to reduce distress, working on negative schemas, managing and reducing stressful environments if possible, compensating for reasoning biases by using disconfirmation strategies, and considering the full range of evidence in order to reduce high conviction. Theoretical ideas supported by experimental evidence can inform the development of cognitive behaviortherapy for persistent positive symptoms of psychosis. PMID:16885206
Background In this studyMindfulness and CBT were combined to investigate the enhance of psychotropic work. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive behavioraltherapies to create efficacious treatments. That is, introduce use of MBCT in active phase of treatment and chronic depression. Objectives This study was done to evaluate efficacy of Mindfulness Based Cognitive Therapy (MBCT) and traditional Cognitive BehaviorTherapy (CBT) with Treatments as usual (TAU) to reduce psychiatric symptoms in a sample of patients with Major Depressive Disorder (MDD). Materials and Methods 90 patients who were referred to clinics of university of Social Welfare and Rehabilitation Sciences and Tehran University Counseling Centre and met DSM-IV criteria for MDD were selected. They were randomly assigned to MBCT (n = 30), CBT (n = 30), or TAU (n = 30). They were aged between 18 and 45 years (M = 28, SD = 8), with an average of two previous depression episodes. They were interviewed through the Structured Clinical Interview for DSM-IV and self-report by Brief Symptom Inventory, pre and post treatment. Patients in MBCT and CBT group received the treatment, while TAU group continued therapy (anti-depressant). Results The results indicated that MBCT and CBT groups have significant efficacy on reduction of MDD symptoms. Conclusions MBCT appears to be as effective as CBT in the treatment of current depression. PMID:23682326
Background and Purpose Fear of movement is a risk factor for poor postoperative outcomes in patients following spine surgery. The purposes of this case series were: (1) to describe the effects of a cognitive-behavioral–based physical therapy (CBPT) intervention in patients with high fear of movement following lumbar spine surgery and (2) to assess the feasibility of physical therapists delivering cognitive-behavioral techniques over the telephone. Case Description Eight patients who underwent surgery for a lumbar degenerative condition completed the 6-session CBPT intervention. The intervention included empirically supported behavioral self-management, problem solving, and cognitive restructuring and relaxation strategies and was conducted in person and then weekly over the phone. Patient-reported outcomes of pain and disability were assessed at baseline (6 weeks after surgery), postintervention (3 months after surgery), and at follow-up (6 months after surgery). Performance-based outcomes were tested at baseline and postintervention. The outcome measures were the Brief Pain Inventory, Oswestry Disability Index, 5-Chair Stand Test, and 10-Meter Walk Test. Outcomes Seven of the patients demonstrated a clinically significant reduction in pain, and all 8 of the patients had a clinically significant reduction in disability at 6-month follow-up. Improvement on the performance-based tests also was noted postintervention, with 5 patients demonstrating clinically meaningful change on the 10-Meter Walk Test. Discussion The findings suggest that physical therapists can feasibly implement cognitive-behavioral skills over the telephone and may positively affect outcomes after spine surgery. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the CBPT intervention. Clinical implications include broadening the availability of well-accepted cognitive-behavioral strategies by expanding implementation to physical therapists and through a telephone delivery model. PMID:23599351
Motzny, Nicole; Abraham, Christine M.; Yaffe, Donna; Seebach, Caryn L.; Devin, Clinton J.; Spengler, Dan M.; McGirt, Matthew J.; Aaronson, Oran S.; Cheng, Joseph S.; Wegener, Stephen T.
