Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

ERIC Educational Resources Information Center

Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

2011-01-01

This study pilot tested a newly developed modular cognitive-behavioral therapy (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…

Technology-Based Training in Cognitive Behavioral Therapy for Substance Abuse Counselors

ERIC Educational Resources Information Center

Weingardt, Kenneth R.; Villafranca, Steven W.; Levin, Cindy

2006-01-01

This study compared the learning outcomes achieved by 166 practicing substance abuse counselors who were randomized to one of three conditions: (1) a Web-Based Training (WBT) module designed to familiarize practitioners with the "Coping with Craving" module from the NIDA treatment manual, "A Cognitive-Behavioral Approach: Treating Cocaine…

Cognitive Behavior Therapy: Notes on Theory and Application with Children.

ERIC Educational Resources Information Center

Sigmon, Scott B.

Cognitive behavioral psychology is a new theoretical orientation. When applied in treatment, it is known as cognitive behavior therapy (CBT). CBT, although based primarily on an information processing model, rests firmly on the twin pillars of both behaviorism and cognitive psychology. Today cognitive therapy and behavioral therapy are terms which…

A Randomized Controlled Trial of Acceptance-Based Behavior Therapy and Cognitive Therapy for Test Anxiety: A Pilot Study

ERIC Educational Resources Information Center

Brown, Lily A.; Forman, Evan M.; Herbert, James D.; Hoffman, Kimberly L.; Yuen, Erica K.; Goetter, Elizabeth M.

2011-01-01

Many university students suffer from test anxiety that is severe enough to impair performance. Given mixed efficacy results of previous cognitive-behavior therapy (CBT) trials and a theoretically driven rationale, an acceptance-based behavior therapy (ABBT) approach was compared to traditional CBT (i.e., Beckian cognitive therapy; CT) for the…

Cognitive Behavior Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility and Acceptability

PubMed Central

Stanley, Barbara; Brown, Gregory; Brent, David; Wells, Karen; Poling, Kim; Curry, John; Kennard, Betsy D.; Wagner, Ann; Cwik, Mary; Klomek, Anat Brunstein; Goldstein, Tina; Vitiello, Benedetto; Barnett, Shannon; Daniel, Stephanie; Hughes, Jennifer

2009-01-01

Objective To describe the elements of a manualized cognitive behavior psychotherapy 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 CBT-SP was developed using a risk reduction, relapse prevention approach and theoretically grounded in principles of cognitive behavior therapy, dialectical behavioral therapy and targeted therapies for suicidal, depressed youth. CBT-SP consists of acute and continuation phases, each lasting about 12 sessions, and includes a chain analysis of the suicidal event, safety plan development, skill building, psychoeducation, family intervention, and relapse prevention. Results CBT-SP was administered to 110 depressed, recent suicide attempters aged 13–19 years (mean 15.8±1.6) across five academic sites. Twelve or more sessions were completed by 72.4% of the sample. Conclusions A specific intervention for adolescents at high risk for repeated suicide attempts has been developed and manualized, and further testing of its efficacy appears feasible. PMID:19730273

Cognitive-Behavioral Therapy for Depression in Adolescents with Inflammatory Bowel Disease: A Pilot Study.

ERIC Educational Resources Information Center

Szigethy, Eva; Whitton, Sarah W.; Levy-Warren, Anna; DeMaso, David Ray; Weisz, John; Beardslee, William R.

2004-01-01

Objective: To evaluate the safety and feasibility of cognitive-behavioral therapy (CBT) for depression in physically ill adolescents. Method: In an open trial, 11 adolescents (12-17 years) with inflammatory bowel disease and either major or minor depression underwent 12 sessions of a manual-based CBT enhanced by social skills, physical illness…

Therapist Strategies for Building Involvement in Cognitive-Behavioral Therapy for Adolescent Depression

ERIC Educational Resources Information Center

Jungbluth, Nathaniel J.; Shirk, Stephen R.

2009-01-01

This study examined predictive relations between 9 therapist behaviors and client involvement in manual-guided, cognitive-behavioral therapy 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…

[Psychological Treatments for Borderline Personality Disorder: A Review of Cognitive-Behavioral Oriented Therapies].

PubMed

Marques, Sofia; Barrocas, Daniel; Rijo, Daniel

2017-04-28

Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder. A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy. Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively. Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model. In summary, the available studies support

Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual [and] Participant Workbook.

ERIC Educational Resources Information Center

Reilly, Patrick M.; Shopshire, Michael S.; Durazzo, Timothy C.; Campbell, Torri A.

This manual and workbook set focuses on anger management. The manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger programs. The manual describes a 12-week cognitive behavioral anger management group treatment. Each of the 12 90-minute…

Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy

PubMed Central

Kondo, Masaki; Ino, Keiko; Imai, Risa; Ii, Toshitaka; Furukawa, Toshi A.; Akechi, Tatsuo

2018-01-01

Background Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. Objectives The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Methods Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Results Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive (β = −0.15, P < 0.01), depression (β = −0.13, P < 0.05), phobic anxiety (β = −0.15, P < 0.05), and Global Severity Index (β = −0.13, P < 0.05). Conclusion Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline. PMID:29721499

Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy.

PubMed

Ogawa, Sei; Kondo, Masaki; Ino, Keiko; Imai, Risa; Ii, Toshitaka; Furukawa, Toshi A; Akechi, Tatsuo

2018-01-01

Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive ( β = -0.15, P < 0.01), depression ( β = -0.13, P < 0.05), phobic anxiety ( β = -0.15, P < 0.05), and Global Severity Index ( β = -0.13, P < 0.05). Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline.

The Use of Treatment Manuals in Cognitive Therapy: Experience and Issues.

ERIC Educational Resources Information Center

Dobson, Keith S.; Shaw, Brian F.

1988-01-01

Traces historical developments in use of treatment manuals in psychotherapy research and reviews characteristics that have facilitated development of cognitive therapy manuals. Reviews arguments in favor of and opposed to further development of treatment manuals. Discusses relevant research and suggests three areas for future treatment manual…

Internet-Assisted Cognitive Behavioral Therapy.

PubMed

Andersson, Gerhard; Carlbring, Per

2017-12-01

Internet-assisted cognitive-behavioral therapy (ICBT) is a way to deliver cognitive-behavioral therapy (CBT) that has been found to generate similar effects as face-to-face CBT in some studies. Results have been replicated by different research groups. This article presents the treatment format and reviews evidence for mood and anxiety disorders. Future developments are discussed, including the lack of theories specific for the treatment format and ways to handle comorbidity. Although some programs have been implemented there is a need for further studies in clinical settings. Overall, clinician-assisted ICBT is becoming one of the most evidence-based forms of psychological treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Child-Therapist Alliance and Clinical Outcomes in Cognitive Behavioral Therapy for Child Anxiety Disorders

ERIC Educational Resources Information Center

Chiu, Angela W.; McLeod, Bryce D.; Har, Kim; Wood, Jeffrey J.

2009-01-01

Background: Few studies have examined the link between child-therapist alliance and outcome in manual-guided cognitive behavioral therapy (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…

Brief Cognitive-Behavioral Therapy for Anxious Youth: Feasibility and Initial Outcomes

ERIC Educational Resources Information Center

Crawley, Sarah A.; Kendall, Philip C.; Benjamin, Courtney L.; Brodman, Douglas M.; Wei, Chiaying; Beidas, Rinad S.; Podell, Jennifer L.; Mauro, Christian

2013-01-01

We developed and evaluated a brief (8-session) version of cognitive-behavioral therapy (BCBT) for anxiety disorders in youth ages 6 to 13. This report describes the design and development of the BCBT program and intervention materials (therapist treatment manual and child treatment workbook) and an initial evaluation of child treatment outcomes.…

Cognitive behavioral therapy for back pain

MedlinePlus

... this page: //medlineplus.gov/ency/patientinstructions/000415.htm Cognitive behavioral therapy for back pain To use the sharing features on this page, please enable JavaScript. Cognitive behavioral therapy (CBT) can help many people deal with chronic ...

Therapist adherence to manualized cognitive-behavioral therapy for anger management delivered to veterans with PTSD via videoconferencing.

PubMed

Morland, Leslie A; Greene, Carolyn J; Grubbs, Kathleen; Kloezeman, Karen; Mackintosh, Margaret-Anne; Rosen, Craig; Frueh, B Christopher

2011-06-01

Therapist adherence to a manualized cognitive-behavioral anger management group treatment (AMT) was compared between therapy delivered via videoconference (VC) and the traditional in-person modality, using data from a large, randomized controlled trial comparing the effectiveness of AMT for veterans with combat-related posttraumatic stress disorder. Therapist adherence was rated for the presence or absence of process and content treatment elements. Secondary analyses were conducted using a repeated measures ANOVA. Overall adherence to the protocol was excellent (M = 96%, SD = 1%). Findings indicate that therapist adherence to AMT is similar across delivery modalities and VC is a viable service delivery strategy that does not compromise a therapist's ability to effectively structure sessions and manage patient care. © 2011 Wiley Periodicals, Inc.

Cognitive-behavioral therapy for women with lifelong vaginismus: a randomized waiting-list controlled trial of efficacy.

PubMed

van Lankveld, Jacques J D M; ter Kuile, Moniek M; de Groot, H Ellen; Melles, Reinhilde; Nefs, Janneke; Zandbergen, Maartje

2006-02-01

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 participants per group. Assistance with minimal-contact bibliotherapy consisted of 6 biweekly, 15-min telephone contacts. Twenty-one percent of the participants left the study before posttreatment assessment. Intent-to-treat analysis revealed that successful intercourse at posttreatment was reported by 14% of the treated participants compared with none of the participants in the control condition. At the 12-month follow-up 21% of the group therapy participants and 15% of the bibliotherapy participants, respectively, reported successful intercourse. Cognitive-behavioral treatment of lifelong vaginismus was thus found to be efficacious, but the small effect size of the treatment warrants future efforts to improve the treatment. Copyright (c) 2006 APA, all rights reserved.

We Don't Train in Vain: A Dissemination Trial of Three Strategies of Training Clinicians in Cognitive-Behavioral Therapy

ERIC Educational Resources Information Center

Sholomskas, Diane E.; Syracuse-Siewert, Gia; Rounsaville, Bruce J.; Ball, Samuel A.; Nuro, Kathryn F.; Carroll, Kathleen M.

2005-01-01

There has been little research on the effectiveness of different training strategies or the impact of exposure to treatment manuals alone on clinicians' ability to effectively implement empirically supported therapies. Seventy-eight community-based clinicians were assigned to 1 of 3 training conditions: review of a cognitive-behavioral therapy…

Efficacy of cognitive behavioral internet-based therapy in parents after the loss of a child during pregnancy: pilot data from a randomized controlled trial.

PubMed

Kersting, Anette; Kroker, Kristin; Schlicht, Sarah; Baust, Katja; Wagner, Birgit

2011-12-01

The loss of a child during pregnancy can be a traumatic event associated with long-lasting grief and psychological distress. This study examined the efficacy of an internet-based cognitive behavioral therapy program for mothers after pregnancy loss. In a randomized controlled trial with a waiting list control group, 83 participants who had lost a child during pregnancy were randomly allocated either to 5 weeks of internet therapy or to a 5-week waiting condition. Within a manualized cognitive behavioral treatment program, participants wrote ten essays on loss-specific topics. Posttraumatic stress, grief, and general psychopathology, especially depression, were assessed pretreatment, posttreatment, and at 3-month follow-up. Intention-to-treat analyses and completer analyses were performed. Relative to controls, participants in the treatment group showed significant improvements in posttraumatic stress, grief, depression, and overall mental health, but not in anxiety or somatization. Medium to large effect sizes were observed, and the improvement was maintained at 3-month follow-up. This internet-based cognitive behavioral therapy program represents an effective treatment approach with stable effects for women after pregnancy loss. Implementation of the program can thus help to improve the health care provision for mothers in this traumatic loss situation.

Examining the Relation between the Therapeutic Alliance, Treatment Adherence, and Outcome of Cognitive Behavioral Therapy for Children with Anxiety Disorders

ERIC Educational Resources Information Center

Liber, Juliette M.; McLeod, Bryce D.; Van Widenfelt, Brigit M.; Goedhart, Arnold W.; van der Leeden, Adelinde J. M.; Utens, Elisabeth M. W. J.; Treffers, Philip D. A.

2010-01-01

Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for…

Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study.

PubMed

Klinger, E; Bouchard, S; Légeron, P; Roy, S; Lauer, F; Chemin, I; Nugues, P

2005-02-01

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 behavior therapies (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 standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial.

Positive Association of Child Involvement and Treatment Outcome within a Manual-Based Cognitive-Behavioral Treatment for Children with Anxiety

ERIC Educational Resources Information Center

Chu, Brian C.; Kendall, Philip C.

2004-01-01

Ratings of child involvement in manual-based cognitive-behavioral treatment for anxiety were associated with the absence of primary anxiety diagnosis and reductions in impairment ratings at posttreatment for 59 children with anxiety (ages 8-14 years). Good-to-excellent interrater reliability was established for the independent ratings of 237…

Clinical Trial of Abstinence-Based Vouchers and Cognitive-Behavioral Therapy for Cannabis Dependence

ERIC Educational Resources Information Center

Budney, Alan J.; Moore, Brent A.; Rocha, Heath L.; Higgins, Stephen T.

2006-01-01

Ninety cannabis-dependent adults seeking treatment were randomly assigned to receive cognitive-behavioral therapy, abstinence-based voucher incentives, or their combination. Treatment duration was 14 weeks, and outcomes were assessed for 12 months post treatment. Findings suggest that (a) abstinence-based vouchers were effective for engendering…

Cognitive-Behavioral Therapy. Second Edition. Theories of Psychotherapy Series

ERIC Educational Resources Information Center

Craske, Michelle G.

2017-01-01

In this revised edition of "Cognitive-Behavioral Therapy," Michelle G. Craske discusses the history, theory, and practice of this commonly practiced therapy. Cognitive-behavioral therapy (CBT) originated in the science and theory of classical and instrumental conditioning when cognitive principles were adopted following dissatisfaction…

Evaluating a Web-Based Cognitive-Behavioral Therapy for Maladaptive Perfectionism in University Students

ERIC Educational Resources Information Center

Radhu, Natasha; Daskalakis, Zafiris J.; Arpin-Cribbie, Chantal A.; Irvine, Jane; Ritvo, Paul

2012-01-01

Objective: This study assessed a Web-based cognitive-behavioral therapy (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…

Cognitive behavioral group therapy for anxiety: recent developments.

PubMed

Wolgensinger, Laure

2015-09-01

Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious consequences. This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CBT programs are available for individuals who suffer from different anxiety disorders, enabling them to be treated together in groups.

Psychodynamic psychotherapy for social phobia: a treatment manual based on supportive-expressive therapy.

PubMed

Leichsenring, Falk; Beutel, Manfred; Leibing, Eric

2007-01-01

Social phobia is a very frequent mental disorder characterized by an early onset, a chronic unremitting course, severe psychosocial impairments and high socioeconomic costs. To date, no manual for the psychodynamic treatment of social phobia exists. After a brief description of the disorder, a manual for a short-term psychodynamic treatment of social phobia is presented. The treatment is based on Luborsky s supportive-expressive (SE) therapy, which is complemented by treatment elements specific to social phobia. The treatment includes the characteristic elements of SE therapy, that is, setting goals, focus on the Core Conflictual Relationship Theme (CCRT) associated with the patient s symptoms, interpretive interventions to enhance insight into the CCRT, and supportive interventions, in particular fostering a helping alliance. In order to tailor the treatment more specifically to social phobia, treatment elements have been added, for example informing the patient about the disorder and the treatment, a specific focus on shame and on unrealistic demands, and encouraging the patient to confront anxiety-producing situations. More directive interventions are included as well, such as specific prescriptions to stop persisting self-devaluations. The treatment manual is presently being used in a large-scale randomized controlled multicenter study comparing short-term psychodynamic psychotherapy and cognitive-behavioral therapy in the treatment of social phobia.

Effect of Cognitive Behavioral Therapy for Anxiety Disorders on Quality of Life: A Meta-Analysis

PubMed Central

Hofmann, Stefan G.; Wu, Jade Q.; Boettcher, Hannah

2014-01-01

OBJECTIVE Although cognitive-behavioral therapy is effective for treating anxiety disorders, little is known about its effect on quality of life. To conduct a meta-analysis of cognitive-behavioral therapy for anxiety disorders on quality of life, we searched for relevant studies in PubMed, PsycINFO and the Cochrane Library, and conducted manual searches. METHOD The search identified 44 studies that included 59 CBT trials, totaling 3,326 participants receiving cognitive-behavioral therapy for anxiety disorders. We estimated the controlled and within-group random effects of the treatment changes on quality of life. RESULTS The pre-post within-group and controlled effect sizes were moderately strong, Hedges’ g = 0.54 and Hedges’ g = 0.56, respectively. Improvements were greater for physical and psychological domains of quality of life than for environmental and social domains. The overall effect sizes decreased with publication year and increased with treatment duration. Face-to-face treatments delivered individually and in groups produced significantly higher effect sizes than internet-delivered treatments. CONCLUSION Cognitive-behavioral therapy for anxiety disorders is moderately effective for improving quality of life, especially in physical and psychological domains. Internet-delivered treatments are less effective in improving quality of life than face-to-face treatments. PMID:24447006

Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure.

PubMed

Anderson, Page L; Zimand, Elana; Hodges, Larry F; Rothbaum, Barbara O

2005-01-01

This study used an open clinical trial to test a cognitive-behavioral treatment for public-speaking anxiety that utilized virtual reality as a tool for exposure therapy. Treatment was completed by participants (n = 10) meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for social phobia, or panic disorder with agoraphobia in which public speaking was the predominantly feared stimulus. Treatment was conducted by a licensed psychologist in an outpatient clinic. Treatment consisted of eight individual therapy sessions, including four sessions of anxiety management training and four sessions of exposure therapy using a virtual audience, according to a standardized treatment manual. Participants completed standardized self-report questionnaires assessing public-speaking anxiety at pre-treatment, post-treatment, and 3-month follow-up. Participants were asked to give a speech to an actual audience at pre- and post-treatment. Results showed decreases on all self-report measures of public-speaking anxiety from pre- to post-treatment, which were maintained at follow-up (n = 8; all P = 05). Participants were no more likely to complete a speech post-treatment than at pre-treatment. This study provides preliminary evidence that a cognitive-behavioral treatment using virtual reality for exposure to public speaking may reduce public-speaking anxiety and suggests that further research with a controlled design is needed. Copyright 2005 Wiley-Liss, Inc.

Cognitive-Behavioral Therapy of Panic Disorder with Secondary Major Depression: A Preliminary Investigation.

ERIC Educational Resources Information Center

Laberge, Benoit; And Others

1993-01-01

Investigated extent to which cognitive-behavioral therapy can be used successfully in treatment of secondary depressed panic patients. Findings from eight panic patients with major depression and seven panic patients without major depression showed that cognitive-behavioral therapy was significantly superior to information-based therapy in…

[Practice of Behavioral Activation in Cognitive-behavioral Therapy].

PubMed

Kitagawa, Nobuki

2015-01-01

An approach focusing on behavioral activation (BA) was adopted in the cognitive therapy of A. T. Beck, and it came to be considered that BA can play an important role in cognitive-behavioral therapy (CBT) for depression. Therefore, in recent years, BA based on clinical behavior analysis has been developed as a new treatment (Martell, et al.). The core characteristics are as follows: 1) focusing attention on context in daily life to promote the behavior control of patients and avoidance of a hatred experience ; 2) breaking the vicious circle; 3) promoting the behavior according to the purpose that the patients originally expect; 4) recognizing a relationship between behavior and the situation (contingency), thereby recovering self-efficacy tied to the long-term results that one originally expects. This does not increase pleasant activity at random when the patient is inactive, or give a sense of accomplishment. We know that depression is maintained by conducting functional analysis of detailed life behavior, and encourage the patients to have healthy behavior according to individual values. We help them to complete schedules regardless of mood and reflect on the results patiently. It is considered that those processes are important. BA may be easy to apply in clinical practice and effective for the chronic cases, or the patients in a convalescent stage. Also, in principle in the CBT for major depression, it may be effective that behavioral activation is provided in an early stage, and cognitive reconstruction in a latter stage. However, an approach to carry out functional analysis by small steps with careful activity monitoring is essential when the symptoms are severe. Furthermore, it should be considered that the way of psychoeducation requires caution because we encourage rest in the treatment of depression in our country. In particular, we must be careful not to take an attitude that an inactive behavior pattern is unproductive only based model cases.

Extreme Nonresponse in Cognitive Therapy: Can Behavioral Activation Succeed where Cognitive Therapy Fails?

ERIC Educational Resources Information Center

Coffman, Sandra J.; Martell, Christopher R.; Dimidjian, Sona; Gallop, Robert; Hollon, Steven D.

2007-01-01

In a recent placebo-controlled comparison, behavioral activation was superior to cognitive therapy in the treatment of moderate to severely depressed adults. Moreover, a subset of patients exhibited a pattern of extreme nonresponse to cognitive therapy on self-reports of depression not evident on the clinician ratings. These patients were severely…

A Cognitive Behavioral Therapy-Based Text Messaging Intervention for Methamphetamine Dependence

PubMed Central

Keoleian, Victoria; Stalcup, S. Alex; Polcin, Douglas L.; Brown, Michelle; Galloway, Gantt

2013-01-01

Psychosocial treatments for methamphetamine dependence are of limited effectiveness. Thus, a significant need exists for add-on therapy for this substance user disorder. The aim of this study was to develop and test a novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users. Text messaging has the potential to support patients in real-time, around the clock. We convened 2 meetings of an expert panel, held 3 focus groups in current and former users, and conducted 15 semi-structured interviews with in-treatment users in order to develop a fully-automated, cognitive behavioral therapy-based text messaging intervention. We then conducted a randomized, crossover pre-test in 5 users seeking treatment. Participants’ ratings of ease of use and functionality of the system were high. During the pre-test we performed real-time assessments via text messaging on daily methamphetamine use, craving levels, and the perceived usefulness of messages; 79% of scheduled assessments were collected. The odds of messages being rated as “very” or “extremely” useful were 6.6 times [95% CI: 2.2, 19.4] higher in the active vs. placebo periods. The intervention is now ready for testing in randomized clinical trials. PMID:24592670

Can Independent Judges Recognize Different Psychotherapies? An Experience with Manual-Guided Therapies.

ERIC Educational Resources Information Center

Luborsky, Lester; And Others

1982-01-01

Tested whether independent judges could recognize three different manual-guided psychotherapies, drug counseling, supportive-expressive psychotherapy, and cognitive-behavioral using a special rating form containing scales for the characteristic aspects of each type. Results indicated that manual-guided therapies can be reliably recognized.…

The efficacy of cognitive behavioral therapy for Chinese people: A meta-analysis.