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
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
" in a project funded by Wellcome Trust/DBT India Alliance. Applications are invited for JRF/SRF position(s) to work on an India Alliance grant on Auditory Processing. The applicants must be highly motivated towards). Title of the Project: Connectivity and role of inhibitory neurons in auditory perception Number
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 Behavioral health services for children and adolescents in the U.S. are lacking in accessibility, availability and quality. Evidence-based interventions for emotional and behavioral disorders can improve quality, yet few studies have systematically examined their implementation in routine care settings. Methods Using quantitative and qualitative data, we evaluated a multi-faceted implementation strategy to implement cognitive-behavioraltherapy (CBT) for depressed adolescents into two publicly-funded mental healthcare centers. Extent of implementation during the study's duration and variables influencing implementation were explored. Results Of the 35 clinicians eligible to participate, 25 (71%) were randomized into intervention (n = 11) or usual care (n = 14). Nine intervention clinicians completed the CBT training. Sixteen adolescents were enrolled in CBT with six of the intervention clinicians; half of these received at least six CBT manually-based sessions. Multiple barriers to CBT adoption and sustained use were identified by clinicians in qualitative interviews. Conclusion Strategies to implement evidence-based interventions into routine clinical settings should include multi-method, pre-implementation assessments of the clinical environment and address multiple barriers to initial uptake as well as long-term sustainability. PMID:18312677
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 in agitated behaviors and a statistically significant increase in social interaction pretest to post-test. PMID:14682084
Butyltins (BTs) have been in widespread use. Tributyltin (TBT) has been used as a biocide in a variety of applications and is found in human blood samples. Dibutyltin (DBT) has been used as a stabilizer in polyvinyl chloride plastics and as a de-worming agent in poultry. DBT, like TBT, is found in human blood. Human natural killer (NK) cells are the earliest defense against tumors and viral infections and secrete the cytokine tumor necrosis factor (TNF) alpha (?). TNF? is an important regulator of adaptive and innate immune responses. TNF? promotes inflammation and an association between malignant transformation and inflammation has been established. Previously, we have shown that TBT and DBT were able to interfere with the ability of NK cells to lyse tumor target cells. Here we show that BTs alter cytokine secretion by NK cells as well as a mixture of T and NK lymphocytes (T/NK cells). We examined 24 h, 48 h, and 6 day exposures to TBT (200- 2.5 nM) and DBT (5- 0.05 µM) on TNF? secretion by highly enriched human NK cells and T/NK cells. The results indicate that TBT (200 - 2.5 nM) decreased TNF? secretion from NK cells. In the T/NK cells 200 nM TBT decreased secretion while 100-5 nM TBT increased secretion of TNF?. NK cells or T/NK cells exposed to higher concentrations of DBT showed decreased TNF? secretion while lower concentrations showed increased secretion. The effects of BTs on TNF? secretion are seen at concentrations present in human blood. PMID:23047847
Gay (N = 52) and lesbian (N = 48) alcohol use disorder (AUD) patients and their nonsubstance-abusing same-sex relationship partners were randomly assigned to equally intensive interventions consisting of: (a) behavioral couples therapy plus individual-based treatment (BCT); or (b) individual-based treatment only (IBT). This study reports two separate trials, one with gay male participants and one with lesbian female participants. For both gay and lesbian AUD patients, those who received BCT had a significantly lower percentage of days of heavy drinking during the year after treatment than patients who received IBT only. In addition, both gay and lesbian couples who received BCT reported higher levels of relationship adjustment at the end of treatment and in the year after treatment than those who received IBT only. Thus, the response of gay and lesbian couples with an alcoholic member to BCT was consistent with what has been observed with heterosexual couples. PMID:19553063
To date, the published controlled trials on exposure to alcohol cues have had an abstinence treatment goal. A modification of cue exposure (CE) for moderation drinking, which incorporated priming doses of alcohol, could train participants to stop drinking after 2 to 3 drinks. This study examined the effects of modified CE within sessions, combined with directed homework practice. Nondependent problem drinkers who requested a moderation drinking goal were randomly allocated to modified CE or standard cognitive-behaviortherapy (CBT) for alcohol abuse. Both interventions were delivered in 6 90-min group sessions. Eighty-one percent of eligible participants completed treatment and follow-up assessment. Over 6 months, CE produced significantly greater reductions than CBT in participants' reports of drinking frequency and consumption on each occasion. No pretreatment variables significantly predicted outcome. The modified CE procedure appears viable for nondependent drinkers who want to adopt a moderate drinking goal. PMID:9337506
Sitharthan, T; Sitharthan, G; Hough, M J; Kavanagh, D J
The present study attempted to examine the causal relationships among changes in automatic thoughts, dysfunctional attitudes, and depressive symptoms in a 12-week group cognitive behaviortherapy (GCBT) program for depression. In all, 35 depressed patients attending the GCBT program were monitored with the Automatic Thoughts Questionnaire, Dysfunctional Attitudes Scale, and Beck Depression Inventory at the pre-treatment, 4th and 8th sessions, and post-treatment. The results were as follows: (1). GCBT reduces negative cognitions; (2). changes in automatic thoughts and dysfunctional attitudes lead to change in depressive symptoms; and (3). automatic thoughts play a mediating role between dysfunctional attitudes and depression. The findings taken as a whole support the Causal Cognition Model of depression. PMID:12763394
Irritable bowel syndrome (IBS) is a common disorder, reported to be found in 5%-20% of the general population. Its management accounts for up to 25% of a gastroenterologist’s workload in the outpatient department, and the main symptoms are abdominal pain, bloating, and altered bowel habits. Despite a great amount of available pharmacological treatments aimed at a wide variety of gastrointestinal and brain targets, many patients have not shown adequate symptom relief. In recent years, there has been increasing evidence to suggest that psychological treatments, in particular cognitive-behavioraltherapy (CBT), are effective for the management of IBS. This review discusses CBT for the management of IBS. CBT has proved to be effective in alleviating the physical and psychological symptoms of IBS and has thus been recommended as a treatment option for the syndrome. PMID:24379577
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.
12 clients suffering from chronic tics participated in one of two treatment programs, either a behavioral group using competing response therapy or a group using Beck-style cognitive restructuring. A repertory grid based upon the personal construct psychology of George Kelly was administered to all clients before and after treatment. The grid comprised a set of elements made up of situations with high, medium, and low risk of eliciting tics, and constructs were derived from comparisons between them. Clients' ratings of the elements on the constructs were subjected to a principal components analysis using an INGRID program. Following treatment the total variation around construct means decreased in both groups but significantly more in the cognitive group, indicating a narrowing of the difference in their perceptions of situations which formerly indicated high and low risk of inducing tics. PMID:8284152
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. PMID:24127157
Fields, Barry G; Schutte-Rodin, Sharon; Perlis, Michael L; Myers, Megin
Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist-client dyads receiving 15 sessions of cognitive-behavioraltherapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration. PMID:25611825
Hara, Kimberley M; Westra, Henny A; Aviram, Adi; Button, Melissa L; Constantino, Michael J; Antony, Martin M
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
A three hour continuing education course combining occupational therapy practice and behavior analysis strategies related to children with autism spectrum disorders was developed and delivered to 24 occupational therapy practitioners. Participants completed evaluations pre-course, post-course, and one month follow up on their self-efficacy, knowledge, and skills in managing challenging behaviors of children with autism spectrum disorders. Overall, ratings scores showed an increase in participants' self-efficacy and knowledge and skill at post-course and one-month follow-up. Despite this increase, participants continued to implement sensory strategies to decrease challenging behaviors due to increased self-efficacy in using sensory strategies and the lack of support in implementing behavior techniques outside their session time. PMID:25180710
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
Obsessive-compulsive disorder (OCD) is a prevalent, chronic and disabling anxiety disorder. Despite the efficacy and strength of pharmacologic interventions for OCD, medications are not always well accepted or effective, making an efficacious psychosocial alternative especially attractive. Cognitive-behavioraltherapy (CBT) has been established as an effective treatment for adult OCD, yet access to such treatment is limited, especially in rural areas. Technological advances allow for therapy to be provided in a real-time format over a videoconferencing network. This method allows therapists to provide state-of-the-art treatment to patients who would not otherwise have access to it. This paper presents three cases of OCD successfully treated via videoconferencing CBT. The presence of OCD was established via structured clinical interview and clinician-rated outcome measures were completed by evaluators blinded to the method of treatment. A multiple baseline across individuals design was used to support the internal validity of the CBT outcome data. Patient ratings of therapeutic alliance were high across all three cases. Information gathered from qualitative interviews post-treatment confirmed quantitative measures finding high levels of patient satisfaction. This pilot study suggests that videoconferencing-based CBT is a promising method to bring appropriate treatment to thousands who live far distances from well-trained therapists. PMID:16466688
Himle, Joseph A; Fischer, Daniel J; Muroff, Jordana R; Van Etten, Michelle L; Lokers, Laura M; Abelson, James L; Hanna, Gregory L
The current randomized study evaluated an online cognitive behavioraltherapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed. PMID:24742343
Four clinical trials have shown that a history of interpersonal trauma is associated with diminished response to cognitive-behavioraltherapy (CBT) for adolescent depression. An efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma. Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial conducted in community clinics. Clients were 43 referred adolescents with a depressive disorder and a history of interpersonal trauma. Adolescents either received m-CBT or usual care (UC) therapy. Results indicated that m-CBT was delivered with good fidelity by community clinicians, but that number of sessions completed was attenuated in both m-CBT and UC. Adolescents reported high levels of treatment satisfaction and acceptability for the new treatment. There were significant reductions in depressive symptoms over time, but no differences in outcomes between groups. Although the new treatment produced promising results, it did not outperform UC. Implications for treatment development are considered. PMID:24377410
Shirk, Stephen R; Deprince, Anne P; Crisostomo, Patrice S; Labus, Jennifer
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.