PubMed

Ng, Ting Kin; Wong, Daniel Fu Keung

2018-07-01

Over the past decade, cognitive behavioral therapy has been applied to an increasingly wider range of disorders and problems in Chinese societies. However, no meta-analysis has been conducted to synthesize the studies on cognitive behavioral therapy for Chinese clients. The purpose of this meta-analytic study was to examine the overall efficacy of cognitive behavioral therapy for Chinese people. A literature search was conducted using electronic databases, including Web of Science, PsycINFO and PubMed. Pooled mean effect sizes were calculated using the random-effects model. The literature search identified 55 studies with 6763 Chinese participants. The overall short-term effect of cognitive behavioral therapy on the primary outcome was medium in size. Effect sizes were medium for anxiety, depression/well-being and caregiving stress and small for psychotic symptoms and addictive behaviors. The effects of cognitive behavioral therapy on process variables, dysfunctional thoughts and coping, were in the small range. The overall longer-term effect of cognitive behavioral therapy on the primary outcome was medium in size. Moderator analyses showed that the short-term effect was stronger for culturally adapted cognitive behavioral therapy than for unadapted cognitive behavioral therapy. Type of primary outcome, type of control group, recruitment method, study design, the format of delivery and region were found to moderate the efficacy of cognitive behavioral therapy. The findings of this study provide evidence for the overall efficacy of cognitive behavioral therapy for Chinese people and the benefit of cultural adaptation of cognitive behavioral therapy to Chinese culture.

Building capacity for cognitive behavioral therapy delivery for depression in disaster-impacted contexts.

PubMed

Ngo, Victoria K; Centanni, Angela; Wong, Eunice; Wennerstrom, Ashley; Miranda, Jeanne

2011-01-01

Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioral therapy, 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 behavioral therapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioral therapy 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 behavioral therapy 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.

Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety

PubMed Central

Walkup, John T.; Albano, Anne Marie; Piacentini, John; Birmaher, Boris; Compton, Scott N.; Sherrill, Joel T.; Ginsburg, Golda S.; Rynn, Moira A.; McCracken, James; Waslick, Bruce; Iyengar, Satish; March, John S.; Kendall, Philip C.

2009-01-01

Background Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. Methods In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. Results The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline. Conclusions Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT

Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety.

PubMed

Walkup, John T; Albano, Anne Marie; Piacentini, John; Birmaher, Boris; Compton, Scott N; Sherrill, Joel T; Ginsburg, Golda S; Rynn, Moira A; McCracken, James; Waslick, Bruce; Iyengar, Satish; March, John S; Kendall, Philip C

2008-12-25

Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline. Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.) 2008 Massachusetts Medical

Cognitive-Behavioral Therapy for HIV Medication Adherence and Depression

ERIC Educational Resources Information Center

Safren, Steven A.; Hendriksen, Ellen S.; Mayer, Kenneth H.; Mimiaga, Matthew J.; Pickard, Robert; Otto, Michael W.

2004-01-01

For patients with HIV, depression is a common, distressing condition that can interfere with a critical self-care behavior--adherence to antiretroviral therapy. The present study describes a cognitive-behavioral treatment designed to integrate cognitive-behavioral therapy for depression with our previously tested approach to improving adherence to…

Cognitive-Behavioral Therapy Plus Hypnosis for Distress During Breast Radiotherapy: A Randomized Trial.

PubMed

Montgomery, Guy H; Sucala, Madalina; Dillon, Matthew J; Schnur, Julie B

2017-10-01

Radiotherapy is a common and effective treatment for women with breast cancer. However, radiotherapy has also been shown to adversely affect patients' emotional well-being. Currently, few mind-body interventions are designed to improve patients' quality of life during radiotherapy. One intervention which has demonstrated clinical efficacy in the breast cancer radiotherapy setting is Cognitive-Behavioral Therapy plus Hypnosis. The goal of this study was to investigate the impact of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress in women with breast cancer undergoing radiotherapy. One hundred patients were randomly assigned to either the Cognitive-Behavioral Therapy plus Hypnosis (n = 50) or Attention Control (n = 50) group. Results revealed significant benefits of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress at the mid-point (d = 0.54), the conclusion (d = 0.64), and 4 weeks following the conclusion (d = 0.65) of radiotherapy (all ps < 0.05). In summary, results support further study of Cognitive-Behavioral Therapy plus Hypnosis as an evidence-based intervention to reduce emotional distress in women with breast cancer. Cognitive-Behavioral Therapy plus Hypnosis has the benefits of being brief, noninvasive, lacking side-effects, and producing beneficial effects which last beyond the conclusion of radiotherapy. Given these strengths, we propose that Cognitive-Behavioral Therapy plus Hypnosis is a strong candidate for greater dissemination and implementation in cancer populations.

Telephone-Administered Cognitive Behavioral Therapy for Veterans Served by Community-Based Outpatient Clinics

ERIC Educational Resources Information Center

Mohr, David C.; Carmody, Timothy; Erickson, Lauren; Jin, Ling; Leader, Julie

2011-01-01

Objective: Multiple trials have found telephone-administered cognitive behavioral therapy (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…

Group rational-emotive and cognitive-behavioral therapy.

PubMed

Ellis, A

1992-01-01

The theory of rational-emotive therapy (RET) and of cognitive-behavioral therapy (CBT) is briefly explained and is applied to group therapy. It is shown how RET and CBT therapy groups deal with transference, countertransference, levels of group intervention, process versus content orientation, identifying underlying group process themes, here-and-now activation, working with difficult group members, activity levels of therapist and group members, and other group problems. Although they particularly concentrate on people's tendencies to construct and create their own "emotional" difficulties, RET and CBT group procedures fully acknowledge the interactions of human thoughts, feelings, and actions and active-directively employ a variety of cognitive, emotive, and behavioral group therapy techniques.

Computer-assisted cognitive behavioral therapy for children with epilepsy and anxiety: a pilot study.

PubMed

Blocher, Jacquelyn B; Fujikawa, Mayu; Sung, Connie; Jackson, Daren C; Jones, Jana E

2013-04-01

Anxiety disorders are prevalent in children with epilepsy. The purpose of this study was to evaluate the efficacy, adaptability, and feasibility of a manual-based, computer-assisted cognitive behavioral therapy (CBT) intervention for anxiety disorders in children with epilepsy. Fifteen anxious youth (aged 8-13 years) with epilepsy completed 12 weeks of manualized computer-assisted CBT. The children and parents completed a semi-structured interview at baseline, and questionnaires assessing symptoms of anxiety, depression, and behavior problems were completed prior to treatment, at treatment midpoint, after treatment completion, and at three months posttreatment. There were significant reductions in the symptoms of anxiety and depression reported by the children at completion of the intervention and at the three-month follow-up. Similarly, the parents reported fewer symptoms of anxiety and a reduction in behavior problems. No adverse events were reported. This CBT intervention for children with epilepsy and anxiety disorders appears to be safe, effective, and feasible and should be incorporated into future intervention studies. Copyright © 2012 Elsevier Inc. All rights reserved.

Emotion Regulation Enhancement of Cognitive Behavior Therapy for College Student Problem Drinkers: A Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Ford, Julian D.; Grasso, Damion J.; Levine, Joan; Tennen, Howard

2018-01-01

This pilot randomized clinical trial tested an emotion regulation enhancement to cognitive behavior therapy (CBT) with 29 college student problem drinkers with histories of complex trauma and current clinically significant traumatic stress symptoms. Participants received eight face-to-face sessions of manualized Internet-supported CBT for problem…

Optimizing Cognitive-Behavioral Therapy for Childhood Psychiatric Disorders

ERIC Educational Resources Information Center

Piacentini, John

2008-01-01

Reports that expand the understanding of the treatment of childhood obsessive-compulsive disorder by using exposure-based cognitive-behavioral therapy 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.

User Experience of Cognitive Behavioral Therapy Apps for Depression: An Analysis of App Functionality and User Reviews.

PubMed

Stawarz, Katarzyna; Preist, Chris; Tallon, Debbie; Wiles, Nicola; Coyle, David

2018-06-06

Hundreds of mental health apps are available to the general public. With increasing pressures on health care systems, they offer a potential way for people to support their mental health and well-being. However, although many are highly rated by users, few are evidence-based. Equally, our understanding of what makes apps engaging and valuable to users is limited. The aim of this paper was to analyze functionality and user opinions of mobile apps purporting to support cognitive behavioral therapy for depression and to explore key factors that have an impact on user experience and support engagement. We systematically identified apps described as being based on cognitive behavioral therapy for depression. We then conducted 2 studies. In the first, we analyzed the therapeutic functionality of apps. This corroborated existing work on apps' fidelity to cognitive behavioral therapy theory, but we also extended prior work by examining features designed to support user engagement. Engagement features found in cognitive behavioral therapy apps for depression were compared with those found in a larger group of apps that support mental well-being in a more general sense. Our second study involved a more detailed examination of user experience, through a thematic analysis of publicly available user reviews of cognitive behavioral therapy apps for depression. We identified 31 apps that purport to be based on cognitive behavioral therapy for depression. Functionality analysis (study 1) showed that they offered an eclectic mix of features, including many not based on cognitive behavioral therapy practice. Cognitive behavioral therapy apps used less varied engagement features compared with 253 other mental well-being apps. The analysis of 1287 user reviews of cognitive behavioral therapy apps for depression (study 2) showed that apps are used in a wide range of contexts, both replacing and augmenting therapy, and allowing users to play an active role in supporting their mental

Cognitive behavior therapy for eating disorders versus normalization of eating behavior.

PubMed

Södersten, P; Bergh, C; Leon, M; Brodin, U; Zandian, M

2017-05-15

We examine the science and evidence supporting cognitive behavior therapy (CBT) for the treatment of bulimia nervosa and other eating disorders. Recent trials focusing on the abnormal cognitive and emotional aspects of bulimia have reported a remission rate of about 45%, and a relapse rate of about 30% within one year. However, an early CBT trial that emphasized the normalization of eating behavior had a better outcome than treatment that focused on cognitive intervention. In support of this finding, another treatment, that restores a normal eating behavior using mealtime feedback, has an estimated remission rate of about 75% and a relapse rate of about 10% over five years. Moreover, when eating behavior was normalized, cognitive and emotional abnormalities were resolved at remission without cognitive therapy. The critical aspect of the CBT treatment of bulimia nervosa therefore may actually have been the normalization of eating behavior. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Cognitive-behavioral couple therapy.

PubMed

Epstein, Norman B; Zheng, Le

2017-02-01

This article describes how cognitive-behavioral couple therapy (CBCT) provides a good fit for intervening with a range of stressors that couples experience from within and outside their relationship. It takes an ecological perspective in which a couple is influenced by multiple systemic levels. We provide an overview of assessment and intervention strategies used to modify negative behavioral interaction patterns, inappropriate or distorted cognitions, and problems with the experience and regulation of emotions. Next, we describe how CBCT can assist couples in coping with stressors involving (a) a partner's psychological disorder (e.g. depression), (b) physical health problems (e.g. cancer), (c) external stressors (e.g. financial strain), and (d) severe relational problems (e.g. partner aggression). Copyright © 2016 Elsevier Ltd. All rights reserved.

The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis.

PubMed

Linardon, Jake; Wade, Tracey D; de la Piedad Garcia, Xochitl; Brennan, Leah

2017-11-01

This meta-analysis examined the efficacy of cognitive-behavioral therapy (CBT) for eating disorders. Randomized controlled trials of CBT were searched. Seventy-nine trials were included. Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies. CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores.

PubMed

Christensen, Helen; Griffiths, Kathleen M; Korten, Ailsa

2002-01-01

Cognitive behavior therapy is well recognized as an effective treatment and prevention for depression when delivered face-to-face, via self-help books (bibliotherapy), and through computer administration. The public health impact of cognitive behavior therapy has been limited by cost and the lack of trained practitioners. We have developed a free Internet-based cognitive behavior therapy intervention (MoodGYM, http://moodgym.anu.edu.au) designed to treat and prevent depression in young people, available to all Internet users, and targeted to those who may have no formal contact with professional help services. To document site usage, visitor characteristics, and changes in depression and anxiety symptoms among users of MoodGYM, a Web site delivering a cognitive-behavioral-based preventive intervention to the general public. All visitors to the MoodGYM site over about 6 months were investigated, including 2909 registrants of whom 1503 had completed at least one online assessment. Outcomes for 71 university students enrolled in an Abnormal Psychology course who visited the site for educational training were included and examined separately. The main outcome measures were (1) site-usage measures including number of sessions, hits and average time on the server, and number of page views; (2) visitor characteristics including age, gender, and initial Goldberg self-report anxiety and depression scores; and (3) symptom change measures based on Goldberg anxiety and depression scores recorded on up to 5 separate occasions. Over the first almost-6-month period of operation, the server recorded 817284 hits and 17646 separate sessions. Approximately 20% of sessions lasted more than 16 minutes. Registrants who completed at least one assessment reported initial symptoms of depression and anxiety that exceeded those found in population-based surveys and those characterizing a sample of University students. For the Web-based population, both anxiety and depression scores decreased

A randomized trial of female-specific cognitive behavior therapy for alcohol dependent women.

PubMed

Epstein, Elizabeth E; McCrady, Barbara S; Hallgren, Kevin A; Cook, Sharon; Jensen, Noelle K; Hildebrandt, Thomas

2018-02-01

This study compared Female-Specific Cognitive Behavioral Therapy (FS-CBT) to evidence-based, gender-neutral CBT (GN-CBT; Epstein & McCrady, 2009) for women with alcohol use disorder (AUD). Women (N = 99) with AUD, mean age 48, were randomly assigned to 12 outpatient manual-guided sessions of FS-CBT (n = 44) or GN-CBT (n = 55). Women were assessed at baseline and 3, 9 and 15 months after baseline for drinking and for specific issues common among women with AUD. A FS-CBT protocol was developed that was discriminable on treatment integrity ratings from GN-CBT. No treatment condition differences were found in treatment engagement, changes in drinking, alcohol-related coping, abstinence self-efficacy, motivation to change, or constructs directly targeted in FS-CBT (sociotropy, autonomy, depression, anxiety). Women in both conditions were highly engaged and satisfied with treatment, and reported significant reductions in drinking and changes in desired directions for all other variables except social support for abstinence. In the year following treatment, women in the FS-CBT but not in the CBT condition reported an increase in percentage of abstainers in their social networks (0.69% per month, SE = 0.21, p = .002). The value and appeal of female-specific programming in AUD treatment has been established in the wider literature (Epstein & Menges, 2013), and the current study provides support for the use of the Female-Specific Cognitive Behavioral Therapy (FS-CBT) manual as an option that may yield outcomes similar to standard gender-neutral CBT for women with AUD. Future research should examine whether FS-CBT enhances treatment utilization for women. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Trauma-Focused Cognitive Behavior Therapy for School Psychologists

ERIC Educational Resources Information Center

Fitzgerald, Monica M.; Cohen, Judith A.

2012-01-01

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 behavioral therapy, to students affected by childhood posttraumatic stress disorder and co-occurring mental health and behavioral…

Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design.

PubMed

Cully, Jeffrey A; Armento, Maria E A; Mott, Juliette; Nadorff, Michael R; Naik, Aanand D; Stanley, Melinda A; Sorocco, Kristen H; Kunik, Mark E; Petersen, Nancy J; Kauth, Michael R

2012-07-11

Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1) to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases) primary care patients and (2) to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200) or usual care (n = 120). Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points) and qualitative methods (e.g., focus interviews

The cognitive treatment components and therapies of cognitive behavioral therapy for insomnia: A systematic review.

PubMed

Jansson-Fröjmark, Markus; Norell-Clarke, Annika

2018-06-07

Since the beginning of the twenty-first century, there has been an increased focus on developing and testing cognitive components and therapies for insomnia disorder. The aim of the current review was thus to describe and review the efficacy of cognitive components and therapies for insomnia. A systematic review was conducted on 32 studies (N = 1455 subjects) identified through database searches. Criteria for inclusion required that each study constituted a report of outcome from a cognitive component or therapy, that the study had a group protocol, adult participants with diagnosed insomnia or undiagnosed insomnia symptoms or reported poor sleep, and that the study was published until and including 2016 in English. Each study was systematically reviewed with a standard coding sheet. Several cognitive components, a multi-component cognitive program, and cognitive therapy were identified. It is concluded that there is support for paradoxical intention and cognitive therapy. There are also other cognitive interventions that appears promising, such as cognitive refocusing and behavioral experiments. For most interventions, the study quality was rated as low to moderate. We conclude that several cognitive treatment components and therapies can be viewed as efficacious or promising interventions for patients with insomnia disorder. Methodologically stronger studies are, however, warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cognitive behavioral therapy for adolescents with ADHD.

PubMed

Antshel, Kevin M; Olszewski, Amy K

2014-10-01

Attention deficit/hyperactivity disorder (ADHD) often persists into adolescence and has the same functional impairments as were present during childhood. Medications lessen ADHD symptoms yet do not reliably affect functioning. Thus, there exists a great need for psychosocial treatments in adolescents with ADHD. Nonetheless, relative to the vast literature that has been reported on children with ADHD, much less data have been reported about psychosocial interventions for adolescents with ADHD. Cognitive behavioral therapy interventions that are being used with adolescents rely more on traditional behavioral principles than cognitive therapy tenets. Copyright © 2014 Elsevier Inc. All rights reserved.

Sustaining clinician penetration, attitudes and knowledge in cognitive-behavioral therapy for youth anxiety

PubMed Central

2014-01-01

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-behavioral therapy, attitudes toward evidence-based practices, and knowledge of cognitive-behavioral therapy for youth anxiety two years following training and consultation in cognitive-behavioral therapy 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-behavioral therapy 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

Jogging the Cogs: Trauma-Focused Art Therapy and Cognitive Behavioral Therapy with Sexually Abused Children

ERIC Educational Resources Information Center

Pifalo, Terry

2007-01-01

Art therapy in conjunction with cognitive behavioral therapy 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…

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder – the gold standard treatment for adults with binge eating disorder. Methods/design In a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight. Discussion This trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial.

PubMed

Hilbert, Anja

2013-09-25

Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder - the gold standard treatment for adults with binge eating disorder. In a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight. This trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results from this trial will enhance

First-line treatment: a critical appraisal of cognitive behavioral therapy developments and alternatives.

PubMed

Arch, Joanna J; Craske, Michelle G

2009-09-01

In this article, the authors assess the successes, remaining challenges, and new developments in cognitive behavioral therapy (CBT) for anxiety disorders. They define CBT, examine treatment components, review treatment efficacy, and discuss the challenges of attrition, long-term follow-up, co-occurring/comorbid disorders, limited treatment comparisons, treatment mediators, and broader implementation. In addition, they present recent developments in cognitive behavioral therapy for anxiety disorders, including linking exposure therapy to basic science, mindfulness and acceptance-based treatments, and unified or transdiagnostic treatment protocols.

Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: results from a randomized controlled trial.

PubMed

Hedman, Erik; Andersson, Erik; Ljótsson, Brjánn; Andersson, Gerhard; Rück, Christian; Lindefors, Nils

2011-11-01

Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n=64) or CBGT (n=62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD. Copyright © 2011 Elsevier Ltd. All rights reserved.

Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia.

PubMed

Eidelman, Polina; Talbot, Lisa; Ivers, Hans; Bélanger, Lynda; Morin, Charles M; Harvey, Allison G

2016-01-01

As part of a larger randomized controlled trial, 188 participants were randomized to behavior therapy (BT), cognitive therapy (CT), or cognitive-behavioral therapy (CBT) for insomnia. The aims of this study were threefold: (a) to determine whether change in dysfunctional beliefs about sleep was related to change in sleep, insomnia symptoms, and impairment following treatment; (b) to determine whether BT, CT, and CBT differ in their effects on dysfunctional beliefs; and (c) to determine whether the treatments differ in their effects on particular kinds of dysfunctional beliefs. Beliefs, sleep, insomnia symptoms, and sleep-related psychosocial impairment were assessed at pretreatment, posttreatment, and 6- and 12-month follow-up. Greater change in dysfunctional beliefs occurring over the course of BT, CT, or CBT was associated with greater improvement in insomnia symptoms and impairment at posttreatment and both follow-ups. All groups experienced a significant decrease in dysfunctional beliefs during treatment, which were sustained through 6- and 12-month follow-up. Compared with the BT group, a greater proportion of participants in the CT and/or CBT groups endorsed dysfunctional beliefs below a level considered clinically significant at posttreatment and 12-month follow-up. The results demonstrate the importance of targeting dysfunctional beliefs in insomnia treatment, suggest that beliefs may be significantly modified with BT alone, and indicate that cognitive interventions may be particularly powerful in enhancing belief change. Copyright © 2016. Published by Elsevier Ltd.

School-Based Cognitive-Behavioral Therapy for Adolescent Depression: A Benchmarking Study

ERIC Educational Resources Information Center

Shirk, Stephen R.; Kaplinski, Heather; Gudmundsen, Gretchen

2009-01-01

The current study evaluated cognitive-behavioral therapy (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…

Guided Web-Based Cognitive Behavior Therapy for Perfectionism: Results From Two Different Randomized Controlled Trials.

PubMed

Rozental, Alexander; Shafran, Roz; Wade, Tracey D; Kothari, Radha; Egan, Sarah J; Ekberg, Linda; Wiss, Maria; Carlbring, Per; Andersson, Gerhard

2018-04-26

Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-up data. The objective of this study was to explore the outcomes at follow-up of internet-based cognitive behavioral therapy with guided self-help, delivered as 2 separate randomized controlled trials conducted in Sweden and the United Kingdom. In total, 120 participants randomly assigned to internet-based cognitive behavioral therapy were included in both intention-to-treat and completer analyses: 78 in the Swedish trial and 62 in the UK trial. The primary outcome measure was the Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale (FMPS CM). Secondary outcome measures varied between the trials and consisted of the Clinical Perfectionism Questionnaire (CPQ; both trials), the 9-item Patient Health Questionnaire (PHQ-9; Swedish trial), the 7-item Generalized Anxiety Disorder scale (GAD-7; Swedish trial), and the 21-item Depression Anxiety Stress Scale (DASS-21; UK trial). Follow-up occurred after 6 months for the UK trial and after 12 months for the Swedish trial. Analysis of covariance revealed a significant difference between pretreatment and follow-up in both studies. Intention-to-treat within-group Cohen d effect sizes were 1.21 (Swedish trial; 95% CI 0.86-1.54) and 1.24 (UK trial; 95% CI 0.85-1.62) for the FMPS CM. Furthermore, 29 (59%; Swedish trial) and 15 (43%; UK trial) of the participants met the criteria for recovery on the FMPS CM. Improvements were also significant for the CPQ, with effect sizes of 1.32 (Swedish trial; 95% CI 0.97-1.66) and 1.49 (UK trial; 95% CI 1.09-1.88); the PHQ-9, effect size 0.60 (95% CI 0.28-0.92); the GAD-7, effect size 0.67 (95% CI 0.34-0.99); and the DASS-21, effect size 0.50 (95% CI 0.13-0.85). The results are promising for

[Significance of emotion-focused concepts to cognitive-behavioral therapy].

PubMed

Lammers, C-H

2006-09-01

Emotions are the central process of motivation and play a key role in adaptive behavior in humans. Although cognitive-behavioral therapy stresses the importance of changing both cognition and behavior, there is growing emphasis on direct therapeutic work on emotions and emotional processing, as problematic emotional processes are at the core of nearly all psychic disorders. This type of work is the goal of emotion-focused psychotherapy, which centers on direct change of problematic emotions, especially those which are usually suppressed resp. overregulated by the patient. This paper examines the basic phobic/emotional conflict, the problematic emotional processes arising from this conflict, and the importance to cognitive-behavioral therapy of their potentially integrative role.

Do we need to challenge thoughts in cognitive behavior therapy?

PubMed

Longmore, Richard J; Worrell, Michael

2007-03-01

Cognitive behavior therapy (CBT) emphasizes the primacy of cognition in mediating psychological disorder. It aims to alleviate distress by modifying cognitive content and process, realigning thinking with reality. Recently, various authors have questioned the need for CBT therapists to use logico-rational strategies to directly challenge maladaptive thoughts. Hayes [Hayes, S.C. (2004). Acceptance and commitment therapy and the new behavior therapies. In S.C. Hayes, V.M. Follette, & M.M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive behavioral tradition. (pp. 1-29). New York: Guilford] has identified three empirical anomalies in the research literature. Firstly, treatment component analyzes have failed to show that cognitive interventions provide significant added value to the therapy. Secondly, CBT treatments have been associated with a rapid symptomatic improvement prior to the introduction of specific cognitive interventions. Thirdly, there is a paucity of data that changes in cognitive mediators instigate symptomatic change. This paper critically reviews the empirical literature that addresses these significant challenges to CBT. A comprehensive review of component studies finds little evidence that specific cognitive interventions significantly increase the effectiveness of the therapy. Although evidence for the early rapid response phenomenon is lacking, there is little empirical support for the role of cognitive change as causal in the symptomatic improvements achieved in CBT. These findings are discussed with reference to the key question: Do we need to challenge thoughts in CBT?

An Integrative Approach: Relational Cultural Theory and Cognitive Behavior Therapy in College Counseling

ERIC Educational Resources Information Center

Crumb, Loni; Haskins, Natoya

2017-01-01

This article presents an integrative framework for using cognitive behavior therapy through the lens of relational cultural theory. The authors provide an overview of cognitive behavior therapy and relational cultural theory, followed by suggestions on how to facilitate cognitive behavior therapy using the principles of relational cultural theory…

Effectively Utilizing the "Behavioral" in Cognitive-Behavioral Group Therapy of Sex Offenders

ERIC Educational Resources Information Center

Jennings, Jerry L.; Deming, Adam

2013-01-01

Although cognitive-behavioral therapy (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…

Facets of clinicians' anxiety and the delivery of cognitive behavioral therapy.

PubMed

Levita, Liat; Salas Duhne, Paulina Gonzalez; Girling, Carla; Waller, Glenn

2016-02-01

Psychological therapists commonly fail to adhere to treatment protocols in everyday clinical practice. In part, this pattern of drift is attributable to anxious therapists being less likely to undertake some elements of evidence-based therapies - particularly the exposure-based elements. This study considers what facets of anxiety (cognitive, behavioral, physiological) are related to junior clinicians' reported use of cognitive-behavioral therapy techniques. Thirty-two clinicians (mean age = 28.9 years; mean length of CBT experience = 1.5 years; 23 female, nine male) who offered CBT were assessed for their cognitive, behavioral and physiological characteristics (Intolerance of Uncertainty scale; risk taking; skin conductance response and heart rate variability). While the three different facets of anxiety were relatively poorly associated with each other, as is usual in this literature, each facet was linked differently to the reported delivery of CBT techniques (P < .05). Overall, higher anxiety levels were associated with a poorer use of exposure methods or with a greater use of other behavioral or cognitive methods. Of the three facets of anxiety, only physiological reactivity showed an association with the clinicians' temporal characteristics, with more experienced therapists being more likely to have greater skin conductance responses to positive and negative outcomes. These findings suggest that clinicians who are more anxious are less likely to deliver the full evidence-based form of CBT and to focus instead on less challenging elements of the therapy. Potential ways of overcoming this limitation are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cognitive behavior therapy in the treatment of panic disorder

PubMed Central

Manjula, M.; Kumariah, V.; Prasadarao, P. S. D. V.; Raguram, R.

2009-01-01

Background: Comprehensive cognitive behavior therapies have been proved to be more effective than behavioral interventions. However, the efficacy of CBT is not studied in the Indian context and also, the amount of change brought about by CBT is not known. Aims: This study aims to examine the efficacy of cognitive behavioral intervention (CBI) in the treatment of panic disorder. Our specific objectives were to assess the effectiveness of CBI in reducing symptom severity as well as cognitions related to panic and panic-related behaviors. Design: The study adopted a two-group comparison with pre- and postassessments design. Materials and Methods: The sample consisted of 30 patients sequentially allotted to the CBI (n = 15) and behavioral intervention (BI, n = 15) groups. Assessment was done using a semistructured interview schedule, panic disorder severity scale, Texas panic attack record form, Anxiety Sensitivity Index, Agoraphobic cognitions questionnaire, Behavioral avoidance checklist, and Panic appraisal inventory. The CBI group was provided with comprehensive cognitive behavior therapy and the BI group with psycho-education and applied relaxation. Results: CBI was found to be superior to BI in the reduction of panic symptoms, behavioral avoidance, safety behaviors, and cognitions. A large percentage of the CBI group patients met the criteria for clinically significant change with a large magnitude of change. Conclusion: Multicomponent CBI is superior to BI in terms of the amount of change it brings about with respect to panic symptoms, avoidance, safety behaviors, and cognitions. PMID:19823629

Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

PubMed Central

Prazeres, Angélica M; Nascimento, Antônio L; Fontenelle, Leonardo F

2013-01-01

The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies 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 behavioral therapies 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 behavioral therapy 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 behavioral therapies for body dysmorphic disorder. PMID:23467711

Teaching Cognitive-Behavioral Therapy to Undergraduate Psychology Students

ERIC Educational Resources Information Center

Ryan, Tracey Ellen; Blau, Shawn; Grozeva, Dima

2011-01-01

This article describes an experimental undergraduate psychology course that ran for two semesters during the 2009 academic year at a private, urban university in the United States. Students learned the techniques and strategies of cognitive behavioral therapy (CBT) and rational emotive behavior therapy (REBT) with a focus on the practical elements…

Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment

PubMed Central

Mahvi-Shirazi, Majid; Rasoolzade-Tabatabaei, Sayed-Kazem; Amini, Mohsen

2012-01-01

Introduction The study aims to investigate two kinds of treatment in patients suffering from irritable bowel syndrome (IBS) and consequently compares its efficacy on improving the symptoms and mental health of patients; one with just medical treatment and another through a combination of psychotherapy and medical treatment. Material and methods Applying general sampling, 50 IBS patients were selected from among those who used to refer to a Gastroenterology Clinic. After physical and mental evaluations based on ROME-II scale and SCL-90-R questionnaires, the subjects were randomly superseded into: the control group with medical treatment and, the case group with a combination of medical and psychological treatments. The acquired data were then analyzed through t-test and Mann-Whitney U-test. Results The findings show that the mental health of patients receiving cognitive behavioral therapy along with the medical treatment was higher than those of the control group at post-test level. It was observed that the therapy reduces the disability caused by IBS. Comparatively, while the cognitive therapy and medical treatments cured 80% of the patients, those receiving cognitive therapy alone showed an extensive reduction of symptoms. Conclusions Considering the role of cognitive behavioral therapy, it is therefore recommend that such patients be managed by a combined team of gastroenterologists and psychologists. PMID:22457686

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Preliminary Investigation

ERIC Educational Resources Information Center

Misurell, Justin R.; Springer, Craig; Tryon, Warren W.

2011-01-01

This preliminary investigation examined the efficacy of a game-based cognitive-behavioral therapy 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…

A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study.

PubMed

Hallberg, Jonas; Kaldo, Viktor; Arver, Stefan; Dhejne, Cecilia; Öberg, Katarina Görts

2017-07-01

The proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity. To investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients' treatment satisfaction. Ten men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment. The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score. Main results were significant decreases of HD symptoms from before to after treatment on HD:CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found. The CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option. This study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary. Although participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure

Treatment of phobic postural vertigo. A controlled study of cognitive-behavioral therapy and self-controlled desensitization.

PubMed

Holmberg, J; Karlberg, M; Harlacher, U; Rivano-Fischer, M; Magnusson, M

2006-04-01

In balance clinic practice, phobic postural vertigo is a term used to define a population with dizziness and avoidance behavior often as a consequence of a vestibular disorder. It has been described as the most common form of dizziness in middle aged patients in dizziness units. Anxiety disorders are common among patients with vestibular disorders. Cognitive-behavioral therapy is an effective treatment for anxiety disorders, and vestibular rehabilitation exercises are effective for vestibular disorders. This study compared the effect of additional cognitive-behavioral therapy for a population with phobic postural vertigo with the effect of self-administered vestibular rehabilitation exercises. 39 patients were recruited from a population referred for otoneurological investigation. Treatment effects were evaluated with the Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale. All patients had a self treatment intervention based on education about the condition and recommendation of self exposure by vestibular rehabilitation exercises. Every second patient included was offered additional cognitive behavioral therapy. Fifteen patients with self treatment and 16 patients with cognitive- behavioral treatment completed the study. There was significantly larger effect in the group who received cognitive behavioral therapy than in the self treatment group in Vertigo Handicap Questionnaire and the Hospital Anxiety and Depression scale and its subscales. Cognitive-behavioral therapy has an additional effect as treatment for a population with phobic postural vertigo. A multidisciplinary approach including medical treatment, cognitive-behavioral therapy and physiotherapy is suggested.

Mindfulness and acceptance-based group therapy and traditional cognitive behavioral group therapy for social anxiety disorder: Mechanisms of change.

PubMed

Kocovski, Nancy L; Fleming, Jan E; Hawley, Lance L; Ho, Moon-Ho Ringo; Antony, Martin M

2015-07-01

The present study investigated mechanisms of change for two group treatments for social anxiety disorder (SAD): cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT). Participants were treatment completers (n = 37 for MAGT, n = 32 for CBGT) from a randomized clinical trial. Cognitive reappraisal was the hypothesized mechanism of change for CBGT. Mindfulness and acceptance were hypothesized mechanisms of change for MAGT. Latent difference score (LDS) analysis results demonstrate that cognitive reappraisal coupling (in which cognitive reappraisal is negatively associated with the subsequent rate of change in social anxiety) had a greater impact on social anxiety for CBGT than MAGT. The LDS bidirectional mindfulness model (mindfulness predicts subsequent change in social anxiety; social anxiety predicts subsequent change in mindfulness) was supported for both treatments. Results for acceptance were less clear. Cognitive reappraisal may be a more important mechanism of change for CBGT than MAGT, whereas mindfulness may be an important mechanism of change for both treatments. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cognitive-Behavioral Therapy for Anxiety Disordered Youth: A Randomized Clinical Trial Evaluating Child and Family Modalities

ERIC Educational Resources Information Center

Kendall, Philip C.; Hudson, Jennifer L.; Gosch, Elizabeth; Flannery-Schroeder, Ellen; Suveg, Cynthia

2008-01-01

This randomized clinical trial compared the relative efficacy of individual (child) cognitive-behavioral therapy (ICBT), family cognitive-behavioral therapy (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%…

Cognitive Behavioral Guided Self-Help for the Treatment of Recurrent Binge Eating

ERIC Educational Resources Information Center

Striegel-Moore, Ruth H.; Wilson, G. Terence; DeBar, Lynn; Perrin, Nancy; Lynch, Frances; Rosselli, Francine; Kraemer, Helena C.

2010-01-01

Objective: Despite proven efficacy of cognitive behavioral therapy (CBT) for treating eating disorders with binge eating as the core symptom, few patients receive CBT in clinical practice. Our blended efficacy-effectiveness study sought to evaluate whether a manual-based guided self-help form of CBT (CBT-GSH), delivered in 8 sessions in a health…

The Effect of a New Therapy for Children with Tics Targeting Underlying Cognitive, Behavioral, and Physiological Processes.

PubMed

Leclerc, Julie B; O'Connor, Kieron P; J-Nolin, Gabrielle; Valois, Philippe; Lavoie, Marc E

2016-01-01

Tourette disorder (TD) is characterized by motor and vocal tics, and children with TD tend to present a lower quality of life than neurotypical children. This study applied a manualized treatment for childhood tics disorder, Facotik, to a consecutive case series of children aged 8-12 years. The Facotik therapy was adapted from the adult cognitive and psychophysiological program validated on a range of subtypes of tics. This approach aims to modify the cognitive-behavioral and physiological processes against which the tic occurs, rather than only addressing the tic behavior. The Facotik therapy lasted 12-14 weeks. Each week 90-min session contained 20 min of parental training. The therapy for children followed 10 stages including: awareness training; improving motor control; modifying style of planning; cognitive and behavioral restructuring; and relapse prevention. Thirteen children were recruited as consecutive referrals from the general population, and seven cases completed therapy and posttreatment measures. Overall results showed a significant decrease in symptom severity as measured by the YGTSS and the TSGS. However, there was a discrepancy between parent and child rating, with some children perceiving an increase in tics, possibly due to improvement of awareness along therapy. They were also individual changes on adaptive aspects of behavior as measured with the BASC-2, and there was variability among children. All children maintained or improved self-esteem posttreatment. The results confirm the conclusion of a previous pilot study, which contributed to the adaptation of the adult therapy. In summary, the Facotik therapy reduced tics in children. These results underline that addressing processes underlying tics may complement approaches that target tics specifically.

[Cognitive-behavioral therapy of conversion aphonia].

PubMed

Kuljić, Blagoje

2004-01-01

Although a common disease, conversion disorder still calls attention in the clinical practice. A case of conversion disorder, diagnosed as a psychogenic aphonia that persisted for a week, was reported in this paper. A 21-year-old woman developed symptoms after breaking off a long-lasting relationship with her boy-friend. History revealed that she was introvert with high neuroticism and communication problems. Cognitive-behavioral therapy was used. After the positive reinforcement in the therapy of her aphonia, assertion training for the development of communication skills was performed. In the end, cognitive restructuring was used to prevent relapse in regard to her actual life situation of being a refugee preparing for immigration to Australia.

Effectiveness of Group Cognitive-Behavioral Therapy on Symptoms of Premenstrual Syndrome (PMS) ‎.

PubMed

Maddineshat, Maryam; Keyvanloo, Sodabe; Lashkardoost, Hossein; Arki, Mina; Tabatabaeichehr, Mahbubeh

2016-01-01

Standards of care and treatment of premenstrual syndrome (PMS) vary. Non-drug ‎psychosocial intervention therapy is recommended for women with any kind of ‎discomfort or distress caused by PMS. The current study examined the effectiveness of ‎group cognitive-behavioral therapy on the symptoms of PMS at a girls' dormitory of ‎North Khorasan University of Medical Sciences. In this quasi-experimental study, 32 female students with PMS who were majoring in ‎nursing and midwifery and residing in the dormitory were selected using the ‎convenience sampling method and were assigned to experimental and control groups. ‎The Standardized Premenstrual Symptoms Screening Tool was used as the research ‎tool. Eight sessions of cognitive-behavioral group therapy were held for the students Results: There was a significant difference in psychological symptoms before and after ‎cognitive-behavioral therapy (p=0.012). Furthermore, cognitive-behavioral therapy was ‎effective on social interferences caused by PMS symptoms (p=0.012).‎ Group cognitive-behavioral therapy effectively alleviates PMS symptoms in female ‎college students.‎.

Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder.

PubMed

McKay, Dean; Sookman, Debbie; Neziroglu, Fugen; Wilhelm, Sabine; Stein, Dan J; Kyrios, Michael; Matthews, Keith; Veale, David

2015-05-30

Cognitive-behavioral therapy (CBT), which encompasses exposure with response prevention (ERP) and cognitive therapy (CT), 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder.

PubMed

McKay, Dean; Sookman, Debbie; Neziroglu, Fugen; Wilhelm, Sabine; Stein, Dan J; Kyrios, Michael; Matthews, Keith; Veale, David

2015-02-28

Cognitive-behavioral therapy (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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Internet-Based Cognitive Behavior Therapy vs. Cognitive Behavioral Group Therapy for Social Anxiety Disorder: A Randomized Controlled Non-inferiority Trial

PubMed Central

Hedman, Erik; Andersson, Gerhard; Ljótsson, Brjánn; Andersson, Erik; Rück, Christian; Mörtberg, Ewa; Lindefors, Nils

2011-01-01

Background and Aims Cognitive behavioral group therapy (CBGT) is an effective, well-established, but not widely available treatment for social anxiety disorder (SAD). Internet-based cognitive behavior therapy (ICBT) has the potential to increase availability and facilitate dissemination of therapeutic services for SAD. However, ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT have been conducted in clinical settings. Our aim was to investigate if ICBT is at least as effective as CBGT for SAD when treatments are delivered in a psychiatric setting. Methods We conducted a randomized controlled non-inferiority trial with allocation to ICBT (n = 64) or CBGT (n = 62) with blinded assessment immediately following treatment and six months post-treatment. Participants were 126 individuals with SAD who received CBGT or ICBT for a duration of 15 weeks. The Liebowitz Social Anxiety Scale (LSAS) was the main outcome measure. The following non-inferiority margin was set: following treatment, the lower bound of the 95 % confidence interval (CI) of the mean difference between groups should be less than 10 LSAS-points. Results Both groups made large improvements. At follow-up, 41 (64%) participants in the ICBT group were classified as responders (95% CI, 52%–76%). In the CBGT group, 28 participants (45%) responded to the treatment (95% CI, 33%–58%). At post-treatment and follow-up respectively, the 95 % CI of the LSAS mean difference was 0.68–17.66 (Cohen’s d between group = 0.41) and −2.51–15.69 (Cohen’s d between group = 0.36) favoring ICBT, which was well within the non-inferiority margin. Mixed effects models analyses showed no significant interaction effect for LSAS, indicating similar improvement across treatments (F = 1.58; df = 2, 219; p = .21). Conclusions ICBT delivered in a psychiatric setting can be as effective as CBGT in the treatment of SAD and could be used

Pilot Study of Community-Based Cognitive Behavioral Group Therapy for Adolescents with Social Phobia.

ERIC Educational Resources Information Center

Baer, Susan; Garland, E. Jane

2005-01-01

Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…

Cognitive-Behavioral Therapy for Pathological Gamblers

ERIC Educational Resources Information Center

Petry, Nancy M.; Ammerman, Yola; Bohl, Jaime; Doersch, Anne; Gay, Heather; Kadden, Ronald; Molina, Cheryl; Steinberg, Karen

2006-01-01

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…

Family Cognitive Behavioral Therapy for Child Anxiety Disorders

ERIC Educational Resources Information Center

Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian

2006-01-01

Objective: This study compared family-focused cognitive behavioral therapy (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…

Religiously Integrated Cognitive Behavioral Therapy: A New Method of Treatment for Major Depression in Patients With Chronic Medical Illness

PubMed Central

Pearce, Michelle J.; Koenig, Harold G.; Robins, Clive J.; Nelson, Bruce; Shaw, Sally F.; Cohen, Harvey J.; King, Michael B.

2015-01-01

Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients’ spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive–behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

Where Is the Evidence for "Evidence-Based" Therapy?

PubMed

Shedler, Jonathan

2018-06-01

The term evidence-based therapy is a de facto code word for manualized therapy, most often brief cognitive behavior therapy and its variants. It is widely asserted that "evidence-based" therapy is scientifically proven, superior to other forms of psychotherapy, and the gold standard of care. Research findings do not support such assertions. Research on evidence-based therapies demonstrates that they are weak treatments. They have not shown superiority to other forms of psychotherapy, few patients get well, and treatment benefits do not last. Questionable research practices create a distorted picture of the actual benefits of these therapies. Copyright © 2018 Jonathan Shedler. Published by Elsevier Inc. All rights reserved.

Cognitive behavioral therapy for compulsive buying disorder.

PubMed

Mitchell, James E; Burgard, Melissa; Faber, Ron; Crosby, Ross D; de Zwaan, Martina

2006-12-01

To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.

United We Stand: Emphasizing Commonalities Across Cognitive-Behavioral Therapies

PubMed Central

Mennin, Douglas S.; Ellard, Kristen K.; Fresco, David M.; Gross, James J.

2016-01-01

Cognitive behavioral therapy (CBT) has a rich history of alleviating the suffering associated with mental disorders. Recently, there have been exciting new developments, including multi-component approaches, incorporated alternative therapies (e.g., meditation), targeted and cost-effective technologies, and integrated biological and behavioral frameworks. These field-wide changes have led some to emphasize the differences among variants of CBT. Here, we draw attention to commonalities across cognitive-behavioral therapies, including shared goals, change principles, and therapeutic processes. Specifically, we offer a framework for examining common CBT characteristics that emphasizes behavioral adaptation as a unifying goal and three core change principles, namely (1) context engagement to promote adaptive imagining and enacting of new experiences; (2) attention change to promote adaptive sustaining, shifting, and broadening of attention; and (3) cognitive change to promote adaptive perspective taking on events so as to alter verbal meanings. Further, we argue that specific intervention components including behavioral exposure/activation, attention training, acceptance/tolerance, decentering/defusion, and cognitive reframing may be emphasized to a greater or lesser degree by different treatment packages but are still fundamentally common therapeutic processes that are present across approaches and are best understood by their relationships to these core CBT change principles. We conclude by arguing for shared methodological and design frameworks for investigating unique and common characteristics to advance a unified and strong voice for CBT in a widening, increasingly multimodal and interdisciplinary, intervention science. PMID:23611074

United we stand: emphasizing commonalities across cognitive-behavioral therapies.