Summary Impulse control disorders (ICD) (most commonly pathologic gambling, hypersexuality, and uncontrollable spending) and compulsive behaviors can be triggered by dopaminergic therapies in Parkinson disease (PD). ICD are especially prevalent in patients receiving a dopamine agonist as part of their treatment regimen for PD, and have also been reported when dopamine agonists are used for other indications (e.g., restless legs syndrome). Although these iatrogenic disorders are common, affecting 1 in 7 patients with PD on dopamine agonists, they often elude detection by the treating physician. ICD lead to serious consequences, causing significant financial loss and psychosocial morbidity for many patients and families. ICD can appear at any time during treatment with dopamine agonists, sometimes within the first few months, but most often after years of treatment, particularly when patients receive dopamine agonists and levodopa together. In most cases ICD resolve if the dopamine agonist is withdrawn, and PD motor symptoms are managed with levodopa monotherapy. Familiarity with the clinical aspects, risk factors, pathophysiology, and management of ICD is essential for physicians using dopaminergic therapies to treat PD and other disorders. PMID:23634371
Postpartum depression (PPD) afflicts up to 15 % of women following childbirth and negatively impacts both mother and child. Therapist-assisted internet cognitive behaviortherapy (TAICBT) is a promising intervention for the treatment of PPD; however, women's perceptions of TAICBT have not been examined. Responses to 10 open-ended questions from 24 women who received TAICBT for PPD were thematically analyzed. The majority of women expressed that the TAICBT program afforded flexibility, accessibility, and convenience, as well as anonymity and privacy. Some participants described the program as helping them take a step in the right direction and enhance their self-awareness and parenting skills. Participants also described having the internet therapist individualize their treatment. Challenges related to the TAICBT program were also identified by a minority of participants including managing time to log onto the program, the fast pace, completion of homework around childcare duties, and challenges of not having a face-to-face therapist. Participants also made suggestions for future programming. The large majority of participants consistently described their internet therapist favorably; however, challenges related to the internet therapy were also identified. Results should be integrated in the development of future programming. PMID:25109484
This review summarizes the role of cognitive-behaviortherapy (CBT) in obesity treatment. Although not a specific intervention per se, CBT is the systematic application of principles of social cognitive theory to modify behaviors that are thought to contribute to or maintain obesity. Most forms of CBT include the use of five strategies: self-monitoring and goal setting; stimulus control for the modification of eating style, activity, and related habits; cognitive restructuring techniques that focus on challenging and modifying unrealistic or maladaptive thoughts or expectations; stress management; and social support. The use of these strategies in comprehensive obesity programs has been helpful in improving short-term weight losses, but long-term success remains elusive, even though these strategies are predictors of long-term weight loss maintenance. Given that obesity is a chronic condition, not unlike hypertension or diabetes, CBT interventions will need to focus on broader treatment outcomes, such as improved metabolic profiles, quality of life, psychological functioning, and physical fitness. In addition, new methods for delivering CBT interventions should be explored, including home-based programs and combination with adjunctive pharmacotherapy delivered in primary care centers. PMID:9569172
Cognitive behavioraltherapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples. PMID:23459093
Hofmann, Stefan G.; Asnaani, Anu; Vonk, Imke J.J.; Sawyer, Alice T.; Fang, Angela
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…
This report is a post-hoc, exploratory examination of the relationships among patient motivation, therapist protocol adherence, and panic disorder outcome in patients treated with cognitive behavioraltherapy within the context of a randomized clinical trial for the treatment of panic disorder (Barlow, Gorman, Shear, & Woods, 2000). Results…
Huppert, Jonathan D.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.
Over the past 25 years researchers have made enormous strides in the implementation of cognitive-behavioraltherapy (CBT) for social anxiety disorder (SAD), although considerable work remains to be done. The present paper discusses a treatment refractory case seen in our clinic. The young man presented numerous interrelated obstacles, such as low…
This study followed treatment responders from a randomized controlled trial of adults with major depression. Patients treated with medication but withdrawn onto pill-placebo had more relapse through 1 year of follow-up compared to patients who received prior behavioral activation, prior cognitive therapy, or continued medication. Prior…
Dobson, Keith S.; Hollon, Steven D.; Dimidjian, Sona; Schmaling, Karen B.; Kohlenberg, Robert J.; Gallop, Robert J.; Rizvi, Shireen L.; Gollan, Jackie K.; Dunner, David L.; Jacobson, Neil S.
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.
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…
Hyperbaric oxygen therapy (HBOT) has been used to treat individuals with autism. However, few studies of its effectiveness have been completed. The current study examined the effects of 40 HBOT sessions at 24% oxygen at 1.3 ATA on 11 topographies of directly observed behavior. Five replications of multiple baselines were completed across a total…
Jepson, Bryan; Granpeesheh, Doreen; Tarbox, Jonathan; Olive, Melissa L.; Stott, Carol; Braud, Scott; Yoo, J. Helen; Wakefield, Andrew; Allen, Michael S.
A substantial body of evidence indicates that interpersonal trauma increases risk for adolescent and adult depression. Findings from 4 clinical trials for adolescent depression show poorer response to standard cognitive-behavioraltherapy (CBT) among depressed adolescents with a trauma history than youth without such a history. This paper reports…
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.