PubMed

Mennin, Douglas S; Ellard, Kristen K; Fresco, David M; Gross, James J

2013-06-01

Cognitive behavioral therapy (CBT) has a rich history of alleviating the suffering associated with mental disorders. Recently, there have been exciting new developments, including multicomponent approaches, incorporated alternative therapies (e.g., meditation), targeted and cost-effective technologies, and integrated biological and behavioral frameworks. These field-wide changes have led some to emphasize the differences among variants of CBT. Here, we draw attention to commonalities across cognitive-behavioral therapies, including shared goals, change principles, and therapeutic processes. Specifically, we offer a framework for examining common CBT characteristics that emphasizes behavioral adaptation as a unifying goal and three core change principles, namely (a) context engagement to promote adaptive imagining and enacting of new experiences; (b) attention change to promote adaptive sustaining, shifting, and broadening of attention; and (c) cognitive change to promote adaptive perspective taking on events so as to alter verbal meanings. Further, we argue that specific intervention components, including behavioral exposure/activation, attention training, acceptance/tolerance, decentering/defusion, and cognitive reframing, may be emphasized to a greater or lesser degree by different treatment packages but are still fundamentally common therapeutic processes that are present across approaches and are best understood by their relationships to these core CBT change principles. We conclude by arguing for shared methodological and design frameworks for investigating unique and common characteristics to advance a unified and strong voice for CBT in a widening, increasingly multimodal and interdisciplinary, intervention science. Copyright © 2013 Elsevier Ltd. All rights reserved.

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

PubMed

Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N; Conte, Marisa L; Rogers, Mary A M

2016-01-01

Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001) with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post

Cognitive-Behavioral Therapy for Insomnia: Comparison of Individual Therapy, Group Therapy, and Telephone Consultations

ERIC Educational Resources Information Center

Bastien, Celyne H.; Morin, Charles M.; Ouellet, Marie-Christine; Blais, France C.; Bouchard, Sebastien

2004-01-01

Forty-five adults with primary insomnia received cognitive-behavioral therapy (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…

Internet-based Cognitive Behavioral Therapy for Depression: Current Progress & Future Directions

PubMed Central

Webb, Christian A.; Rosso, Isabelle M.; Rauch, Scott L.

2016-01-01

The World Health Organization (WHO) estimates that during a given 12-month period approximately 34 million people suffering from major depressive disorder go untreated in Europe and the Americas alone.1 Barriers to treatment include geographic distance, lack of mental health insurance, prohibitive cost of treatment, long wait-lists, and perceived stigma. Over the past two decades internet-based cognitive behavioral therapy (iCBT) programs have proliferated. A growing body of research supports the efficacy of iCBT for depression and other psychiatric conditions, and these programs may help address barriers that hinder access to effective treatment. The present review describes common iCBT programs along with the evidence base supporting their efficacy in reducing symptoms of depression, reviews research on moderators of treatment response, and provides suggestions for future directions in research and care. PMID:28475503

Mindfulness-Based Cognitive Therapy for Bipolar Disorder: Effects on Cognitive Functioning

PubMed Central

Stange, Jonathan P.; Eisner, Lori R.; Hölzel, Britta K.; Peckham, Andrew D.; Dougherty, Darin D.; Rauch, Scott L.; Nierenberg, Andrew A.; Lazar, Sara; Deckersbach, Thilo

2012-01-01

Bipolar disorder is associated with impairments in cognition, including difficulties in executive functioning, even when patients are euthymic (neither depressed nor manic). The purpose of this study was to assess changes in self-reported cognitive functioning in patients with bipolar disorder who participated in an open pilot trial of mindfulness-based cognitive therapy (MBCT). Following MBCT, patients reported significant improvements in executive functioning, memory, and ability to initiate and complete tasks, as measured by the Behavior Rating Inventory of Executive Function (BRIEF) and the Frontal Systems Behavior Scale (FrSBe). Changes in cognitive functioning were correlated with increases in mindful, nonjudgmental observance and awareness of thoughts, feelings, and sensations, and were not associated with decreases in depression. Improvements tended to diminish after termination of treatment, but some improvements, particularly those in executive functioning, persisted after 3 months. These results provide preliminary evidence that MBCT may be a treatment option that can be used as an adjunct to medication to improve cognitive functioning in bipolar disorder. PMID:22108398

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

PubMed

Archer, Kristin R; Devin, Clinton J; Vanston, Susan W; Koyama, Tatsuki; Phillips, Sharon E; George, Steven Z; McGirt, Matthew J; Spengler, Dan M; Aaronson, Oran S; Cheng, Joseph S; Wegener, Stephen T

2016-01-01

The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery. This study investigated a targeted cognitive-behavioral-based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Appetite-Focused Cognitive-Behavioral Therapy in the Treatment of Binge Eating with Purging

ERIC Educational Resources Information Center

Dicker, Stacy L.; Craighead, Linda Wilcoxon

2004-01-01

The first-line treatment for bulimia nervosa (BN), cognitive-behavioral therapy (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…

Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence.

PubMed

Thoma, Nathan; Pilecki, Brian; McKay, Dean

2015-09-01

Cognitive behavior therapy (CBT) has come to be a widely practiced psychotherapy throughout the world. The present article reviews theory, history, and evidence for CBT. It is meant as an effort to summarize the forms and scope of CBT to date for the uninitiated. Elements of CBT such as cognitive therapy, behavior therapy, and so-called "third wave" CBT, such as dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT) are covered. The evidence for the efficacy of CBT for various disorders is reviewed, including depression, anxiety disorders, personality disorders, eating disorders, substance abuse, schizophrenia, chronic pain, insomnia, and child/adolescent disorders. The relative efficacy of medication and CBT, or their combination, is also briefly considered. Future directions for research and treatment development are proposed.

Preliminary Evidence for Cognitive Mediation during Cognitive-Behavioral Therapy of Panic Disorder

ERIC Educational Resources Information Center

Hofmann, Stefan G.; Meuret, Alicia E.; Rosenfield, David; Suvak, Michael K.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

2007-01-01

Cognitive-behavioral therapy (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…

[Cognitive behavioral therapy for tension-type headache: a case report].

PubMed

Salman, İsmail Barış; Sertel Berk, Hanife Özlem

2017-10-01

Tension-type headache has a very high socioeconomic impact, and its lifetime prevalence is reported to be between 30% and 78% in different studies. It is widely acknowledged that noninvasive management with a multidisciplinary approach should be considered for the treatment of tension-type headache. Cognitive behavioral therapy and relaxation exercises are efficient techniques. This article illustrates the application of a cognitive behavioral therapy protocol enhanced with progressive muscle stretching and relaxation exercises in the treatment of chronic tension-type headache via a case report. Our patient had an ongoing headache for 6 years when he was referred to us by the department of psychiatry. After 10 cognitive behavioral therapy sessions, the patient had learned to notice muscle tension and relax the muscles as well as to recognize and express his emotions in a better way. He became aware of automatic thoughts and learned to find alternative thoughts. Headache severity decreased, and he was able to increase participation in daily life activities.

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis

PubMed Central

Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N.; Conte, Marisa L.; Rogers, Mary A. M.

2016-01-01

Background Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. Objectives The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. Data Sources We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Methods Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. Results We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001) with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were

Sleep spindles may predict response to cognitive-behavioral therapy for chronic insomnia.

PubMed

Dang-Vu, Thien Thanh; Hatch, Benjamin; Salimi, Ali; Mograss, Melodee; Boucetta, Soufiane; O'Byrne, Jordan; Brandewinder, Marie; Berthomier, Christian; Gouin, Jean-Philippe

2017-11-01

While cognitive-behavioral therapy for insomnia constitutes the first-line treatment for chronic insomnia, only few reports have investigated how sleep architecture relates to response to this treatment. In this pilot study, we aimed to determine whether pre-treatment sleep spindle density predicts treatment response to cognitive-behavioral therapy for insomnia. Twenty-four participants with chronic primary insomnia participated in a 6-week cognitive-behavioral therapy for insomnia performed in groups of 4-6 participants. Treatment response was assessed using the Pittsburgh Sleep Quality Index and the Insomnia Severity Index measured at pre- and post-treatment, and at 3- and 12-months' follow-up assessments. Secondary outcome measures were extracted from sleep diaries over 7 days and overnight polysomnography, obtained at pre- and post-treatment. Spindle density during stage N2-N3 sleep was extracted from polysomnography at pre-treatment. Hierarchical linear modeling analysis assessed whether sleep spindle density predicted response to cognitive-behavioral therapy. After adjusting for age, sex, and education level, lower spindle density at pre-treatment predicted poorer response over the 12-month follow-up, as reflected by a smaller reduction in Pittsburgh Sleep Quality Index over time. Reduced spindle density also predicted lower improvements in sleep diary sleep efficiency and wake after sleep onset immediately after treatment. There were no significant associations between spindle density and changes in the Insomnia Severity Index or polysomnography variables over time. These preliminary results suggest that inter-individual differences in sleep spindle density in insomnia may represent an endogenous biomarker predicting responsiveness to cognitive-behavioral therapy. Insomnia with altered spindle activity might constitute an insomnia subtype characterized by a neurophysiological vulnerability to sleep disruption associated with impaired responsiveness to

D-Cycloserine Augmentation of Cognitive-Behavioral Therapy: Directions for Pilot Research in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Storch, Eric A.; McKay, Dean; Reid, Jeannette M.; Geller, Daniel A.; Goodman, Wayne K.; Lewin, Adam B.; Murphy, Tanya K.

2010-01-01

This paper discusses a recent translational success in combining behavioral psychotherapy with a novel medication, d-cycloserine (DCS), to augment cognitive-behavioral therapy (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…

One-year follow-up of cognitive behavioral therapy for phobic postural vertigo.

PubMed

Holmberg, Johan; Karlberg, Mikael; Harlacher, Uwe; Magnusson, Måns

2007-09-01

Phobic postural vertigo is characterized by dizziness in standing and walking despite normal clinical balance tests. Patients sometimes exhibit anxiety reactions and avoidance behavior to specific stimuli. Different treatments are possible for PPV, including vestibular rehabilitation exercises, pharmacological treatment, and cognitive behavioral therapy. We recently reported significant benefits of cognitive behavioural therapy for patients with phobic postural vertigo. This study presents the results of a one-year follow-up of these patients. Swedish translations of the following questionnaires were administered: (Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale) were administered to 20 patients (9 men and 11 women; mean age 43 years, range 23-59 years) one year after completion of cognitive behavioral therapy. Test results were similar to those obtained before treatment, showing that no significant treatment effects remained. Cognitive behavioral therapy has a limited long-term effect on phobic postural vertigo. This condition is more difficult to treat than panic disorder with agoraphobia. Vestibular rehabilitation exercises and pharmacological treatment might be the necessary components of treatment.

Psychodynamic Therapists' Reservations About Cognitive-Behavioral Therapy

PubMed Central

PERSONS, JACQUELINE B.; GROSS, JAMES J.; ETKIN, MARK S.; MADAN, SIMONE K.

1996-01-01

This article offers suggestions for psychodynamic therapists who encounter obstacles while learning cognitive-behavioral therapy (CBT) or working in settings where CBT is used. The authors discuss three types of questions commonly raised by psychodynamic therapists about CBT. These concern 1) the therapeutic relationship, 2) the focus of therapeutic interventions, and 3) the depth of change. To help psychodynamic therapists overcome obstacles to learning CBT, the authors focus on similarities between psychodynamic and cognitive-behavioral models in these three areas. They also examine differences between the models, including differences dependent on value judgments, and offer suggestions for making productive use of differences between the models in the training process. PMID:22700289

Quasi-experimental Effectiveness of Cognitive-behavioral Therapy on Reliving Migraine Headaches in Migraine Sufferers.

PubMed

Ebrahimi Moghadam, Hosein; Karimi, Ahoo; Seifi, Kimia

2017-01-01

This study aimed to investigate the effectiveness of cognitive-behavioral therapy on relieving migraine headaches in migraine sufferers. In this quasi-experimental study with pre-test and post-test method, the samples were outpatients of public hospitals in Ilam City, southwestern Iran since May-Jul 2010. They were selected based on inclusion and exclusion criteria, and divided into experimental and control groups. The data were analyzed using SPSS ver. 16 and via multivariate covariance method. Cognitive-behavioral therapy affected on reducing the duration of symptoms of migraine in sufferers ( P <0.05). Cognitive behavioral therapy effects on reducing the time duration of symptoms of migraine headaches. Thistherapeutic method increases the level of individual, familial, social and occupational activities by reducing the time duration of symptoms and this method helps the individuals to resume their activities and regain their previous control instead of founding themselves incapable and helpless due to the pain they suffer from.

Personalized multistep cognitive behavioral therapy for obesity

PubMed Central

Dalle Grave, Riccardo; Sartirana, Massimiliano; El Ghoch, Marwan; Calugi, Simona

2017-01-01

Multistep cognitive behavioral therapy for obesity (CBT-OB) is a treatment that may be delivered at three levels of care (outpatient, day hospital, and residential). In a stepped-care approach, CBT-OB associates the traditional procedures of weight-loss lifestyle modification, ie, physical activity and dietary recommendations, with specific cognitive behavioral strategies that have been indicated by recent research to influence weight loss and maintenance by addressing specific cognitive processes. The treatment program as a whole is delivered in six modules. These are introduced according to the individual patient’s needs in a flexible and personalized fashion. A recent randomized controlled trial has found that 88 patients suffering from morbid obesity treated with multistep residential CBT-OB achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between months 6 and 12. The treatment has also shown promising long-term results in the management of obesity associated with binge-eating disorder. If these encouraging findings are confirmed by the two ongoing outpatient studies (one delivered individually and one in a group setting), this will provide evidence-based support for the potential of multistep CBT-OB to provide a more effective alternative to standard weight-loss lifestyle-modification programs. PMID:28615960

Randomized Clinical Trial of Cognitive Behavioral Therapy (CBT) versus Acceptance and Commitment Therapy (ACT) for Mixed Anxiety Disorders

ERIC Educational Resources Information Center

Arch, Joanna J.; Eifert, Georg H.; Davies, Carolyn; Vilardaga, Jennifer C. Plumb; Rose, Raphael D.; Craske, Michelle G.

2012-01-01

Objective: Randomized comparisons of acceptance-based treatments with traditional cognitive behavioral therapy (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%…

Measuring treatment process in cognitive-behavioral and interactional group therapies for adolescent substance abusers.

PubMed

Kaminer, Y; Blitz, C; Burleson, J A; Kadden, R M; Rounsaville, B J

1998-07-01

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-behavioral therapy (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.

Cognitive-Behavioral Therapy for Bulimia: An Initial Outcome Study.

ERIC Educational Resources Information Center

Ordman, Arnold M.; Kirschenbaum, Daniel S.

1985-01-01

Examined the efficacy of a cognitive-behavioral therapy for bulimia. Assigned 20 bulimic women to full- or brief-intervention therapy programs. Results indicated that full-intervention clients, relative to brief-intervention clients, substantially reduced the frequency of their bingeing-vomiting; improved their psychological adjustment; and…

A Comparison of Pharmacological (Amitriptyline HCL) and Nonpharmacological (Cognitive-Behavioral) Therapies for Chronic Tension Headaches.

ERIC Educational Resources Information Center

Holroyd, Kenneth A.; And Others

1991-01-01

Randomly assigned 41 recurrent tension headache sufferers to either cognitive-behavioral therapy or to amitriptyline therapy. Both therapies yielded clinically significant improvements in headache activity. In instances where differences in treatment effectiveness were observed, cognitive-behavioral therapy yielded somewhat more positive outcomes…

Cognitive behavioral therapy for compulsive buying behavior: Predictors of treatment outcome.

PubMed

Granero, R; Fernández-Aranda, F; Mestre-Bach, G; Steward, T; Baño, M; Agüera, Z; Mallorquí-Bagué, N; Aymamí, N; Gómez-Peña, M; Sancho, M; Sánchez, I; Menchón, J M; Martín-Romera, V; Jiménez-Murcia, S

2017-01-01

Compulsive buying behavior (CBB) is receiving increasing consideration in both consumer and psychiatric-epidemiological research, yet empirical evidence on treatment interventions is scarce and mostly from small homogeneous clinical samples. To estimate the short-term effectiveness of a standardized, individual cognitive behavioral therapy intervention (CBT) in a sample of n=97 treatment-seeking patients diagnosed with CBB, and to identify the most relevant predictors of therapy outcome. The intervention consisted of 12 individual CBT weekly sessions, lasting approximately 45minutes each. Data on patients' personality traits, psychopathology, sociodemographic factors, and compulsive buying behavior were used in our analysis. The risk (cumulative incidence) of poor adherence to the CBT program was 27.8%. The presence of relapses during the CBT program was 47.4% and the dropout rate was 46.4%. Significant predictors of poor therapy adherence were being male, high levels of depression and obsessive-compulsive symptoms, low anxiety levels, high persistence, high harm avoidance and low self-transcendence. Cognitive behavioral models show promise in treating CBB, however future interventions for CBB should be designed via a multidimensional approach in which patients' sex, comorbid symptom levels and the personality-trait profiles play a central role. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The Effect of a New Therapy for Children with Tics Targeting Underlying Cognitive, Behavioral, and Physiological Processes

PubMed Central

Leclerc, Julie B.; O’Connor, Kieron P.; J.-Nolin, Gabrielle; Valois, Philippe; Lavoie, Marc E.

2016-01-01

Tourette disorder (TD) is characterized by motor and vocal tics, and children with TD tend to present a lower quality of life than neurotypical children. This study applied a manualized treatment for childhood tics disorder, Facotik, to a consecutive case series of children aged 8–12 years. The Facotik therapy was adapted from the adult cognitive and psychophysiological program validated on a range of subtypes of tics. This approach aims to modify the cognitive–behavioral and physiological processes against which the tic occurs, rather than only addressing the tic behavior. The Facotik therapy lasted 12–14 weeks. Each week 90-min session contained 20 min of parental training. The therapy for children followed 10 stages including: awareness training; improving motor control; modifying style of planning; cognitive and behavioral restructuring; and relapse prevention. Thirteen children were recruited as consecutive referrals from the general population, and seven cases completed therapy and posttreatment measures. Overall results showed a significant decrease in symptom severity as measured by the YGTSS and the TSGS. However, there was a discrepancy between parent and child rating, with some children perceiving an increase in tics, possibly due to improvement of awareness along therapy. They were also individual changes on adaptive aspects of behavior as measured with the BASC-2, and there was variability among children. All children maintained or improved self-esteem posttreatment. The results confirm the conclusion of a previous pilot study, which contributed to the adaptation of the adult therapy. In summary, the Facotik therapy reduced tics in children. These results underline that addressing processes underlying tics may complement approaches that target tics specifically. PMID:27563292

Effects of a cognitive-behavioral exposure-based body image therapy for overweight females with binge eating disorder: a pilot study.

PubMed

Lewer, Merle; Kosfelder, Joachim; Michalak, Johannes; Schroeder, Dorothea; Nasrawi, Nadia; Vocks, Silja

2017-01-01

Although not part of the diagnostic criteria of the DSM-5, body image disturbance seems to be a relevant feature of Binge Eating Disorder (BED) as well as of other eating disorders such as Anorexia Nervosa (AN) or Bulimia Nervosa (BN). Hence, the aim of the present pilot study was to assess the changeability of body image disturbance in a sample of overweight females with BED by a cognitive-behavioral treatment, directly addressing body image disturbance. Overweight females ( N  = 34) with BED were randomized to a manualized body image therapy or a waiting-list control group. The final sample consisted of n  = 15 participants in the intervention group and n  = 19 in the control group due to two drop-outs in the control condition. Before and after the intervention or the waiting period, respectively, participants filled out a questionnaire battery assessing several body image and eating disorder related features. To quantify the perceptual component of body image disturbance, a digital photo distortion technique based on a picture of each participant taken in a standardized suit was applied. In a two-way ANOVA, significant Time × Group interactions were found for eating and shape concerns, drive for thinness, body dissatisfaction, depressiveness and low self-esteem. Follow-up t -tests indicated a significant symptom reduction of a generally high magnitude in the intervention group. No significant changes concerning body checking and the estimations of one's own "real", "felt" and "ideal" body dimensions were found. The strong symptom reduction in the cognitive-affective component of body image disturbance indicates that an exposure-based cognitive-behavioral body image intervention is a promising treatment module for overweight females with BED, but future research with a larger sample size is needed to quantify possible changes in all components of body image.

Development of an integrated cognitive behavioral therapy for anxiety and opioid use disorder: Study protocol and methods.

PubMed

McHugh, R Kathryn; Votaw, Victoria R; Barlow, David H; Fitzmaurice, Garrett M; Greenfield, Shelly F; Weiss, Roger D

2017-09-01

Opioid use disorder is a highly disabling psychiatric disorder, and is associated with both significant functional disruption and risk for negative health outcomes such as infectious disease and fatal overdose. Even among those who receive evidence-based pharmacotherapy for opioid use disorder, many drop out of treatment or relapse, highlighting the importance of novel treatment strategies for this population. Over 60% of those with opioid use disorder also meet diagnostic criteria for an anxiety disorder; however, efficacious treatments for this common co-occurrence have not be established. This manuscript describes the rationale and methods for a behavioral treatment development study designed to develop and test an integrated cognitive-behavioral therapy for those with co-occurring opioid use disorder and anxiety disorders. The aims of the study are (1) to develop and pilot test a new manualized cognitive behavioral therapy for co-occurring opioid use disorder and anxiety disorders, (2) to test the efficacy of this treatment relative to an active comparison treatment that targets opioid use disorder alone, and (3) to investigate the role of stress reactivity in both prognosis and recovery from opioid use disorder and anxiety disorders. Our overarching aim is to investigate whether this new treatment improves both anxiety and opioid use disorder outcomes relative to standard treatment. Identifying optimal treatment strategies for this population are needed to improve outcomes among those with this highly disabling and life-threatening disorder. Copyright © 2017 Elsevier Inc. All rights reserved.

Individual versus group female-specific cognitive behavior therapy for alcohol use disorder.

PubMed

Epstein, Elizabeth E; McCrady, Barbara S; Hallgren, Kevin A; Gaba, Ayorkor; Cook, Sharon; Jensen, Noelle; Hildebrandt, Thomas; Holzhauer, Cathryn Glanton; Litt, Mark D

2018-05-01

To test group-based Female-Specific Cognitive Behavioral Therapy (G-FS-CBT) for women with Alcohol Use Disorder (AUD) against an individual Female-Specific Cognitive Behavioral Therapy (I-FS-CBT). This aims of this paper are to describe G-FS-CBT development, content, feasibility, acceptability, group process, engagement in treatment, and within- and post-treatment outcomes. Women with AUD (n=155) were randomly assigned to 12 manual-guided sessions of G-FS-CBT or I-FS-CBT; 138 women attended at least one treatment session. Women in G-FS-CBT attended fewer sessions (M=7.6) than women in I-FS-CBT (M=9.7; p<.001). Women in both conditions reported high satisfaction with the treatments. Independent coders rated high fidelity of delivery of both G-FS-CBT and I-FS-CBT. Therapeutic alliance with the therapist was high in both conditions, with I-FS-CBT being slightly but significantly higher than G-FS-CBT. In the first six weeks of treatment, women in both treatment conditions significantly reduced their percent drinking days (PDD) and percent heavy days drinking (PHD) by equivalent amounts, maintained through the rest of treatment and the 12month follow up with no treatment condition effects. Women reported significant improvement in all but one of the secondary outcomes during treatment; gains made during treatment in depression, anxiety, autonomy, and interpersonal problems were maintained during the follow-up period, while gains made during treatment in use of coping skills, self-efficacy for abstinence, self-care, and sociotropy deteriorated over follow up but remained improved compared to baseline. Findings support the feasibility, acceptability, and efficacy of a group format for female-specific CBT for AUD, a new 12-session, single gender, community friendly, group therapy with programming specifically for women. Similar, positive outcomes for individual and group treatment formats were found for drinking, mood, coping skills, self-confidence, interpersonal

The Efficacy of Internet-based Cognitive Behavioral Therapy on the Anxiety Disorders among Adolescent Girls

PubMed Central

Karbasi, Afsaneh; Haratian, Azadeh

2018-01-01

Background: The prevalence of anxiety disorders among children and adolescents are found to be approximately between 8–12 and 5–10, respectively, and the long-lasting effects of such disorders can expose the sufferers to impairment and dysfunction in several areas of life the examples of which are poor educational performance, low self-esteem, and depression. The present study aims to evaluate the efficacy of internet-based, cognitive-behavioral therapy (ICBT) in treating the anxiety disorders among adolescent females. Materials and Methods: The sample included thirty girls aged between 10 and 18 years suffering from a variety of anxiety disorders, under pharmaceutical therapy and referred to clinics of child and adolescent psychiatry specialists in Isfahan. The sample was selected through diagnostic interviews by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision; afterward, they were randomly assigned to either the experimental or the control groups. To evaluate the efficacy of an ICBT in reducing anxiety disorder symptoms, Screen for Child Anxiety Related Emotional Disorders questionnaire was administered among the patients both before and 4 weeks after the treatment. Results: The covariance analysis results aimed to compare the anxiety disorder score variations between the two groups which demonstrate the fact that anxiety disorder scores in these two groups differ from one another (P < 0.001). Conclusions: This study is comprised of two Conclusions.the significant reduction in the mean of anxiety disorders scores in the experimental group compared to those in control group can be indicative of the efficacy of ICBT. In addition the significant reduction in the average of anxiety disorders symptoms’ scores according to the type of anxiety disorders in the experimental group, compared to those in control group, can be indicative of the efficacy of ICBT. PMID:29456984

The Efficacy of Internet-based Cognitive Behavioral Therapy on the Anxiety Disorders among Adolescent Girls.

PubMed

Karbasi, Afsaneh; Haratian, Azadeh

2018-01-01

The prevalence of anxiety disorders among children and adolescents are found to be approximately between 8-12 and 5-10, respectively, and the long-lasting effects of such disorders can expose the sufferers to impairment and dysfunction in several areas of life the examples of which are poor educational performance, low self-esteem, and depression. The present study aims to evaluate the efficacy of internet-based, cognitive-behavioral therapy (ICBT) in treating the anxiety disorders among adolescent females. The sample included thirty girls aged between 10 and 18 years suffering from a variety of anxiety disorders, under pharmaceutical therapy and referred to clinics of child and adolescent psychiatry specialists in Isfahan. The sample was selected through diagnostic interviews by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition, Text Revision; afterward, they were randomly assigned to either the experimental or the control groups. To evaluate the efficacy of an ICBT in reducing anxiety disorder symptoms, Screen for Child Anxiety Related Emotional Disorders questionnaire was administered among the patients both before and 4 weeks after the treatment. The covariance analysis results aimed to compare the anxiety disorder score variations between the two groups which demonstrate the fact that anxiety disorder scores in these two groups differ from one another ( P < 0.001). This study is comprised of two Conclusions.the significant reduction in the mean of anxiety disorders scores in the experimental group compared to those in control group can be indicative of the efficacy of ICBT. In addition the significant reduction in the average of anxiety disorders symptoms' scores according to the type of anxiety disorders in the experimental group, compared to those in control group, can be indicative of the efficacy of ICBT.

The relation between mindfulness and fear of negative evaluation over the course of cognitive behavioral therapy for social anxiety disorder.

PubMed

Burton, Mark; Schmertz, Stefan K; Price, Matthew; Masuda, Akihiko; Anderson, Page L

2013-03-01

This study examined the relation between mindfulness and fear of negative evaluation over the course of nonmindfulness based cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD). We expected that higher levels of mindfulness would be associated with a more positive response to treatment. This study is a secondary report from a randomized controlled trial in which participants (N = 65) diagnosed with SAD were randomly assigned to receive 8 weeks of 1 of 2 manualized treatments (exposure group therapy, n = 33; or virtual reality exposure therapy, n = 32) either immediately or following an 8 week waiting period. Fear of negative evaluation decreased following treatment and was negatively related to mindfulness throughout treatment and follow-up. Mindfulness did not moderate treatment outcome. These findings indicate that while mindfulness is related to fear, it is not a moderator of symptom reduction in nonmindfulness-based treatment. Implications for treatment and future research are discussed. 2012 Wiley Periodicals, Inc

Cognitive-behavioral therapy for clinical pain control: a 15-year update and its relationship to hypnosis.

PubMed

Tan, S Y; Leucht, C A

1997-10-01

Since Tan's (1982) review of cognitive and cognitive-behavioral methods for pain control was published 15 years ago, significant advances have been made in cognitive-behavioral therapy for pain. The scientific evidence for its efficacy for clinical pain attenuation is now much more substantial and is briefly reviewed. In particular, cognitive-behavioral therapy for chronic pain was recently listed as one of 25 empirically validated or supported psychological treatments available for various disorders. A number of emerging issues are further discussed in light of recent developments and research findings. The relationship of cognitive-behavioral therapy to hypnosis for pain control is briefly addressed, with suggestions for integrating hypnotic and cognitive-behavioral techniques.

Termination in cognitive-behavioral therapy with children, adolescents, and parents.

PubMed

Vidair, Hilary B; Feyijinmi, Grace O; Feindler, Eva L

2017-03-01

The process of terminating cognitive-behavioral therapy (CBT) with families has been largely neglected in the literature, with the limited research focused on premature termination. This article describes the natural termination process in CBT with children, adolescents, and their parents. Based on existing theories, we describe a cognitive-behavioral model for: (a) initiating and engaging in discussion of termination, (b) processing the termination of treatment and the therapeutic relationship, (c) key aspects of the termination process in the final session, and (d) the very end of the final session (saying goodbye). For each of the 4 components, we review relevant theories, provide clinical exchanges to demonstrate techniques, and provide related research support. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Cognitive Behavioral Therapies in older adults with depression and cognitive deficits: a systematic review.

PubMed

Simon, Sharon Sanz; Cordás, Táki Athanássios; Bottino, Cássio M C

2015-03-01

The objective of this study is to investigate the effectiveness of cognitive behavioral therapies (CBTs) in improving depressive symptoms, disability, and cognition in older adults with depression and cognitive deficits. It was performed a systematic search for articles published between 1994 and February 2014 in the MEDLINE/Pubmed, PsycINFO, and SCIELO. The studies should have provided information about benefits after CBTs to older adults with depression and cognitive deficits. Cognitive behavioral therapy focused on problem solving is the main approach studied, having better effectiveness than supportive therapy in randomized clinical trials. Significant improvements in mood and disability were consistent, although evidence of changes in cognitive measures is controversial, less studied, and limited. Nevertheless, improvements in executive functions, processing speed, and changes in patients' perspectives of problem solving skills, such as generating alternatives and decision-making, were described. Also, it would be necessary that future studies more often evaluate cognitive status of depressed elders, as well as cognitive changes after psychotherapy. It should be emphasized that there is a lack of studies in this field, and more approaches in CBTs need to be investigated to this population. Older adults with depression and cognitive deficits can benefit from CBTs. Improvements in mood and disability are more consistent than changes in cognition, which are little studied after CBTs. It is necessary more studies in the field, as well as, to investigate more approaches in CBTs to older adults with depression and cognitive deficits. Copyright © 2014 John Wiley & Sons, Ltd.

Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial.

PubMed

Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D'Angelo, Valerio; Urso, Viviana

2015-01-01

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization.

Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial

PubMed Central

Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D’Angelo, Valerio; Urso, Viviana

2015-01-01

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization. PMID:26504391

Cognitive Behavioral Therapy for Anxiety Disorders in Youth

PubMed Central

Seligman, Laura D.; Ollendick, Thomas H.

2011-01-01

Synopsis Cognitive behavioral therapies (CBTs) have been shown to be efficacious for the treatment of anxiety disorders in children and adolescents. Randomized clinical trials indicate that approximately two-thirds of children treated with CBT will be free of their primary diagnosis at posttreatment. Although several CBT treatment packages have been investigated in youth with diverse anxiety disorders, common core components have been identified. A comprehensive assessment, development of a good therapeutic relationship and working alliance, cognitive restructuring, repeated exposure with reduction of avoidance behavior, and skills training comprise the core procedures for the treatment of anxiety disorders in youth. PMID:21440852

Tailoring Cognitive Behavioral Treatment for Binge Eating in Adolescent Girls

ERIC Educational Resources Information Center

Yarborough, Bobbi Jo; DeBar, Lynn L.; Firemark, Alison; Leung, Sue; Clarke, Gregory N.; Wilson, G. Terence

2013-01-01

Whereas effective treatments exist for adults with recurrent binge eating, developmental factors specific to adolescents point to the need for a modified treatment approach for youth. We adapted an existing cognitive behavioral therapy treatment manual for adults with bulimia nervosa and binge eating disorder (Fairburn, 2008) for use with…

Cognitive-Behavioral Body Image Therapy for Body Dysmorphic Disorder.

ERIC Educational Resources Information Center

Rosen, James C.; And Others

1995-01-01

Randomly assigned 54 body dysmorphic disorder (BDD) subjects to cognitive behavior therapy or no treatment. BDD symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82 percent of cases at posttreatment and 77 percent at follow-up. Subjects' overall psychological symptoms and self-esteem also improved. (RJM)

Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.

PubMed

Montesano, Vicki L; Sivec, Harry J; Munetz, Mark R; Pelton, Jeremy R; Turkington, Douglas

2014-03-01

The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

Mindfulness-based cognitive therapy for generalized anxiety disorder.

PubMed

Evans, Susan; Ferrando, Stephen; Findler, Marianne; Stowell, Charles; Smart, Colette; Haglin, Dean

2008-05-01

While cognitive behavior therapy has been found to be effective in the treatment of generalized anxiety disorder (GAD), a significant percentage of patients struggle with residual symptoms. There is some conceptual basis for suggesting that cultivation of mindfulness may be helpful for people with GAD. Mindfulness-based cognitive therapy (MBCT) is a group treatment derived from mindfulness-based stress reduction (MBSR) developed by Jon Kabat-Zinn and colleagues. MBSR uses training in mindfulness meditation as the core of the program. MBCT incorporates cognitive strategies and has been found effective in reducing relapse in patients with major depression (Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V., Soulsby, J., & Lau, M. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 6, 615-623). Eligible subjects recruited to a major academic medical center participated in the group MBCT course and completed measures of anxiety, worry, depressive symptoms, mood states and mindful awareness in everyday life at baseline and end of treatment. Eleven subjects (six female and five male) with a mean age of 49 (range=36-72) met criteria and completed the study. There were significant reductions in anxiety and depressive symptoms from baseline to end of treatment. MBCT may be an acceptable and potentially effective treatment for reducing anxiety and mood symptoms and increasing awareness of everyday experiences in patients with GAD. Future directions include development of a randomized clinical trial of MBCT for GAD.

Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior.

PubMed

Williams, J Mark G; Duggan, Danielle S; Crane, Catherine; Fennell, Melanie J V

2006-02-01

Once suicidal thoughts have emerged as a feature of depression they are likely to be reactivated as part of a suicidal mode of mind whenever sad mood reappears. This article reviews the methods and the usefulness of mindfulness-based cognitive therapy (MBCT) as a treatment for the prevention of the reactivation of the suicidal mode. MBCT integrates mindfulness meditation practices and cognitive therapy techniques. It teaches participants to develop moment-by-moment awareness, approaching ongoing experience with an attitude of nonjudgment and acceptance. Participants are increasingly able to see their thoughts as mental events rather than facts (metacognitive awareness). A case example illustrates how mindfulness skills develop with MBCT and how they relate to the cognitive processes that fuel suicidal crises. An ongoing controlled trial will provide further evidence, but pilot work suggests that MBCT is a promising intervention for those who have experienced suicidal ideation in the past. (c) 2005 Wiley Periodicals, Inc.

Sudden gains in exposure-focused cognitive-behavioral group therapy for panic disorder.

PubMed

Nogueira-Arjona, Raquel; Santacana, Martí; Montoro, María; Rosado, Silvia; Guillamat, Roser; Vallès, Vicenç; Fullana, Miquel A

2017-11-01

In the context of psychological treatment, a sudden gain is a large and enduring improvement in symptom severity that occurs between two single therapy sessions. The influence of sudden gains on long-term outcomes and functional impairment in anxiety disorders is not well understood, and little is known with regard to panic disorder in particular. In addition, previous research on patients with anxiety disorders has produced inconsistent results regarding the relationship between sudden gains and cognitive change. We examined the incidence of sudden gains in a large sample (n = 116) of panic disorder patients undergoing exposure-focused cognitive-behavioral group therapy, and compared panic severity, functional impairment, and cognitive change in patients with and without sudden gains at posttreatment and 6-month follow-up. Participants who experienced sudden gains displayed lower levels of panic severity and functional impairment at posttreatment and 6-month follow-up than those who did not experience sudden gains. However, we observed no difference in cognitive changes between groups, either at posttreatment or at follow-up. Our results demonstrate that the beneficial effects of sudden gains on therapeutic outcomes not only extend to long-term and functional outcome measures but are also evident in less cognitive (i.e., exposure-focused) forms of psychological treatment. Sudden gains are common in panic disorder patients undergoing exposure-based cognitive-behavioral group therapy. Sudden gains during exposure-focused therapy are linked to greater improvement in panic disorder severity and functional impairment. The positive impact of sudden gains on panic disorder severity and functional impairment is maintained in the long term. Copyright © 2017 John Wiley & Sons, Ltd.

The efficacy of Motivational Intervention and Cognitive-Behavioral Therapy for Pathological Gambling.

PubMed

Garcia-Caballero, Anna; Torrens-Lluch, Marina; Ramírez-Gendrau, Isabel; Garrido, Gemma; Vallès, Vicenç; Aragay, Núria

2018-01-15

The aim of the current study is to determine the effectiveness of an individual psychological intervention based on the motivational interview and cognitive-behavioral therapy for the treatment of pathological gambling. A sample of 18 participants, diagnosed of pathological gambling and without any other associated comorbidity, were assessed, attended at the publicly-funded Gambling and Behavioral Addictions Unit (Consorci Sanitari de Terrassa). Median age was 46 years (SD = 12). All the patients achieved abstinence and completed follow-up. The Screen for Gambling Problems (NODS), Quality of Life Enjoyment and Satisfaction (Q-LES-Q), Impulsive Behavior Scale (UPPS-P), Sheehan Disability Inventory (SDI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were administered pre- and posttreatment. Results showed that patients significantly reduced the problems related to gambling behavior according to the NODS score (p < .000). Regarding impulsive behavior (UPPS-P), we found significant differences in negative urgency (p < .001), positive urgency (p < .001), (lack of) premeditation (p < .029) and (lack of) perseverance (p < .048). Some relevant aspects of quality of life as assessed by the Q-LES-Q had improved. In conclusion, the study shows that psychological intervention based on the motivational interview and cognitive-behavioral therapy not only significantly reduces gambling-related behavior problems but also leads to improvements in impulsivity and quality of life. .

An adaptive randomized trial of dialectical behavior therapy and cognitive behavior therapy for binge-eating.

PubMed

Chen, E Y; Cacioppo, J; Fettich, K; Gallop, R; McCloskey, M S; Olino, T; Zeffiro, T A

2017-03-01

Early weak treatment response is one of the few trans-diagnostic, treatment-agnostic predictors of poor outcome following a full treatment course. We sought to improve the outcome of clients with weak initial response to guided self-help cognitive behavior therapy (GSH). One hundred and nine women with binge-eating disorder (BED) or bulimia nervosa (BN) (DSM-IV-TR) received 4 weeks of GSH. Based on their response, they were grouped into: (1) early strong responders who continued GSH (cGSH), and early weak responders randomized to (2) dialectical behavior therapy (DBT), or (3) individual and additional group cognitive behavior therapy (CBT+). Baseline objective binge-eating-day (OBD) frequency was similar between DBT, CBT+ and cGSH. During treatment, OBD frequency reduction was significantly slower in DBT and CBT+ relative to cGSH. Relative to cGSH, OBD frequency was significantly greater at the end of DBT (d = 0.27) and CBT+ (d = 0.31) although these effects were small and within-treatment effects from baseline were large (d = 1.41, 0.95, 1.11, respectively). OBD improvements significantly diminished in all groups during 12 months follow-up but were significantly better sustained in DBT relative to cGSH (d = -0.43). At 6- and 12-month follow-up assessments, DBT, CBT and cGSH did not differ in OBD. Early weak response to GSH may be overcome by additional intensive treatment. Evidence was insufficient to support superiority of either DBT or CBT+ for early weak responders relative to early strong responders in cGSH; both were helpful. Future studies using adaptive designs are needed to assess the use of early response to efficiently deliver care to large heterogeneous client groups.

Cognitive Changes, Critical Sessions, and Sudden Gains in Cognitive-Behavioral Therapy for Depression

ERIC Educational Resources Information Center

Tang, Tony Z.; DeRubeis, Robert J.; Beberman, Rachel; Pham, Thu

2005-01-01

Using an independent cognitive-behavioral therapy (CBT) data set, the authors replicated T. Z. Tang and R. J. DeRubeis' (1999) discovery of sudden gains--sudden and large decreases in depression severity in a single between-session interval. By incorporating therapy session transcripts, the authors of this study improved the reliability of the…

Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects.

PubMed

Boersma, Katja; Ljótsson, Brjánn; Edebol-Carlman, Hanna; Schrooten, Martien; Linton, Steven J; Brummer, Robert J

2016-11-01

Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.

Comparison of the Effects of Religious Cognitive Behavioral Therapy (RCBT), Cognitive Behavioral Therapy (CBT), and Sertraline on Depression and Anxiety in Patients after Coronary Artery Bypass Graft Surgery: Study Protocol for a Randomized Controlled Trial.

PubMed

Hosseini, Seyed Hamzeh; Rafiei, Alireza; Gaemian, Ali; Tirgari, Abdolhakim; Zakavi, Aliasghar; Yazdani, Jamshid; Bolhari, Jafar; Golzari, Mahmood; Esmaeili Douki, Zahra; Vaezzadeh, Nazanin

2017-07-01

Objective: The present study aimed at comparing the effects of Religious Cognitive Behavioral Therapy (RCBT), Cognitive Behavioral Therapy (CBT), and sertraline on depression, anxiety, biomarker levels, and quality of life in patients after coronary artery bypass graft (CABG) surgery. Method: This was a randomized controlled trial with parallel groups. A total of 160 patients after CABG surgery will be screened for anxiety and depression according to clinical interviews based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and Hospital Anxiety Depression Scale (HADS) scores (≥ 8). To assess religious attitude, Golriz and Baraheni's Religious Attitude questionnaire will be used. Participants will be randomly allocated to 4 groups of 40 including 3 intervention groups (RCBT, CBT, and sertraline) and 1 control group (usual care). RCBT and CBT programs will consist of 12 one-hour weekly sessions. The participants in the pharmacological intervention group will receive 25-200 mg/d of sertraline for 3 months. The Short Form-36 Health Survey (SF-36) will be administered to assess the patients' quality of life. Blood samples will be taken and biomarker levels will be determined using the enzyme-linked immunosorbent assay (ELISA). The primary outcome will be reduction in anxiety and depression scores after the interventions. The secondary outcomes will be increase in quality of life scores and normalized biomarker levels after the interventions. Discussion: If RCBT is found to be more effective than the other methods; it can be used to improve patients' health status after CABG surgery. Irct ID: IRCT201404122898N5.

Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

ERIC Educational Resources Information Center

Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

2010-01-01

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 behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

[Mindfulness-Based Cognitive Therapy (MBCT) and the 'Third Wave' of Cognitive-Bahavioral Therapies (CBT)].

PubMed

Garay, Cristian J; Korman, Guido P; Keegan, Eduardo G

2015-01-01

The paper presents the reasons that led to the incorporation of mindfulness as part of a cognitive therapy approach to the prevention of relapse of recurrent depressive disorders. It describes the context in which models focused on the contents of cognition gave way to models focused on cognitive processes. We highlight the problems encountered by the standard cognitive model when trying to account for the cognitive vulnerability of individuals who, having experienced a depressive episode, are in remission. We briefly describe the theoretical foundations of Mindfulness-Based Cognitive Therapy and its therapeutic approach.

A 5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder.

PubMed

Hedman, Erik; Furmark, Tomas; Carlbring, Per; Ljótsson, Brjánn; Rück, Christian; Lindefors, Nils; Andersson, Gerhard

2011-06-15

Internet-based cognitive behavior therapy (CBT) has been shown to be a promising method to disseminate cognitive behavior therapy for social anxiety disorder (SAD). Several trials have demonstrated that Internet-based CBT can be effective for SAD in the shorter term. However, the long-term effects of Internet-based CBT for SAD are less well known. Our objective was to investigate the effect of Internet-based CBT for SAD 5 years after completed treatment. We conducted a 5-year follow-up study of 80 persons with SAD who had undergone Internet-based CBT. The assessment comprised a diagnostic interview and self-report questionnaires. The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates were low: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires. Mixed-effect models analysis showed a significant effect of time on the three social anxiety measures, LSAS-SR, SIAS, and SPS (F(3,98-102) = 16.05 - 29.20, P < .001) indicating improvement. From baseline to 5-year follow-up, participants' mean scores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI] 66.1-76.5) to 40.3 (95% CI 35.2 - 45.3). The effect sizes of the LSAS-SR were large (Cohen's d range 1.30 - 1.40, 95% CI 0.77 - 1.90). Improvements gained at the 1-year follow-up were sustained 5 years after completed treatment. Internet-based CBT for SAD is a treatment that can result in large and enduring effects. Clinicaltrials.gov NCT01145690; http://clinicaltrials.gov/ct2/show/NCT01145690 (Archived by WebCite at http://www.webcitation.org/5ygRxDLfK).