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
This study compared cognitive behavioraltherapy (CBT) and treatment-as-usual (TAU) in terms of effects on observed social communication-related autism symptom severity during unstructured play time at school for children with autism spectrum disorders (ASD). Thirteen children with ASD (7-11 years old) were randomly assigned to 32 sessions of CBT…
Wood, Jeffrey J.; Fujii, Cori; Renno, Patricia; Van Dyke, Marilyn
Objective: To compare the effectiveness of group cognitive-behavioraltherapy (GCBT) and of sertraline in treatment-naive children and adolescents with obsessive-compulsive disorder. Method: Between 2000 and 2002, 40 subjects between 9 and 17 years old were randomized to receive GCBT (n = 20) or sertraline (n = 20). GCBT consisted of a…
Asbahr, Fernando Ramos; Castillo, Ana Regina; Ito, Ligia Montenegro; Latorre, Maria do Rosario Dias de Oliveira; Moreira, Michele Nunes; Lotufo-Neto, Francisco
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 study was designed to examine the effectiveness of the "Fear and Loathing of Speaking Out in Public" program. The program, a personal initiative, adapts primary features of the treatment offered by Cognitive BehavioralTherapy (CBT) for clients suffering from fears and phobias. CBT strategies include progressive desensitization, identifying…
This article explored the relationship between daytime affect and REM sleep in 45 depressed men before and after treatment with cognitive–behavioraltherapy and in a control group of 43 healthy subjects. The intensity of daytime affect (as measured by the sum of positive and negative affects) in depressed men correlated significantly and positively with phasic REM sleep measures at both
Eric A. Nofzinger; Robert M. Schwartz; Charles F. Reynolds; Michael E. Thase; J. Richard Jennings; Ellen Frank; Amy L. Fasiczka; Gregory L. Garamoni; David J. Kupfer
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: 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 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.
This study compared training outcomes obtained by 147 substance abuse counselors who completed eight self-paced online modules on cognitive–behavioraltherapy (CBT) and attended a series of four weekly group supervision sessions using Web conferencing software. Participants were randomly assigned to two conditions that systematically varied the degree to which they explicitly promoted adherence to the CBT protocol and the degree
Kenneth R. Weingardt; Michael A. Cucciare; Christine Bellotti; Wen Pin Lai
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
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
We report a randomized trial of a revised Behavioral Family Systems Therapy for Diabetes (BFST-D) intervention. Families of 104 adolescents with diabetes were randomized to standard care (SC) or to 6 months of an educational support group (ES) or BFST-D. Family communication and problem-solving skills were assessed at 0, 6, 12, and 18 months by…
Wysocki, Tim; Harris, Michael A.; Buckloh, Lisa M.; Mertlich, Deborah; Lochrie, Amanda Sobel; Taylor, Alexandra; Sadler, Michelle; White, Neil H.
Study Design: Systematic review. Objective: To examine the evidence supporting the effectiveness of cognitive behavioraltherapy (CBT) for improving psychosocial outcomes in individuals with spinal cord injury (SCI). Method: Electronic databases (MEDLINE, CINAHL, EMBASE, and PsycINFO) were searched for studies published between 1990 and October 2010. Randomized control trials (RCTs) and nonrandomized control trials (non-RCTs) utilizing a CBT intervention to
Swati Mehta; Steven Orenczuk; Kevin T. Hansen; Jo-Anne L. Aubut; Sander L. Hitzig; Matthew Legassic; Robert W. Teasell
Objective: Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioraltherapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the…
Iverson, Katherine M.; Gradus, Jaimie L.; Resick, Patricia A.; Suvak, Michael K.; Smith, Kamala F.; Monson, Candice M.
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.
Unipolar depression is one of the most disabling and costly medical illnesses in the world (Lancet Global Mental Health Group et al., 2007; Moussavi et al., 2007). Cognitive behavioraltherapy (CBT), a widely studied and taught psychotherapeutic treatment for depression, is among the recommended evidence-based treatments. Although CBT and other…
This pilot study investigated the impact of group activity play therapy (GAPT) on displaced orphans aged 10 to 12 years living in a large children's village in Uganda. Teachers and housemothers identified 60 preadolescents exhibiting clinical levels of internalizing and externalizing behavior problems. The participants' ethnicity was…
This single subject case study was conducted to determine the usefulness of a new measure, the Inventory of Cognitive Distortions (lCD). The main purpose was to determine the effectiveness of the ICD in noting changes in dysfunctional thinking during cognitive behavioraltherapy. Because of the high incidence of depression in the population, a subject diagnosed with Major Depressive Disorder was
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.
This case study involved the treatment of a young adult female, referred to as “Marie,” who presented for treatment seeking help with her eating disorder. Marie evinced symptoms of dietary restriction, amenorrhea, low weight, and low body mass index (BMI); she was subsequently diagnosed with anorexia nervosa. She was treated with 20 sessions of enhanced cognitive-behavioraltherapy (CBT-E), a relatively
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
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
Peak bone mass is achieved in adolescence/early adulthood and is the key determinant of bone mass in adulthood. We evaluated the association of bone mass with HIV infection and antiretroviral therapy (ART) during this critical period among behaviorally HIV infected young men and seronegative control...
The efficacy of cognitive-behavioraltherapy (CBT) for anxiety in adults is well established. In the present study, the authors examined whether CBT tested under well-controlled conditions generalizes to less-controlled, real-world circumstances. Fifty-six effectiveness studies of CBT for adult anxiety disorders were located and synthesized.…
Objective: To examine predictors and moderators of response to cognitive behavioraltherapy (CBT) and medication treatments for binge-eating disorder (BED). Method: 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors,…
Grilo, Carlos M.; Masheb, Robin M.; Crosby, Ross D.
Data on the compatibility of evidence-based treatment in ethnic minority groups are limited. This study utilized focus group interviews to elicit Mexican American women's (N = 12) feedback on a cognitive behaviortherapy guided self-help program for binge eating disorders. Findings revealed 6 themes to be considered during the cultural adaptation…
Explored relationship between daytime affect and REM (rapid eye movement) sleep in 45 depressed men before and after treatment with cognitive-behavioraltherapy and in control group of 43 healthy subjects. For depressed subjects only, intensity of daytime affect correlated significantly and positively with phasic REM sleep measures at pre- and…
Objective: Most tests of cognitive behavioraltherapy (CBT) for youth anxiety disorders have shown beneficial effects, but these have been efficacy trials with recruited youths treated by researcher-employed therapists. One previous (nonrandomized) trial in community clinics found that CBT did not outperform usual care (UC). The present study used…
Southam-Gerow, Michael A.; Weisz, John R.; Chu, Brian C.; McLeod, Bryce D.; Gordis, Elana B.; Connor-Smith, Jennifer K.
regulation Reappraisal Suppression CBT Trajectory of change a b s t r a c t Cognitive-behavioraltherapy (CBT. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT
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.
In spite of the fact that cognitive-behavioraltherapy (CBT) for major depressive disorder is an empirically supported treatment, some clients do not respond optimally or readily. The literature has provided a number of hypotheses regarding the factors that may play a role in these clients' difficulties in responding to CBT, with the current paper…
Child-focused and family-focused cognitive-behavioraltherapy (CBT) for 128 children with clinical anxiety disorders and their parents were compared in terms of efficacy and partial effectiveness. Results indicate that 53% of the children under the child CBT became free of anxiety disorders at posttreamtent compared to only 28% under family CBT.…
Bodden, Denise H. M.; Bogels, Susan M.; Nauta, Maaike H.; De Hann, Else; Ringrose, Jaap; Appelboom, Carla; Brinkman, Andries G.; Appelboom-Geerts, Karen C. M. M. J.
Data suggesting that cognitive-behavioraltherapy (CBT) is efficacious for late-life anxiety are accumulating; however, effectiveness has not been well established. Incorporating CBT for anxiety into home care is needed to facilitate access to evidenced-based treatment for a growing population of community-dwelling, functionally impaired elderly…
Diefenbach, Gretchen J.; Tolin, David F.; Gilliam, Christina M.; Meunier, Suzanne A.
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…
-SE) mediate the effects of individually administered cognitive-behavioraltherapy (I-CBT) for social anxiety SAD were randomly assigned to 16 sessions of I-CBT (n 38) or a wait-list control (WL) group (n 37 and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year posttreatment. Results: Compared
A comprehensive review of the literature on clinical work with African American youth with cognitive behaviortherapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. (Contains 3…
This study evaluated a locally developed cognitive behaviortherapy (CBT) intervention program in a public elementary school. In the prevention approach, 118 children were randomly assigned either to an 8-week intervention or to a wait-list control. Results of statistical analysis indicated that the manualized CBT intervention did not reduce…
Miller, Lynn D.; Short, Christina; Garland, E. Jane; Clark, Sandra
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
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
A comprehensive evidence-based treatment for substance abuse and other associated problems (Family BehaviorTherapy) is described, including its application to both adolescents and adults across a wide range of clinical contexts (i.e., criminal justice, child welfare). Relevant to practitioners and applied clinical researchers, topic areas include…
Donohue, Brad; Azrin, Nathan; Allen, Daniel N.; Romero, Valerie; Hill, Heather H.; Tracy, Kendra; Lapota, Holly; Gorney, Suzanne; Abdel-al, Ruweida; Caldas, Diana; Herdzik, Karen; Bradshaw, Kelsey; Valdez, Robby; Van Hasselt, Vincent B.