Cognitive Behavioral Therapy for Children with Dental Anxiety: A Randomized Controlled Trial.

PubMed

Shahnavaz, S; Hedman, E; Grindefjord, M; Reuterskiöld, L; Dahllöf, G

2016-10-01

Dental anxiety affects approximately 9% of children and is associated with poor oral health, pain, and psychosocial problems. The objective of this study was to investigate the efficacy of cognitive behavioral therapy (CBT) for children with dental anxiety in specialist pediatric dentistry. The study used a parallel-group superiority randomized controlled trial design. The primary outcome measure was the behavioral avoidance test; assessors were blind to treatment allocation. Participants were 8 boys and 22 girls 7 to 18 y old (mean ± SD, 10 ± 3.1). Children fulfilling the diagnostic criteria for dental anxiety were randomized to CBT (n = 13) or treatment as usual (n = 17), such as various sedation methods. Psychologists provided 10 h of CBT based on a treatment manual. Treatments were conducted in a naturalistic real-world clinical setting. Assessments were conducted before the treatment, 3 mo after the start of treatment, and at 1-y follow-up. The analyses of the primary outcome measure by repeated-measures analysis of variance and independent t test showed that children receiving CBT made superior, statistically significant improvements at follow-up (16.8 ± 2.4) compared with treatment as usual (11.4 ± 3.1, P < 0.01). A large between-group effect size (Cohen's d = 1.9) was found. Following treatment, 73% of those in the CBT group managed all stages of the dental procedures included in the behavioral avoidance test compared with 13% in the treatment-as-usual group. Furthermore, 91% in the CBT group compared with 25% in the treatment-as-usual group no longer met the diagnostic criteria for dental anxiety at the 1-y follow-up according to the secondary outcome measure. Measures of dental anxiety and self-efficacy showed larger improvements in the CBT group compared with controls. We conclude that CBT is an efficacious treatment for children and adolescents with dental anxiety and should be made accessible in pediatric dentistry (ClinicalTrials.gov: NCT01798355

What Did They Learn? Effects of a Brief Cognitive Behavioral Therapy Workshop on Community Therapists' Knowledge.

PubMed

Scott, Kelli; Klech, David; Lewis, Cara C; Simons, Anne D

2016-11-01

Knowledge gain has been identified as necessary but not sufficient for therapist behavior change. Declarative knowledge, or factual knowledge, is thought to serve as a prerequisite for procedural knowledge, the how to knowledge system, and reflective knowledge, the skill refinement system. The study aimed to examine how a 1-day workshop affected therapist cognitive behavioral therapy declarative knowledge. Participating community therapists completed a test before and after training that assessed cognitive behavioral therapy knowledge. Results suggest that the workshop significantly increased declarative knowledge. However, post-training total scores remained moderately low, with several questions answered incorrectly despite content coverage in the workshop. These findings may have important implications for structuring effective cognitive behavioral therapy training efforts and for the successful implementation of cognitive behavioral therapy in community settings.

In-session caregiver behavior predicts symptom change in youth receiving trauma-focused cognitive behavioral therapy (TF-CBT).

PubMed

Yasinski, Carly; Hayes, Adele M; Ready, C Beth; Cummings, Jorden A; Berman, Ilana S; McCauley, Thomas; Webb, Charles; Deblinger, Esther

2016-12-01

Involving caregivers in trauma-focused treatments for youth has been shown to result in better outcomes, but it is not clear which in-session caregiver behaviors enhance or inhibit this effect. The current study examined the associations between caregiver behaviors during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and youth cognitive processes and symptoms. Participants were a racially diverse sample of Medicaid-eligible youth (ages 7-17) and their nonoffending caregivers (N = 71 pairs) who received TF-CBT through an effectiveness study in a community setting. Caregiver and youth processes were coded from audio-recorded sessions, and outcomes were measured using the Child Behavior Checklist (CBCL) and UCLA PTSD Reaction Index for Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV; UPID) at 3, 6, 9, and 12 months postintake. Piecewise linear growth curve modeling revealed that during the trauma narrative phase of TF-CBT, caregivers' cognitive-emotional processing of their own and their child's trauma-related reactions predicted decreases in youth internalizing and externalizing symptoms over treatment. Caregiver support predicted lower internalizing symptoms over follow-up. In contrast, caregiver avoidance and blame of the child predicted worsening of youth internalizing and externalizing symptoms over follow-up. Caregiver avoidance early in treatment also predicted worsening of externalizing symptoms over follow-up. During the narrative phase, caregiver blame and avoidance were correlated with more child overgeneralization of trauma beliefs, and blame was also associated with less child accommodation of balanced beliefs. The association between in-session caregiver behaviors and youth symptomatology during and after TF-CBT highlights the importance of assessing and targeting these behaviors to improve clinical outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Two-Day, Intensive Cognitive-Behavioral Therapy for Panic Disorder: A Case Study

ERIC Educational Resources Information Center

Deacon, Brett

2007-01-01

Cognitive-behavioral therapy (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…

Acceptance-based behavior therapy to promote HIV medication adherence.

PubMed

Moitra, Ethan; Herbert, James D; Forman, Evan M

2011-12-01

A significant number of adults with HIV in the USA do not maintain adherence to highly active antiretroviral therapy (HAART) at adequate levels. Although traditional cognitive behavioral interventions have shown promise in promoting HAART adherence, acceptance-based behavior therapy (ABBT) may be particularly useful in this population. ABBT has the potential to overcome common avoidance-based barriers associated with poor adherence, including denial of various illness-related factors and avoidance of stigmatization. We describe the rationale for promoting psychological and behavioral acceptance in HIV-positive populations; outline an ABBT to promote HAART adherence targeting primary care patients from urban, minority, low socioeconomic backgrounds; and report preliminary qualitative observations of treatment feasibility and acceptability.

Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions: A Meta-analysis.

PubMed

Wu, Jade Q; Appleman, Erica R; Salazar, Robert D; Ong, Jason C

2015-09-01

Cognitive behavioral therapy for insomnia (CBT-I) is the most prominent nonpharmacologic treatment for insomnia disorders. Although meta-analyses have examined primary insomnia, less is known about the comparative efficacy of CBT-I on comorbid insomnia. To examine the efficacy of CBT-I for insomnia comorbid with psychiatric and/or medical conditions for (1) remission from insomnia; (2) self-reported sleep efficiency, sleep onset latency, wake after sleep onset, total sleep time, and subjective sleep quality; and (3) comorbid symptoms. A systematic search was conducted on June 2, 2014, through PubMed, PsycINFO, the Cochrane Library, and manual searches. Search terms included (1) CBT-I or CBT or cognitive behavioral [and its variations] or behavioral therapy [and its variations] or behavioral sleep medicine or stimulus control or sleep restriction or relaxation therapy or relaxation training or progressive muscle relaxation or paradoxical intention; and (2) insomnia or sleep disturbance. Studies were included if they were randomized clinical trials with at least one CBT-I arm and had an adult population meeting diagnostic criteria for insomnia as well as a concomitant condition. Inclusion in final analyses (37 studies) was based on consensus between 3 authors' independent screenings. Data were independently extracted by 2 authors and pooled using a random-effects model. Study quality was independently evaluated by 2 authors using the Cochrane risk of bias assessment tool. A priori main outcomes (ie, clinical sleep and comorbid outcomes) were derived from sleep diary and other self-report measures. At posttreatment evaluation, 36.0% of patients who received CBT-I were in remission from insomnia compared with 16.9% of those in control or comparison conditions (pooled odds ratio, 3.28; 95% CI, 2.30-4.68; P < .001). Pretreatment and posttreatment controlled effect sizes were medium to large for most sleep parameters (sleep efficiency: Hedges g = 0.91 [95% CI, 0

Open Trial of Modular Cognitive-Behavioral Therapy in the Treatment of Anxiety Among Late Adolescents with Autism Spectrum Disorder.

PubMed

Wise, Jillian M; Cepeda, Sandra L; Ordaz, D Luis; McBride, Nicole M; Cavitt, Mark A; Howie, Flora R; Scalli, Leanne; Ehrenreich-May, Jill; Wood, Jeffrey J; Lewin, Adam B; Storch, Eric A

2018-05-31

Given the high rates of comorbid anxiety and autism spectrum disorder (ASD) in the adolescent and young adult population, effective treatment protocols to address anxiety symptoms are of importance to help promote greater independence across settings. While research supports the use of cognitive-behavioral therapy (CBT) across younger age groups with ASD, the literature is limited on interventions benefitting adolescents and young adults with comorbid anxiety disorders and ASD. Therefore, this open trial utilized a modified CBT manual for seven participants between the ages of 16 and 20 years, consisting of a 16-week modularized CBT treatment, including psychoeducation, cognitive therapy, and exposure therapy. Measures of anxiety and depression were completed at baseline and post-treatment. Findings demonstrated significant reductions on clinician-rated measures of anxiety. While findings are encouraging, additional studies examining the efficacy of CBT for this population with ASD and clinical anxiety are necessary to further identify beneficial treatment components.

Cognitive-Behavioral Therapy for Rapid Cycling Bipolar Disorder

ERIC Educational Resources Information Center

Reilly-Harrington, Noreen A.; Knauz, Robert O.

2005-01-01

This article describes the application of cognitive-behavioral therapy (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…

Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder.

PubMed

Price, Matthew; Anderson, Page L

2012-06-01

Outcome expectancy, the extent that clients anticipate benefiting from therapy, is theorized to be an important predictor of treatment response for cognitive-behavioral therapy. However, there is a relatively small body of empirical research on outcome expectancy and the treatment of social anxiety disorder. This literature, which has examined the association mostly in group-based interventions, has yielded mixed findings. The current study sought to further evaluate the effect of outcome expectancy as a predictor of treatment response for public-speaking fears across both individual virtual reality and group-based cognitive-behavioral therapies. The findings supported outcome expectancy as a predictor of the rate of change in public-speaking anxiety during both individual virtual reality exposure therapy and group cognitive-behavioral therapy. Furthermore, there was no evidence to suggest that the impact of outcome expectancy differed across virtual reality or group treatments. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Child- And Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: Development and Preliminary Results.

ERIC Educational Resources Information Center

Pavuluri, Mani N.; Graczyk, Patricia A.; Henry, David B.; Carbray, Julie A.; Heidenreich, Jodi; Miklowitz, David J.

2004-01-01

Objective: To describe child- and family-focused cognitive-behavioral therapy (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)…

Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study

PubMed Central

Tang, Tan; Yang, Xuemei; Zhang, Weijun; Wang, Xiaohua; Ji, Li; Xiao, Yun; Ma, Kun; Wang, Ying; Kong, Xianglei; Wang, Jianping; Liu, Jun; Xu, Qian; Tian, Donghua; Qu, Zhiyong

2015-01-01

Background The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. Methods We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. Results The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. Conclusions The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed. PMID:26371473

Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study.

PubMed

Tang, Xinfeng; Yang, Fahui; Tang, Tan; Yang, Xuemei; Zhang, Weijun; Wang, Xiaohua; Ji, Li; Xiao, Yun; Ma, Kun; Wang, Ying; Kong, Xianglei; Wang, Jianping; Liu, Jun; Xu, Qian; Tian, Donghua; Qu, Zhiyong

2015-01-01

The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders' access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed.

New Developments in Cognitive-Behavioral Therapy for Social Anxiety Disorder.

PubMed

Stangier, Ulrich

2016-03-01

Social anxiety disorder (SAD) is a highly prevalent and chronic disorder that causes considerable psychosocial impairment. This article reviews recent changes in the definition of SAD in DSM-5 and summarizes the current evidence for effective cognitive-behavioral treatments in adults, children, and adolescents. Current data suggests that cognitive-behavioral therapy (CBT) is efficacious in the treatment of this condition. Among different CBT approaches, individual cognitive therapy may be associated with the largest effect sizes. In this review, interventions targeting dysfunctional cognitive processes that contribute to the effective treatment of SAD are discussed. Some recent findings from neuroimaging research and studies on the augmentation of CBT using neuroenhancers indicate that changes in emotion regulation as well as fear extinction are important psychological mediators of positive outcome. Furthermore, internet-delivered CBT is a promising field of technological innovation that may improve access to effective treatments. Despite the availability of effective treatments, treatment-resistant SAD remains a common problem in clinical practice that requires more research efforts. Finally, potential areas for further development of CBT as well as its dissemination in health care are summarized.

Application of Alternatives for Families: A Cognitive-Behavioral Therapy to School Settings

ERIC Educational Resources Information Center

Herschell, Amy D.; Kolko, David J.; Baumann, Barbara L.; Brown, Elissa J.

2012-01-01

Alternatives for Families: A Cognitive-Behavioral Therapy (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…

Trial Protocol: Cognitive functional therapy compared with combined manual therapy and motor control exercise for people with non-specific chronic low back pain: protocol for a randomised, controlled trial.

PubMed

Belache, Fabiana Terra Cunha; Souza, Cíntia Pereira de; Fernandez, Jessica; Castro, Julia; Ferreira, Paula Dos Santos; Rosa, Elizana Rodrigues de Sousa; Araújo, Nathalia Cristina Gimenez de; Reis, Felipe José Jandre; Almeida, Renato Santos de; Nogueira, Leandro Alberto Calazans; Correia, Luís Cláudio Lemos; Meziat-Filho, Ney

2018-06-11

Chronic low back pain is a public health problem, and there is strong evidence that it is associated with a complex interaction of biopsychosocial factors. Cognitive functional therapy is an intervention that deals with potentially modifiable multidimensional aspects of pain (eg, provocative cognitive, movement and lifestyle behaviours). There is evidence (from a single randomised, controlled trial) that cognitive functional therapy is better than combined manual therapy and motor control exercise. However, this study had significant methodological shortcomings including the failure to carry out an intention-to-treat analysis and a considerable loss of follow-up of participants. It is important to replicate this study in another domain through a randomised clinical trial with similar objectives but correcting these methodological shortcomings. To investigate the efficacy of cognitive functional therapy compared to combined manual therapy and exercise on pain and disability at 3 months in patients with chronic non-specific low back pain. Two-group, randomised, multicentre controlled trial with blinded assessors. One hundred and forty-eight participants with chronic low back pain that has persisted for >3months and no specific spinal pathology will be recruited from the school clinic of the Centro Universitário Augusto Motta and a private clinic in the city of Rio de Janeiro, Brazil. Four to 10 sessions of cognitive functional therapy. The physiotherapists who will treat the participants in the cognitive functional therapy group have previously attended 2 workshops with two different tutors of the method. Such physiotherapists have completed 106 hours of training, including workshops and patient examinations, as well as conducting a pilot study under the supervision of another physiotherapist with>3 years of clinical experience in cognitive functional therapy. Four to 10 sessions of combined manual therapy and motor control exercises. Participants in the combined

Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation

PubMed Central

Thiart, Hanne; Ebert, David Daniel; Lehr, Dirk; Nobis, Stephanie; Buntrock, Claudia; Berking, Matthias; Smit, Filip; Riper, Heleen

2016-01-01

Study Objectives: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective. Methods: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a cost-effectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping. Results: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: −593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: −296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism. Conclusions: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care. Clinical Trials Registration: Title: Online Recovery Training for Better Sleep in Teachers with High Psychological Strain. German Clinical Trial Register (DRKS), URL: https

Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions.

PubMed

Fischer, Melanie S; Baucom, Donald H; Cohen, Matthew J

2016-09-01

Cognitive-behavioral couple therapy (CBCT) is an approach to assisting couples that has strong empirical support for alleviating relationship distress. This paper provides a review of the empirical status of CBCT along with behavioral couple therapy (BCT), as well as the evidence for recent applications of CBCT principles to couple-based interventions for individual psychopathology and medical conditions. Several meta-analyses and major reviews have confirmed the efficacy of BCT and CBCT across trials in the United States, Europe, and Australia, and there is little evidence to support differential effectiveness of various forms of couple therapy derived from behavioral principles. A much smaller number of effectiveness studies have shown that successful implementation in community settings is possible, although effect sizes tend to be somewhat lower than those evidenced in randomized controlled trials. Adapted for individual problems, cognitive-behavioral couple-based interventions appear to be at least as effective as individual cognitive behavioral therapy (CBT) across a variety of psychological disorders, and often more effective, especially when partners are substantially involved in treatment. In addition, couple-based interventions tend to have the unique added benefit of improving relationship functioning. Findings on couple-based interventions for medical conditions are more varied and more complex to interpret given the greater range of target outcomes (psychological, relational, and medical variables). © 2016 Family Process Institute.

Gender Differences in the Maintenance of Response to Cognitive Behavior Therapy for Posttraumatic Stress Disorder

ERIC Educational Resources Information Center

Felmingham, Kim L.; Bryant, Richard A.

2012-01-01

Objective: To examine potential differential responses in men and women to cognitive behavior therapy for posttraumatic stress disorder (PTSD). Method: Fifty-two men and 56 women diagnosed with PTSD participated in randomized controlled trials of cognitive behavior therapy for PTSD. Participants were randomly allocated to either (a) exposure-only…

Inpatient Applications of Cognitive-Behavioral Therapy

PubMed Central

STUART, SCOTT; THASE, MICHAEL E.

1994-01-01

The authors review empirical research of the past decade on cognitive-behavioral therapy (CBT) in the treatment of depressed inpatients and offer suggestions for future investigations. CBT appears to offer additive benefits in combination with pharmacotherapy, particularly after the transition from inpatient to outpatient treatment. CBT also holds promise as a primary treatment for inpatients but has not been clearly shown to be as effective as antidepressants. There is as yet no evidence that inpatient CBT is superior to other psychotherapies of comparable intensity or that short-term inpatient CBT has enduring value if not followed by outpatient therapy. Further research is needed to clarify the specific effects of CBT for inpatients and to establish its cost-effectiveness. PMID:22700196

Feasibility and acceptability of two incentive-based implementation strategies for mental health therapists implementing cognitive-behavioral therapy: a pilot study to inform a randomized controlled trial.

PubMed

Beidas, Rinad S; Becker-Haimes, Emily M; Adams, Danielle R; Skriner, Laura; Stewart, Rebecca E; Wolk, Courtney Benjamin; Buttenheim, Alison M; Williams, Nathaniel J; Inacker, Patricia; Richey, Elizabeth; Marcus, Steven C

2017-12-15

Informed by our prior work indicating that therapists do not feel recognized or rewarded for implementation of evidence-based practices, we tested the feasibility and acceptability of two incentive-based implementation strategies that seek to improve therapist adherence to cognitive-behavioral therapy for youth, an evidence-based practice. This study was conducted over 6 weeks in two community mental health agencies with therapists (n = 11) and leaders (n = 4). Therapists were randomized to receive either a financial or social incentive if they achieved a predetermined criterion on adherence to cognitive-behavioral therapy. In the first intervention period (block 1; 2 weeks), therapists received the reward they were initially randomized to if they achieved criterion. In the second intervention period (block 2; 2 weeks), therapists received both rewards if they achieved criterion. Therapists recorded 41 sessions across 15 unique clients over the project period. Primary outcomes included feasibility and acceptability. Feasibility was assessed quantitatively. Fifteen semi-structured interviews were conducted with therapists and leaders to assess acceptability. Difference in therapist adherence by condition was examined as an exploratory outcome. Adherence ratings were ascertained using an established and validated observational coding system of cognitive-behavioral therapy. Both implementation strategies were feasible and acceptable-however, modifications to study design for the larger trial will be necessary based on participant feedback. With respect to our exploratory analysis, we found a trend suggesting the financial reward may have had a more robust effect on therapist adherence than the social reward. Incentive-based implementation strategies can be feasibly administered in community mental health agencies with good acceptability, although iterative pilot work is essential. Larger, fully powered trials are needed to compare the effectiveness of

Cognitive behavioral therapy for insomnia as a preparatory treatment for exposure therapy for posttraumatic stress disorder.

PubMed

Baddeley, Jenna L; Gros, Daniel F

2013-01-01

Insomnia is present in a majority of individuals with posttraumatic stress disorder (PTSD). However, when both disorders are present, disagreements exist about whether to provide exposure therapy for PTSD before insomnia treatment, or vice versa. The current case study describes the psychological treatment of a psychotherapy-naive veteran with comorbid insomnia and PTSD. The patient initially refused exposure therapy for PTSD; thus, cognitive-behavioral therapy for insomnia (CBTi) was a first-step treatment. Cognitive Behavior Therapy for Insomnia provided insomnia symptom relief psychoeducation and self-monitoring of PTSD symptoms prepared the patient to enter exposure therapy. After six CBTi sessions, the patient completed seven sessions of trauma-specific exposure therapy. At the conclusion of treatment and at 90-day follow up, the patient demonstrated significant reductions in insomnia and PTSD symptoms. Findings support the safe and effective use of CBTi in patients with comorbid insomnia and PTSD to improve sleep and facilitate entry into exposure therapy for PTSD.

Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial.