The differential efficacies of supportive and cognitive behavioral group therapy models designed for young children (ages 2 to 8) who have experienced sexual abuse and their nonoffending mothers were compared. Forty-four mothers and their respective children participated in either supportive or cognitive behavioraltherapy groups with the group format being randomly determined. Repeated measures MANOVAs indicated that compared to mothers
Esther Deblinger; Lori B. Stauffer; Robert A. Steer
Purpose Youth living with HIV account for over one-third of new HIV infections and are at high risk of adverse psychosocial, everyday living, and health outcomes. HIV-associated neurocognitive disorders (HAND) are known to affect health outcomes of HIV-infected adults even in the era of combination antiretroviral therapy (cART). Thus, the current study aimed to characterize the prevalence and clinical correlates of HAND in youth living with HIV. Here we report baseline neurocognitive data for behaviorally HIV-infected youth enrolled in a prospective study evaluating strategies of antiretroviral treatment initiation and use. Methods Two hundred twenty participants, age 18-24, naïve to treatment (except for prevention of mother to child HIV transmission; n=3), completed a comprehensive neurocognitive, substance use, and behavioral health assessment battery. Results 64.7% of youth met criteria for HAND (96.4% asymptomatic, 3.5% syndromic), with deficits in episodic memory and fine-motor skills emerging as the most commonly affected ability areas. Multivariable models showed that lower CD4 count, longer time since HIV diagnosis, and high risk alcohol use were uniquely associated with neurocognitive deficits. Conclusions Over two-thirds of youth with behaviorally acquired HIV evidence neurocognitive deficits, which have modest associations with more advanced HIV disease as well as other factors. Research is needed to determine the impact of such neuropsychiatric morbidity on mental health and HIV disease treatment outcomes (e.g., non-adherence) and transition to independent living responsibilities in HIV-infected youth, as well as its long-term trajectory and possible responsiveness to cognitive rehabilitation and pharmacotherapy. PMID:23972941
Nichols, Sharon L.; Bethel, James; Garvie, Patricia A.; Patton, Doyle E; Thornton, Sarah; Kapogiannis, Bill G.; Ren, Weijia; Major-Wilson, Hanna; Puga, Ana; Woods, Steven P.
Background Dialectical Behaviour Therapy (DBT) has been used to treat adults and adolescents with suicidal and non-suicidal self-injury. This article describes initial progress in modifying DBT for affected pre-adolescent children. Method Eleven children from regular education classes participated in a 6-week pilot DBT skills training program for children. Self-report measures of children’s emotional and behavioural difficulties, social skills and coping strategies were administered at pre- and post-intervention, and indicated that the children had mild to moderate symptoms of depression, anxiety and suicidal ideation at baseline. Results Subjects were able to understand and utilise DBT skills for children and believed that the skills were important and engaging. Parents also regarded skills as important, child friendly, comprehensible and beneficial. At post-treatment, children reported a significant increase in adaptive coping skills and significant decreases in depressive symptoms, suicidal ideation and problematic internalising behaviours. Conclusions These promising preliminary results suggest that continued development of DBT for children with more severe clinical impairment is warranted. Progress on adapting child individual DBT and developing a caregiver training component in behavioural modification and validation techniques is discussed. PMID:21643467
Perepletchikova, Francheska; Axelrod, Seth R.; Kaufman, Joan; Rounsaville, Bruce J.; Douglas-Palumberi, Heather; Miller, Alec L.
Efficacious treatments for seasonal affective disorder include light therapy and a seasonal affective disorder-tailored form of cognitive-behavioraltherapy. Using data from a parent clinical trial, these secondary analyses examined the relationship between cognitive change over treatment with cognitive-behavioraltherapy, light therapy, or combination treatment and mood outcomes the next winter. Sixty-nine participants were randomly assigned to 6-weeks of cognitive-behavioraltherapy, light therapy, or combination treatment. Cognitive constructs (i.e., dysfunctional attitudes, negative automatic thoughts, and rumination) were assessed at pre- and post-treatment. Dysfunctional attitudes, negative automatic thoughts, and rumination improved over acute treatment, regardless of modality; however, in participants randomized to solo cognitive-behavioraltherapy, a greater degree of improvement in dysfunctional attitudes and automatic thoughts was uniquely associated with less severe depressive symptoms the next winter. Change in maladaptive thoughts during acute treatment appears mechanistic of solo cognitive-behavioraltherapy’s enduring effects the next winter, but is simply a consequence of diminished depression in light therapy and combination treatment. PMID:24415812
Evans, Maggie; Rohan, Kelly J.; Sitnikov, Lilya; Mahon, Jennifer N.; Nillni, Yael I.; Lindsey, Kathryn Tierney; Vacek, Pamela M.
Brain-computer interface (BCI) technology is being incorporated into new stroke rehabilitation devices, but little is known about brain changes associated with its use. We collected anatomical and functional MRI of nine stroke patients with persistent upper extremity motor impairment before, during, and after therapy using a BCI system. Subjects were asked to perform finger tapping of the impaired hand during fMRI. Action Research Arm Test (ARAT), 9-Hole Peg Test (9-HPT), and Stroke Impact Scale (SIS) domains of Hand Function (HF) and Activities of Daily Living (ADL) were also assessed. Group-level analyses examined changes in whole-brain task-based functional connectivity (FC) to seed regions in the motor network observed during and after BCI therapy. Whole-brain FC analyses seeded in each thalamus showed FC increases from baseline at mid-therapy and post-therapy (p < 0.05). Changes in FC between seeds at both the network and the connection levels were examined for correlations with changes in behavioral measures. Average motor network FC was increased post-therapy, and changes in average network FC correlated (p < 0.05) with changes in performance on ARAT (R2 = 0.21), 9-HPT (R2 = 0.41), SIS HF (R2 = 0.27), and SIS ADL (R2 = 0.40). Multiple individual connections within the motor network were found to correlate in change from baseline with changes in behavioral measures. Many of these connections involved the thalamus, with change in each of four behavioral measures significantly correlating with change from baseline FC of at least one thalamic connection. These preliminary results show changes in FC that occur with the administration of rehabilitative therapy using a BCI system. The correlations noted between changes in FC measures and changes in behavioral outcomes indicate that both adaptive and maladaptive changes in FC may develop with this therapy and also suggest a brain-behavior relationship that may be stimulated by the neuromodulatory component of BCI therapy. PMID:25071547
Natural disasters can have devastating consequences. Each year, about 225 million people are victims of natural disasters worldwide, and up to 13,5 million of these people can develop post-traumatic stress disorder (PTSD) in the first or second year following the disaster. Cognitive-behaviortherapy (CBT) is the first-choice treatment for this disorder. In order to evaluate the efficacy of psychotherapeutic treatment based on cognitive-behaviortherapy for people who developed post traumatic stress disorder after natural disasters we conducted a systematic search of published studies. We used the terms reported below in the electronic databases ISI Web of Science, PsycINFO, PubMed, PILOTS and Scopus with no restrictions of language or publication date. Articles that described randomized controlled, non-randomized controlled and non controlled studies on the efficacy of cognitive-behaviortherapy for individuals diagnosed with post-traumatic stress disorder after exposure to a natural disaster were eligible for inclusion. The studies were required to use a standardized measure of effectiveness before and after the intervention and have a group of patients who had used cognitive-behaviortherapy as the only intervention. Our search identified 820 studies, and 11 were selected for this review. These 11 studies involved 742 subjects, 10 related to earthquakes and 1 to a hurricane. The cognitive-behaviortherapy techniques used were various: 7 studies used exposure therapy, 2 studies used problem solving, and the only 2 studies with adolescents used techniques including reconstructions and reprocessing of the traumatic experience. As limitations, the search involved only five electronic databases, no experts in the field were consulted, and the heterogeneity of the findings made it impossible to perform a meta-analysis. The results suggest the efficacy of cognitive-behaviortherapy, particularly exposure techniques, for the treatment of post-traumatic stress disorder after earthquakes. However, further studies with stronger methodologies, i.e. randomized-control trials and non-randomized controlled trials, are needed. PMID:25296020
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 year. Methods Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF), the 36-item Short-Form Health Survey (SF-36), the Hamilton Rating Scale for Depression (HRSD), the Dysfunctional Attitudes Scale (DAS), and the Automatic Thought Questionnaire-Revised (ATQ-R) at baseline, at the termination of treatment, and at the 12-month follow-up. Results Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT. Conclusions These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance. PMID:20230649
An objective, laboratory-based diagnostic tool could increase the diagnostic accuracy of major depressive disorders (MDDs), identify factors that characterize patients and promote individualized therapy. The goal of this study was to assess a blood-based biomarker panel, which showed promise in adolescents with MDD, in adult primary care patients with MDD and age-, gender- and race-matched nondepressed (ND) controls. Patients with MDD received cognitive behavioraltherapy (CBT) and clinical assessment using self-reported depression with the Patient Health Questionnaire-9 (PHQ-9). The measures, including blood RNA collection, were obtained before and after 18 weeks of CBT. Blood transcript levels of nine markers of ADCY3, DGKA, FAM46A, IGSF4A/CADM1, KIAA1539, MARCKS, PSME1, RAPH1 and TLR7, differed significantly between participants with MDD (N=32) and ND controls (N=32) at baseline (q< 0.05). Abundance of the DGKA, KIAA1539 and RAPH1 transcripts remained significantly different between subjects with MDD and ND controls even after post-CBT remission (defined as PHQ-9 <5). The ROC area under the curve for these transcripts demonstrated high discriminative abili