PubMed

Pramana, Gede; Parmanto, Bambang; Lomas, James; Lindhiem, Oliver; Kendall, Philip C; Silk, Jennifer

2018-05-10

Cognitive behavioral therapy is an efficacious treatment for child anxiety disorders. Although efficacious, many children (40%-50%) do not show a significant reduction in symptoms or full recovery from primary anxiety diagnoses. One possibility is that they are unwilling to learn and practice cognitive behavioral therapy skills beyond therapy sessions. This can occur for a variety of reasons, including a lack of motivation, forgetfulness, and a lack of cognitive behavioral therapy skills understanding. Mobile health (mHealth) gamification provides a potential solution to improve cognitive behavioral therapy efficacy by delivering more engaging and interactive strategies to facilitate cognitive behavioral therapy skills practice in everyday lives (in vivo). The goal of this project was to redesign an existing mHealth system called SmartCAT (Smartphone-enhanced Child Anxiety Treatment) so as to increase user engagement, retention, and learning facilitation by integrating gamification techniques and interactive features. Furthermore, this project assessed the effectiveness of gamification in improving user engagement and retention throughout posttreatment. We redesigned and implemented the SmartCAT system consisting of a smartphone app for children and an integrated clinician portal. The gamified app contains (1) a series of interactive games and activities to reinforce skill understanding, (2) an in vivo skills coach that cues the participant to use cognitive behavioral therapy skills during real-world emotional experiences, (3) a home challenge module to encourage home-based exposure tasks, (4) a digital reward system that contains digital points and trophies, and (5) a therapist-patient messaging interface. Therapists used a secure Web-based portal connected to the app to set up required activities for each session, receive or send messages, manage participant rewards and challenges, and view data and figures summarizing the app usage. The system was implemented as

Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial

PubMed Central

Pramana, Gede; Lomas, James; Lindhiem, Oliver; Kendall, Philip C; Silk, Jennifer

2018-01-01

Background Cognitive behavioral therapy is an efficacious treatment for child anxiety disorders. Although efficacious, many children (40%-50%) do not show a significant reduction in symptoms or full recovery from primary anxiety diagnoses. One possibility is that they are unwilling to learn and practice cognitive behavioral therapy skills beyond therapy sessions. This can occur for a variety of reasons, including a lack of motivation, forgetfulness, and a lack of cognitive behavioral therapy skills understanding. Mobile health (mHealth) gamification provides a potential solution to improve cognitive behavioral therapy efficacy by delivering more engaging and interactive strategies to facilitate cognitive behavioral therapy skills practice in everyday lives (in vivo). Objective The goal of this project was to redesign an existing mHealth system called SmartCAT (Smartphone-enhanced Child Anxiety Treatment) so as to increase user engagement, retention, and learning facilitation by integrating gamification techniques and interactive features. Furthermore, this project assessed the effectiveness of gamification in improving user engagement and retention throughout posttreatment. Methods We redesigned and implemented the SmartCAT system consisting of a smartphone app for children and an integrated clinician portal. The gamified app contains (1) a series of interactive games and activities to reinforce skill understanding, (2) an in vivo skills coach that cues the participant to use cognitive behavioral therapy skills during real-world emotional experiences, (3) a home challenge module to encourage home-based exposure tasks, (4) a digital reward system that contains digital points and trophies, and (5) a therapist-patient messaging interface. Therapists used a secure Web-based portal connected to the app to set up required activities for each session, receive or send messages, manage participant rewards and challenges, and view data and figures summarizing the app usage

[Development and Effects of a Cognitive-behavioral Therapy Based Program in Reducing Internalized Stigma in Patients with Schizophrenia].

PubMed

Kim, Mi Young; Jun, Seong Sook

2016-06-01

This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness. The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group=32, control group=32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using χ²-test, t-test, repeated measures ANOVA with the SPSS program. Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group. Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.

Cultural Adaptations of Cognitive Behavioral Therapy.

PubMed

Hinton, Devon E; Patel, Anushka

2017-12-01

In increasingly multicultural societies, cognitive behavioral therapy (CBT) must be made appropriate for diverse groups. This article examines cultural adaptations of CBT, focusing on anxiety and depressive disorders. The article presents a culturally informed, transdiagnostic model of how anxious-depressive distress is generated and culturally shaped. Guided by this model, it discusses how interventions can be designed to decrease anxiety-type and depressive-type psychopathology in a culturally sensitive way. It describes such concepts as explanatory model bridging, cultural grounding, and contextual sensitivity. Copyright © 2017 Elsevier Inc. All rights reserved.

Internet-Based Cognitive Behavioral Therapy for Adults With ADHD in Outpatient Psychiatric Care.

PubMed

Pettersson, Richard; Söderström, Staffan; Edlund-Söderström, Kerstin; Nilsson, Kent W

2017-04-01

The purpose of the study was to evaluate an Internet-based cognitive behavioral therapy (iCBT) program targeting difficulties and impairments associated with adult ADHD. Forty-five adults diagnosed with ADHD were randomized to either self-help (iCBT self-help format [iCBT-S]), self-help with weekly group sessions (iCBT group-therapy format [iCBT-G]), or a waiting-list control group. Treatment efficacy was measured at pre- and posttreatment and at 6-month follow-up. Intention-to-treat (ITT) analysis showed a significant reduction in ADHD symptoms for the iCBT-S group in comparison with the waiting-list controls at posttreatment, with a between-group effect size of d = 1.07. The result was maintained at 6-month follow-up. No significant difference was found at posttreatment or 6-month follow-up between the iCBT-S and iCBT-G groups. The findings show that a CBT treatment program administered through the Internet can be a promising treatment for adult ADHD. Limitations of the study design and directions for future research are discussed.

Efficacy of Group Cognitive-behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents.

PubMed

Arman, Soroor; Golmohammadi, Farnaz; Maracy, Mohammadreza; Molaeinezhad, Mitra

2018-01-01

Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive-behavioral therapy (G-CBT) for female bipolar adolescents. During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12-19 years old, receiving usual maintenance medications (UMM), were selected. Participants were randomized to the control (UMM) and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM). The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions ( P > 0.05). However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%). Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

Cognitive-behavioral therapy for physical and emotional disturbances in adolescents with polycystic ovary syndrome: a pilot study.

PubMed

Rofey, Dana L; Szigethy, Eva M; Noll, Robert B; Dahl, Ronald E; Lobst, Emily; Arslanian, Silva A

2009-03-01

To evaluate the feasibility and effectiveness of an enhanced cognitive-behavioral therapy (CBT), Primary and Secondary Control Enhancement Training (PASCET-PI-2), for physical (obesity) and emotional (depression) disturbances in adolescents with polycystic ovary syndrome (PCOS). In an open trial, 12 adolescents with PCOS, obesity, and depression underwent eight weekly sessions and three family-based sessions of CBT enhanced by lifestyle goals (nutrition and exercise), physical illness narrative (meaning of having PCOS), and family psychoeducation (family functioning). Weight showed a significant decrease across the eight sessions from an average of 104 kg (SD = 26) to an average of 93 kg (SD = 18), t(11) = 6.6, p <.05. Depressive symptoms on the Children's Depression Inventory significantly decreased from a mean of 17 (SD = 3) to a mean of 9.6 (SD = 2), t(11) = 16.8, p <.01. A manual-based CBT approach to treat depression in adolescents with PCOS and obesity appears to be promising.

What Cognitive Behavioral Techniques Do Therapists Report Using when Delivering Cognitive Behavioral Therapy for the Eating Disorders?

ERIC Educational Resources Information Center

Waller, Glenn; Stringer, Hannah; Meyer, Caroline

2012-01-01

Objective: Clinicians commonly "drift" away from using proven therapeutic techniques. This study examined the degree to which such drift occurs among cognitive behavioral therapy (CBT) clinicians working with a specific clinical population--adults with eating disorders. Method: The study used a correlational design. The participants were…

Trauma-Focused Cognitive Behavioral Therapy: Assessing the Evidence

PubMed Central

Ramirez de Arellano, Michael A.; Jobe-Shields, Lisa; George, Preethy; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Huang, Larke; Delphin-Rittmon, Miriam E.

2015-01-01

Objective Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base. Methods Authors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness. Results The level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations. Conclusions TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development. PMID:24638076

Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients.

PubMed

Chen, Hung-Yuan; Cheng, I-Chih; Pan, Yi-Ju; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Peng, Yu-Sen; Tsai, Tun-Jun; Wu, Kwan-Dun

2011-08-01

Sleep disturbance is common in dialysis patients and is associated with the development of enhanced inflammatory responses. Cognitive-behavioral therapy 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 controlled interventional study of 72 sleep-disturbed hemodialysis patients. Within this patient cohort, 37 received tri-weekly cognitive-behavioral therapy lasting 6 weeks and the remaining 35, who received sleep hygiene education, served as controls. The adjusted post-trial primary outcome scores of the Pittsburgh Sleep Quality Index, the Fatigue Severity Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory were all significantly improved from baseline by therapy compared with the control group. The post-trial secondary outcomes of high-sensitive C-reactive protein, IL-18, and oxidized low-density lipoprotein levels significantly declined with cognitive-behavioral therapy in comparison with the control group. Thus, our results suggest that cognitive-behavioral therapy is effective for correcting disorganized sleep patterns, and for reducing inflammation and oxidative stress in hemodialysis patients.

Effects of Brief Communication Skills Training for Workers Based on the Principles of Cognitive Behavioral Therapy

PubMed Central

Sasaki, Norio; Somemura, Hironori; Nakamura, Saki; Yamamoto, Megumi; Isojima, Manabu; Shinmei, Issei; Horikoshi, Masaru; Tanaka, Katsutoshi

2017-01-01

Objective: Stimulating communication is an important workplace issue. We investigated the effects of a brief communication skills training (CST) program based on the principles of cognitive behavioral therapy (CBT). Methods: A randomized controlled trial was conducted on 206 white-collar workers. The intervention group underwent a 2-hour CST group training conducted by an occupational physician. Result: The results of the intention-to-treat analysis using a mixed-effects model showed that there was a significant interaction between group and time observed for the item “thinking together to solve problems and issues” (P = 0.02). The effect size (Cohen d) was 0.35 (95% confidence interval, 0.07 to 0.62). Conclusions: The present study suggests that a brief CST based on the principles of CBT could improve the communication behavior of workers. PMID:28045799

[Obesity psychological treatment: beyond cognitive and behavioral therapy].

PubMed

Volery, M; Bonnemain, A; Latino, A; Ourrad, N; Perroud, A

2015-03-25

The psychological assessment of the patient with obesity aims to identify the factors of maintenance of excess weight, such as eating disorders or anxio-depressive disorders. Psychotherapy helps a better weight management. Cognitive-behavioral therapy has shown its effectiveness in the treatment of obesity. New psychotherapeutic approaches are explored. The hypnosis and mindfulness are proposed for the management of emotions and stress. A targeted approach on the body image disorder decreases body dissatisfaction. When post-traumatic stress syndrome is involved, EMDR (Eye Movement Desensitization & Reprocessing) is better than other types of therapies. Family therapy is indicated when the entourage is impacted. Psychological difficulties should be the subject of specific care.

Does the form or the amount of exposure make a difference in the cognitive-behavioral therapy treatment of social phobia?

PubMed

Borgeat, François; Stankovic, Miroslava; Khazaal, Yasser; Rouget, Beatrice Weber; Baumann, Marie-Claude; Riquier, Françoise; O'Connor, Kieron; Jermann, Françoise; Zullino, Daniele; Bondolfi, Guido

2009-07-01

Exposure is considered to be an essential ingredient of cognitive-behavioral therapy treatment of social phobia and of most anxiety disorders. To assess the impact of the amount of exposure on outcome, 30 social phobic patients were randomly allocated to 1 of 2 group treatments of 8 weekly sessions: Self-Focused Exposure Therapy which is based essentially on prolonged exposure to public speaking combined with positive feedback or a more standard cognitive and behavioral method encompassing psychoeducation, cognitive work, working through exposure hierarchies of feared situations for exposure within and outside the group. The results show that the 2 methods led to significant and equivalent symptomatic improvements which were maintained at 1-year follow-up. There was a more rapid and initially more pronounced decrease in negative cognitions with the Self-Focused Exposure Therapy, which included no formal cognitive work, than with the more standard approach in which approximately a third of the content was cognitive. In contrast, decrease in social avoidance was more persistent with standard cognitive-behavior therapy which involved less exposure. The results indicate that positive cognitive change can be achieved more rapidly with non cognitive methods while avoidance decreases more reliably with a standard approach rather than an approach with an exclusive focus on exposure.

Cognitive Behavioral Therapy Is Associated With Enhanced Cognitive Control Network Activity in Major Depression and Posttraumatic Stress Disorder

PubMed Central

Yang, Zhen; Oathes, Desmond J.; Linn, Kristin A.; Bruce, Steven E.; Satterthwaite, Theodore D.; Cook, Philip A.; Satchell, Emma K.; Shou, Haochang; Sheline, Yvette I.

2018-01-01

BACKGROUND Both major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are characterized by depressive symptoms, abnormalities in brain regions important for cognitive control, and response to cognitive behavioral therapy (CBT). However, whether a common neural mechanism underlies CBT response across diagnoses is unknown. METHODS Brain activity during a cognitive control task was measured using functional magnetic resonance imaging in 104 participants: 28 patients with MDD, 53 patients with PTSD, and 23 healthy control subjects; depression and anxiety symptoms were determined on the same day. A patient subset (n = 31) entered manualized CBT and, along with controls (n = 19), was rescanned at 12 weeks. Linear mixed effects models assessed the relationship between depression and anxiety symptoms and brain activity before and after CBT. RESULTS At baseline, activation of the left dorsolateral prefrontal cortex was negatively correlated with Montgomery–Åsberg Depression Rating Scale scores across all participants; this brain–symptom association did not differ between MDD and PTSD. Following CBT treatment of patients, regions within the cognitive control network, including ventrolateral prefrontal cortex and dorsolateral prefrontal cortex, showed a significant increase in activity. CONCLUSIONS Our results suggest that dimensional abnormalities in the activation of cognitive control regions were associated primarily with symptoms of depression (with or without controlling for anxious arousal). Furthermore, following treatment with CBT, activation of cognitive control regions was similarly increased in both MDD and PTSD. These results accord with the Research Domain Criteria conceptualization of mental disorders and implicate improved cognitive control activation as a transdiagnostic mechanism for CBT treatment outcome. PMID:29628063

THE COST-EFFECTIVENESS OF COGNITIVE BEHAVIOR THERAPY FOR BORDERLINE PERSONALITY DISORDER: RESULTS FROM THE BOSCOT TRIAL

PubMed Central

Palmer, Stephen; Davidson, Kate; Tyrer, Peter; Gumley, Andrew; Tata, Philip; Norrie, John; Murray, Heather; Seivewright, Helen

2007-01-01

Borderline personality disorder places a significant burden on healthcare providers and other agencies. This study evaluated the cost-effectiveness of cognitive behavior therapy plus treatment as usual compared to treatment as usual alone for patients with borderline personality disorder. The economic analysis was conducted alongside a multi-center, randomized controlled trial. The costs of primary and secondary healthcare utilization, alongside the wider economic costs, were estimated from medical records and patient self-report. The primary outcome measure used was the quality-adjusted life year (QALY), assessed using EuroQol. On average, total costs per patient in the cognitive behavior therapy group were lower than patients receiving usual care alone (−£689), although this group also reported a lower quality of life (−0.11 QALYs). These differences were small and did not approach conventional levels of statistical significance. The use of cognitive therapy for borderline personality disorder does not appear to demonstrate any significant cost-effective advantage based on the results of this study. PMID:17032159

Occupational and Physical Therapy Services, School Based Programs: An Organizational Manual, 1982-83.

ERIC Educational Resources Information Center

McKee, Marlene, Comp.; And Others

A 1982-83 manual on school-based occupational therapy and physical therapy (OT/PT) services in Texas is presented. Contents include: guidelines, evaluation forms, student and therapists' documentation forms, and policy/procedures manuals for a suburban independent school district and a rural independent school district. Part I provides the…

Cognitive-behavioral therapy and hypnotic relaxation to treat sleep problems in an adolescent with diabetes.

PubMed

Perfect, Michelle M; Elkins, Gary R

2010-11-01

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. © 2010 Wiley Periodicals, Inc.

Tailoring Cognitive Behavioral Therapy to Subtypes of Voice-Hearing

PubMed Central

Smailes, David; Alderson-Day, Ben; Fernyhough, Charles; McCarthy-Jones, Simon; Dodgson, Guy

2015-01-01

Cognitive behavioral therapy (CBT) for voice-hearing (i.e., auditory verbal hallucinations; AVH) has, at best, small to moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualize voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly heterogeneous nature of voice-hearing suggests that many different cognitive processes may be involved in the etiology of AVH. These heterogeneous voice-hearing experiences do, however, appear to cluster into a set of subtypes, opening up the possibility of tailoring treatment to the subtype of AVH that a voice-hearer reports. In this paper, we (a) outline our rationale for tailoring CBT to subtypes of voice-hearing, (b) describe CBT for three putative subtypes of AVH (inner speech-based AVH, memory-based AVH, and hypervigilance AVH), and (c) discuss potential limitations and problems with such an approach. We conclude by arguing that tailoring CBT to subtypes of voice-hearing could prove to be a valuable therapeutic development, which may be especially effective when used in early intervention in psychosis services. PMID:26733919

Cost-effectiveness of cognitive behavioral therapy for insomnia comorbid with depression: Analysis of a randomized controlled trial.

PubMed

Watanabe, Norio; Furukawa, Toshiaki A; Shimodera, Shinji; Katsuki, Fujika; Fujita, Hirokazu; Sasaki, Megumi; Sado, Mitsuhiro; Perlis, Michael L

2015-06-01

Although the efficacy of cognitive behavioral therapy for insomnia has been confirmed, dissemination depends on the balance of benefits and costs. This study aimed to examine the cost-effectiveness of cognitive behavioral therapy for insomnia consisting of four weekly individual sessions. We conducted a 4-week randomized controlled trial with a 4-week follow up in outpatient clinics in Japan. Thirty-seven patients diagnosed as having major depressive disorder according to DSM-IV and suffering from chronic insomnia were randomized to receive either treatment as usual (TAU) alone or TAU plus cognitive behavioral therapy for insomnia. Effectiveness was evaluated as quality-adjusted life years (QALY) over 8 weeks' time, estimated by bootstrapping of the observed total scores of the Hamilton Depression Rating Scale. Direct medical costs for cognitive behavioral therapy for insomnia and TAU were also evaluated. We calculated the incremental cost-effectiveness ratio. Over the 8 weeks of the study, the group receiving cognitive behavioral therapy for insomnia plus TAU had significantly higher QALY (P = 0.002) than the TAU-alone group with an incremental value of 0.019 (SD 0.006), and had non-significantly higher costs with an incremental value of 254 (SD 203) USD in direct costs. The incremental cost-effectiveness ratio was 13 678 USD (95% confidence interval: -5691 to 71 316). Adding cognitive behavioral therapy for insomnia demonstrated an approximately 95% chance of gaining one more QALY if a decision-maker was willing to pay 60 000 USD, and approximately 90% for 40 000 USD. Adding cognitive behavioral therapy for insomnia is highly likely to be cost-effective for patients with residual insomnia and concomitant depression. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Investigating the Similarities and Differences between Practitioners of Second and Third Wave Cognitive-Behavioral Therapies

PubMed Central

Brown, Lily A.; Gaudiano, Brandon A.; Miller, Ivan W.

2013-01-01

There has been much discussion in the literature recently regarding the conceptual and techniual differences between so-called second (e.g., Beckian cognitive therapy) and third “wave” (e.g., acceptance and commitment therapy) behavior therapies. Previous research has not addressed the potential similarities and differences among the practitioners of these types of approaches. The current study examined possible differences in the characteristics of second wave (n=55) and third wave cognitive-behavioral therapists (n=33) using an internet-based survey. There were differences found at the technique level between the two groups. As expected, third wave therapists reported greater use of mindfulness/acceptance techniques. Also, third wave therapists reported greater use of exposure techniques and second wave therapists reported greater use of cognitive restructuring and relaxation techniques. In general, third wave clinicians were more eclectic at the technique level, and demonstrated significantly greater use of family systems techniques, existential/humanistic techniques, and the total number of techniques used. No significant differences were found on the attitudinal measures administered, including reliance on an intuitive thinking style, acceptance of complementary and alternative therapies and related health beliefs, or most attitudes toward evidence-based practices. We did not identify many differences between second wave and third wave therapists other than in terms of the techniques they employ. The clinical and research implications for these findings are discussed. PMID:21324946

Cognitive Coping as a Mechanism of Change in Cognitive-Behavioral Therapy for Fear of Flying: A Longitudinal Study With 3-Year Follow-Up.

PubMed

Busscher, Bert; Spinhoven, Philip

2017-09-01

To examine the predictive value of cognitive coping strategies at pretreatment and the value of changes in these strategies during cognitive-behavioral treatment for aviophobia for long-term therapy results. Data from baseline, after therapy at 2 months, short-term follow-up at 5 months, and long-term follow-up at 41 months were analyzed (N = 59). Participants were in a long-term process of change, which continued positively after therapy for maladaptive cognitive coping strategies. The use of cognitive coping strategies at baseline was not predictive of long-term outcome. However, a greater increase in the use of adaptive coping strategies, and more importantly, a greater decrease in the use of maladaptive coping strategies were predictive of improvements indicated in self-report of flight anxiety and actual flight behavior at long-term follow-up. Improvement of maladaptive cognitive coping strategies is possibly a key mechanism of change in cognitive-behavioral therapy for aviophobia. © 2016 Wiley Periodicals, Inc.

Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Comparison of Intensive and Weekly Approaches

ERIC Educational Resources Information Center

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.

2007-01-01

Objective: To examine the relative efficacy of intensive versus weekly cognitive-behavioral therapy (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…

Embodied simulation in exposure-based therapies for posttraumatic stress disorder—a possible integration of cognitive behavioral theories, neuroscience, and psychoanalysis

PubMed Central

Peri, Tuvia; Gofman, Mordechai; Tal, Shahar; Tuval-Mashiach, Rivka

2015-01-01

Exposure to the trauma memory is the common denominator of most evidence-based interventions for posttraumatic stress disorder (PTSD). Although exposure-based therapies aim to change associative learning networks and negative cognitions related to the trauma memory, emotional interactions between patient and therapist have not been thoroughly considered in past evaluations of exposure-based therapy. This work focuses on recent discoveries of the mirror-neuron system and the theory of embodied simulation (ES). These conceptualizations may add a new perspective to our understanding of change processes in exposure-based treatments for PTSD patients. It is proposed that during exposure to trauma memories, emotional responses of the patient are transferred to the therapist through ES and then mirrored back to the patient in a modulated way. This process helps to alleviate the patient's sense of loneliness and enhances his or her ability to exert control over painful, trauma-related emotional responses. ES processes may enhance the integration of clinical insights originating in psychoanalytic theories—such as holding, containment, projective identification, and emotional attunement—with cognitive behavioral theories of learning processes in the alleviation of painful emotional responses aroused by trauma memories. These processes are demonstrated through a clinical vignette from an exposure-based therapy with a trauma survivor. Possible clinical implications for the importance of face-to-face relationships during exposure-based therapy are discussed. PMID:26593097

Embodied simulation in exposure-based therapies for posttraumatic stress disorder-a possible integration of cognitive behavioral theories, neuroscience, and psychoanalysis.

PubMed

Peri, Tuvia; Gofman, Mordechai; Tal, Shahar; Tuval-Mashiach, Rivka

2015-01-01

Exposure to the trauma memory is the common denominator of most evidence-based interventions for posttraumatic stress disorder (PTSD). Although exposure-based therapies aim to change associative learning networks and negative cognitions related to the trauma memory, emotional interactions between patient and therapist have not been thoroughly considered in past evaluations of exposure-based therapy. This work focuses on recent discoveries of the mirror-neuron system and the theory of embodied simulation (ES). These conceptualizations may add a new perspective to our understanding of change processes in exposure-based treatments for PTSD patients. It is proposed that during exposure to trauma memories, emotional responses of the patient are transferred to the therapist through ES and then mirrored back to the patient in a modulated way. This process helps to alleviate the patient's sense of loneliness and enhances his or her ability to exert control over painful, trauma-related emotional responses. ES processes may enhance the integration of clinical insights originating in psychoanalytic theories-such as holding, containment, projective identification, and emotional attunement-with cognitive behavioral theories of learning processes in the alleviation of painful emotional responses aroused by trauma memories. These processes are demonstrated through a clinical vignette from an exposure-based therapy with a trauma survivor. Possible clinical implications for the importance of face-to-face relationships during exposure-based therapy are discussed.

Sudden gains in group cognitive-behavioral therapy for panic disorder.

PubMed

Clerkin, Elise M; Teachman, Bethany A; Smith-Janik, Shannan B

2008-11-01

The current study investigates sudden gains (rapid symptom reduction) in group cognitive-behavioral therapy for panic disorder. Sudden gains occurring after session 2 of treatment predicted overall symptom reduction at treatment termination and some changes in cognitive biases. Meanwhile, sudden gains occurring immediately following session 1 were not associated with symptom reduction or cognitive change. Together, this research points to the importance of examining sudden gains across the entire span of treatment, as well as the potential role of sudden gains in recovery from panic disorder.

A Review and Empirical Comparison of Two Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy and Cognitive Behavior Therapy

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Siv, Alexander M.

2005-01-01

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 behavioral therapy based on…

Empirical Comparison of Three Treatments for Adolescent Males with Physical and Sexual Aggression: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Murphy, Christopher J.; Hunter, Linda A.; Siv, Alexander M.

2005-01-01

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 behavioral therapy based on…

Effects of Cognitive Behavioral Therapy for Insomnia on Suicidal Ideation in Veterans

PubMed Central

Trockel, Mickey; Karlin, Bradley E.; Taylor, C. Barr; Brown, Gregory K.; Manber, Rachel

2015-01-01

Objective: To examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on suicidal ideation among Veterans with insomnia. Design: Longitudinal data collected in the course of an uncontrolled evaluation of a large-scale CBT-I training program. Setting: Outpatient and residential treatment facilities. Participants: Four hundred five Veterans presenting for treatment of insomnia. Interventions: Cognitive behavioral therapy for insomnia. Measurement and Results: At baseline, 32% of patients, compared with 21% at final assessment, endorsed some level of suicidal ideation [χ2(df = 1) = 125; P < 0.001]. After adjusting for demographic variables and baseline insomnia severity, each 7-point decrease in Insomnia Severity Index score achieved during CBT-I treatment was associated with a 65% (odds ratio = 0.35; 95% confidence intervals = 0.24 to 0.52) reduction in odds of suicidal ideation. The effect of change in insomnia severity on change in depression severity was also significant. After controlling for change in depression severity and other variables in the model, the effect of change in insomnia severity on change in suicidal ideation remained significant. Conclusion: This evaluation of the largest dissemination of cognitive behavioral therapy for insomnia (CBT-I) in the United States found a clinically meaningful reduction in suicidal ideation among Veterans receiving CBT-I. The mechanisms by which effective treatment of insomnia with CBT-I reduces suicide risk are unknown and warrant investigation. The current results may have significant public health implications for preventing suicide among Veterans. Citation: Trockel M, Karlin BE, Taylor CB, Brown GK, Manber R. Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans. SLEEP 2015;38(2):259–265. PMID:25515115

Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS: results of a randomized controlled trial.

PubMed

Himelhoch, Seth; Medoff, Deborah; Maxfield, Jennifer; Dihmes, Sarah; Dixon, Lisa; Robinson, Charles; Potts, Wendy; Mohr, David C

2013-10-01

This pilot randomized controlled trial evaluated a previously developed manualized telephone based cognitive behavioral therapy (T-CBT) intervention compared to face-to-face (f2f) therapy among low-income, urban dwelling HIV infected depressed individuals. The primary outcome was the reduction of depressive symptoms as measured by the Hamliton rating scale for depression scale. The secondary outcome was adherence to HAART as measured by random telephone based pill counts. Outcome measures were collected by trained research assistants masked to treatment allocation. Analysis was based on intention-to-treat. Thirty-four participants met eligibility criteria and were randomly assigned to receive T-CBT (n = 16) or f2f (n = 18). There was no statistically significant difference in depression treatment outcomes comparing f2f to T-CBT. Within group evaluation demonstrated that both the T-CBT and the f2f psychotherapy groups resulted in significant reductions in depressive symptoms. Those who received the T-CBT were significantly more likely to maintain their adherence to antiretroviral medication compared to the f2f treatment. None of the participants discontinued treatment due to adverse events. T-CBT can be delivered to low-income, urban dwelling HIV infected depressed individuals resulting in significant reductions in depression symptoms and improved adherence to antiretroviral medication. Clinical Trial.gov identifier: NCT01055158.

Cognitive Therapy Versus Exposure and Applied Relaxation in Social Phobia: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Clark, David M.; Ehlers, Anke; Hackmann, Ann; McManus, Freda; Fennell, Melanie; Grey, Nick; Waddington, Louise; Wild, Jennifer

2006-01-01

A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT…

Rationale and study design of a trial of mindfulness-based cognitive therapy for preventing suicidal behavior (MBCT-S) in military veterans.

PubMed

Kline, Anna; Chesin, Megan; Latorre, Miriam; Miller, Rachael; St Hill, Lauren; Shcherbakov, Anton; King, Arlene; Stanley, Barbara; Weiner, Marc D; Interian, Alejandro

2016-09-01

Although suicide ranks 10th as a cause of death in the United States, and 1st among active military personnel, there are surprisingly few evidence-based therapies addressing suicidality, and development of new treatments is limited. This paper describes a clinical trial testing a novel therapy for reducing suicide risk in military veterans. The intervention, Mindfulness-Based Cognitive Therapy for Preventing Suicide Behavior (MBCT-S), is a 10-week group intervention adapted from an existing treatment for depression (Mindfulness-Based Cognitive Therapy - MBCT). MBCT-S incorporates the Safety Planning Intervention, which is currently implemented throughout the Veterans Health Administration (VHA) for veterans at high suicide risk. MBCT-S is being tested in a VHA setting using an intention-to-treat, two-group randomized trial design in which 164 high suicide risk veterans are randomized to either VHA Treatment As Usual (TAU; n=82) or TAU+MBCT-S (n=82). Our primary outcome measure, suicide-related event, defined to include suicide preparatory behaviors, self-harm behavior with suicidal or indeterminate intent, suicide-related hospitalizations and Emergency Department (ED) visits, will be measured through five assessments administered by blinded assessors between baseline and 12months post-baseline. We will measure suicide attempts and suicide deaths as a secondary outcome, because of their anticipated low incidence during the study period. Secondary outcomes also include severity of suicidal ideation, hopelessness and depression. This study has the potential to significantly enhance the quality and efficiency of VHA care for veterans at suicide risk and to substantially improve the quality of life for veterans and their families. Copyright © 2016 Elsevier Inc. All rights reserved.

[Cognitive behavior therapy for depression in children and adolescents - procedure, effects, and developments].

PubMed

Groen, Gunter; Petermann, Franz

2012-11-01

Cognitive behavior therapy offers a theoretically and empirically valid therapeutic approach for children and adolescents suffering from depression. It can be recommended according to present guidelines and efficacy studies. Further research and conceptual development, however, is necessary especially regarding the small to moderate effect sizes as well as the lack of long-term efficacy and effect factors. This article gives a short overview of the basics and contents of cognitive behavior therapy for depressive children and adolescents. It furthermore presents the latest findings and an assessment of its efficacy and relevant developments and perspectives.

Integrated Cognitive Behavioral Therapy Versus Cognitive Processing Therapy for Adults With Depression, Substance Use Disorder, and Trauma.

PubMed

Haller, Moira; Norman, Sonya B; Cummins, Kevin; Trim, Ryan S; Xu, Xiaomin; Cui, Ruifeng; Allard, Carolyn B; Brown, Sandra A; Tate, Susan R

2016-03-01

The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history. Copyright © 2015. Published by Elsevier Inc.

Behavioral Bibliotherapy: A Review of Self-Help Behavior Therapy Manuals

ERIC Educational Resources Information Center

Glasgow, Russell E.; Rosen, Gerald M.

1978-01-01

Describes the organizing concepts and strategies for the development and evaluation of self-help behavioral treatment manuals. Reviews programs that have been published or empirically tested for the treatment of phobias, smoking, obesity, sexual dysfunction, assertiveness, child behavior problems, study skills, and physical fitness, as well as…

A state survey of Child Advocacy Center therapists' attitudes toward treatment manuals and evidence-based practice.

PubMed

Staudt, Marlys; Williams-Hayes, Mona

2011-01-01

The objective of this descriptive study was to examine Child Advocacy Center therapists' attitudes toward treatment manuals and evidence-based practices and to gather information about the treatments they use most frequently. An online survey was sent to 30 therapists employed by 15 Child Advocacy Centers in a southeastern state. The response rate was 70%. The respondents generally had positive attitudes toward the use of treatment manuals and the implementation of evidence-based practices. The treatment utilized most frequently was trauma focused cognitive-behavioral therapy. More outcome research of Child Advocacy Center services is needed, and information about how children and parents perceive the acceptability and outcomes of Child Advocacy Center services can be used to enhance services.

A Systematic Review and Meta-Analysis of the Efficacy of Cognitive Behavioral Therapy for the Management of Pediatric Migraine.

PubMed

Ng, Qin Xiang; Venkatanarayanan, Nandini; Kumar, Lakshmi

2017-03-01

Migraine headaches are common in children and adolescents. Current pharmacologic treatment options are limited despite the prevalence and debilitating effects of pediatric migraine. Cognitive behavioral therapy (CBT) is an evidence-based practice that focuses on the development of coping strategies and cognitive restructuring to alter the pain experience. Till date, no meta-analysis has been done to examine the use of CBT in pediatric migraine. Using the keywords (cognitive behavioral therapy OR cognitive behavior therapy OR cognitive behavioral therapy OR cognitive behavior therapy OR CBT) AND (headache OR migraine), a preliminary search on the PubMed and Ovid database yielded 3841 articles published in English between 1 Jan 1980 and 1 May 2016. Full articles were also reviewed for references of interest. After data extraction, 14 studies were included in the meta-analysis. The results of the meta-analysis well-support the clinical role of CBT in the management of pediatric migraine. The pooled odds ratios of clinically significant improvement, that is, 50% or greater headache activity reduction post-treatment and at follow-up (3 months or later) were OR 9.11 (95% CI: 5.01 to 16.58, P < .001) and OR 9.18 (95% CI: 5.69 to 14.81, P < .001) respectively, demonstrating significant clinical improvement with CBT as compared with wait-list control, placebo, or standard medication. Furthermore, the clinical improvement was stable, even at a 1-year follow-up as evident in some of the studies. There is good evidence that CBT is beneficial to children suffering from migraine, and may also augment the efficacy of standard medications such as amitriptyline. © 2016 American Headache Society.

Cognitive-Behavioral Therapy for Anxiety in Youth with an Autism Spectrum Disorder: A Follow-Up Study

ERIC Educational Resources Information Center

Selles, Robert R.; Arnold, Elysse B.; Phares, Vicky; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

2015-01-01

Cognitive-behavioral therapy for anxiety in youth with an autism spectrum disorder appears efficacious; however, maintenance of treatment gains has not yet been studied. Using a sample of 32 youth who had benefited at least minimally from a past trial of cognitive-behavioral therapy for anxiety in autism spectrum disorder, this study assessed…

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Three-Month Follow-Up Investigation

ERIC Educational Resources Information Center

Springer, Craig; Misurell, Justin R.; Hiller, Atara

2012-01-01

This study examined the efficacy of a game-based cognitive-behavioral group therapy program for addressing problems typically found among elementary school-aged victims of child sexual abuse immediately after treatment and at three months following treatment. It was hypothesized that positive gains would be observed among the following domains:…

Lost in translation? Moving contingency management and cognitive behavioral therapy into clinical practice.

PubMed

Carroll, Kathleen M

2014-10-01

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 behavioral therapies, contingency management (CM) and cognitive behavioral therapy (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 Behavioral Therapies 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. © 2014 New York Academy of Sciences.

Cognitive Reappraisal Self-Efficacy Mediates the Effects of Individual Cognitive-Behavioral Therapy for Social Anxiety Disorder

ERIC Educational Resources Information Center

Goldin, Philippe R.; Ziv, Michal; Jazaieri, Hooria; Werner, Kelly; Kraemer, Helena; Heimberg, Richard G.; Gross, James J.

2012-01-01

Objective: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (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%…

[Effectiveness of cognitive-behavioral therapy in childhood anxiety disorders in a university psychiatric outpatient clinic].

PubMed

Goletz, Hildegard; Yang, Young-Im; Suhr-Dachs, Lydia; Walter, Daniel; Döpfner, Manfred

2013-07-01

Only few studies have examined whether the efficacy of cognitive-behavioral therapy for childhood anxiety disorders as demonstrated in randomized controlled trials (RCTs) generalizes to clinical practice. This study examines the effectiveness of cognitive-behavioral therapy for juvenile anxiety disorders under routine care conditions in a university-based psychiatric outpatient clinic. 92 children and adolescents with parent-ratings regarding anxiety and comorbid symptoms and 61 children and adolescents with self-ratings regarding anxiety and comorbid symptoms were treated with cognitive-behavioral interventions. Pre/post mean comparisons, effect sizes, and the clinical significance of changes in symptoms were examined. The effect size for reduction of anxiety symptoms was .81 for children whose parents had completed the rating scale and .79 for children who had filled in a self-rating scale. Effect sizes for reduction of comorbid symptoms varied between .37 and .84 for parent ratings and between .21 and .62 for self-ratings. The percentage of children and adolescents who achieved clinically significant improvements in anxiety symptoms was 55.1 % according to the parent ratings and 65.7 % according to the children's self-ratings. More than 50 % of parents and children reported clinically significant improvements in comorbid symptoms. Significant reductions in both anxiety and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile anxiety disorders in a university psychiatric outpatient clinic. The effect sizes for anxiety symptoms were found to be comparable to the effect sizes reported in RCTs. Similarly, clinically significant improvements were as frequent as the rates of remission of anxiety symptoms reported in RCTs.

Cognitive-Behavioral Therapy to Promote Smoking Cessation among African American Smokers: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Webb, Monica S.; de Ybarra, Denise Rodriguez; Baker, Elizabeth A.; Reis, Isildinha M.; Carey, Michael P.

2010-01-01

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-behavioral therapy (CBT) for smoking cessation among African Americans. Method: Participants…

The Effect of Cognitive Behavioral Therapy and Cognitive Behavioral Therapy Plus Media on the Reduction of Bullying and Victimization and the Increase of Empathy and Bystander Response in a Bully Prevention Program for Urban Sixth-Grade Students

ERIC Educational Resources Information Center

McLaughlin, Laura Pierce

2009-01-01

The purpose of this study was to investigate the effect of cognitive behavioral therapy and cognitive behavioral therapy 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…

Mediated Moderation in Combined Cognitive Behavioral Therapy versus Component Treatments for Generalized Anxiety Disorder

ERIC Educational Resources Information Center

Newman, Michelle G.; Fisher, Aaron J.

2013-01-01

Objective: This study examined (a) duration of generalized anxiety disorder (GAD) as a moderator of cognitive behavioral therapy (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…

Sudden Gains in Group Cognitive-Behavioral Therapy for Panic Disorder

PubMed Central

Clerkin, Elise M.; Teachman, Bethany A.; Smith-Janik, Shannan B.

2008-01-01

The current study investigates sudden gains (rapid symptom reduction) in group cognitive-behavioral therapy for panic disorder. Sudden gains occurring after session 2 of treatment predicted overall symptom reduction at treatment termination and some changes in cognitive biases. Meanwhile, sudden gains occurring immediately following session 1 were not associated with symptom reduction or cognitive change. Together, this research points to the importance of examining sudden gains across the entire span of treatment, as well as the potential role of sudden gains in recovery from panic disorder. PMID:18804199

Cognitive predictors and moderators of winter depression treatment outcomes in cognitive-behavioral therapy vs. light therapy.

PubMed

Sitnikov, Lilya; Rohan, Kelly J; Evans, Maggie; Mahon, Jennifer N; Nillni, Yael I

2013-12-01

There is no empirical basis for determining which seasonal affective disorder (SAD) patients are best suited for what type of treatment. Using data from a parent clinical trial comparing light therapy (LT), cognitive-behavioral therapy (CBT), and their combination (CBT + LT) for SAD, we constructed hierarchical linear regression models to explore baseline cognitive vulnerability constructs (i.e., dysfunctional attitudes, negative automatic thoughts, response styles) as prognostic and prescriptive factors of acute and next winter depression outcomes. Cognitive constructs did not predict or moderate acute treatment outcomes. Baseline dysfunctional attitudes and negative automatic thoughts were prescriptive of next winter treatment outcomes. Participants with higher baseline levels of dysfunctional attitudes and negative automatic thoughts had less severe depression the next winter if treated with CBT than if treated with LT. In addition, participants randomized to solo LT who scored at or above the sample mean on these cognitive measures at baseline had more severe depressive symptoms the next winter relative to those who scored below the mean. Baseline dysfunctional attitudes and negative automatic thoughts did not predict treatment outcomes in participants assigned to solo CBT or CBT + LT. Therefore, SAD patients with extremely rigid cognitions did not fare as well in the subsequent winter if treated initially with solo LT. Such patients may be better suited for initial treatment with CBT, which directly targets cognitive vulnerability processes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cognitive-Behavioral Therapy for Anxiety in Children Diagnosed with Autism Spectrum Disorders: Modification Trends

ERIC Educational Resources Information Center

Moree, Brittany N.; Davis, Thompson E., III

2010-01-01

Anxiety disorders have been found to be highly comorbid with autism spectrum disorders (ASDs). Even so, the identification and dissemination of empirically supported treatments for anxiety in adults or children who have ASD has lagged behind the larger evidence-based trend. This review examines the efficacy of cognitive-behavioral therapy as a…

Are changes in worry associated with treatment response in cognitive behavioral therapy for insomnia?

PubMed

Sunnhed, Rikard; Jansson-Fröjmark, Markus

2014-01-01

Little is known about why some patients respond to cognitive behavioral therapy for insomnia, whereas other patients do not. To understand differences in treatment response, there is a dire need to examine processes of change. The purpose was to investigate the long-term association between insomnia-related worry and outcomes following cognitive behavior therapy for insomnia. Sixty patients with early insomnia (3-12 months duration) received group cognitive behavioral therapy for insomnia. At pretreatment and at a 1-year follow-up, the patients completed questionnaires indexing two domains of insomnia-related worry (sleeplessness and health), insomnia severity, anxiety, and depression as well as sleep diaries. Decreases in the two worry domains were associated with improvements in all of the outcomes, except for sleep onset latency (SOL), at a medium to large level. Reductions in insomnia-related worry were associated with improvements in insomnia severity, wake after sleep onset (WASO), total sleep time (TST), and depression, but not in SOL or anxiety. While reductions in worry for sleeplessness were related to improvements in insomnia severity and TST, decreases in worry for health were associated with enhancements in WASO and depression. The findings suggest that reductions in insomnia-related worry might be one process route in which cognitive behavioral therapy operates to improve insomnia symptomatology. The results are discussed in relation to theory, clinical implications, and future research.

Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: a comparison with younger patients.

PubMed

Hendriks, Gert-Jan; Kampman, Mirjam; Keijsers, Ger P J; Hoogduin, Cees A L; Voshaar, Richard C Oude

2014-08-01

Older adults with panic disorder and agoraphobia (PDA) are underdiagnosed and undertreated, while studies of cognitive-behavioral therapy (CBT) are lacking. This study compares the effectiveness of CBT for PDA in younger and older adults. A total of 172 patients with PDA (DSM-IV) received manualized CBT. Primary outcome measures were avoidance behavior (Mobility Inventory Avoidance scale) and agoraphobic cognitions (Agoraphobic Cognitions Questionnaire), with values of the younger (18-60 years) and older (≥ 60 years) patients being compared using mixed linear models adjusted for baseline inequalities, and predictive effects of chronological age, age at PDA onset and duration of illness (DOI) being examined using multiple linear regressions. Attrition rates were 2/31 (6%) for the over-60s and 31/141 (22%) for the under-60s group (χ(2) = 3.43, df = 1, P = .06). Patients in both age groups improved on all outcome measures with moderate-to-large effect sizes. Avoidance behavior had improved significantly more in the 60+ group (F = 4.52, df = 1,134, P = .035), with agoraphobic cognitions showing no age-related differences. Baseline severity of agoraphobic avoidance and agoraphobic cognitions were the most salient predictors of outcome (range standardized betas 0.59 through 0.76, all P-values < .001). Apart from a superior reduction of agoraphobic avoidance in the 60+ participants (β = -0.30, P = .037), chronological age was not related to outcome, while in the older patients higher chronological age, late-onset type and short DOI were linked to superior improvement of agoraphobic avoidance. CBT appears feasible for 60+ PDA-patients, yielding outcomes that are similar and sometimes even superior to those obtained in younger patients. © 2014 Wiley Periodicals, Inc.

Early Childhood OCD: Preliminary Findings from a Family-Based Cognitive-Behavioral Approach

ERIC Educational Resources Information Center

Freeman, Jennifer B.; Garcia, Abbe M.; Coyne, Lisa; Ale, Chelsea; Prezeworski, Amy; Himle, Michael; Compton, Scott; Leonard, Henrietta L.

2008-01-01

A study was conducted to compare the relative usefulness of family-based cognitive-behavioral therapy (CBT) against family-based relaxation treatment for children with obsessive-compulsive disorder (OCD). Results showed that children with early childhood-onset OCD benefited from the CBT program as it effectively decreased OCD symptoms and helped…

Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial.

PubMed

Stefini, Annette; Salzer, Simone; Reich, Günter; Horn, Hildegard; Winkelmann, Klaus; Bents, Hinrich; Rutz, Ursula; Frost, Ulrike; von Boetticher, Antje; Ruhl, Uwe; Specht, Nicole; Kronmüller, Klaus-Thomas

2017-04-01

The authors compared cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (BN) in female adolescents. In this randomized controlled trial, 81 female adolescents with BN or partial BN according to the DSM-IV received a mean of 36.6 sessions of manualized disorder-oriented PDT or CBT. Trained psychologists blinded to treatment condition administered the outcome measures at baseline, during treatment, at the end of treatment, and 12 months after treatment. The primary outcome was the rate of remission, defined as a lack of DSM-IV diagnosis for BN or partial BN at the end of therapy. Several secondary outcome measures were evaluated. The remission rates for CBT and PDT were 33.3% and 31.0%, respectively, with no significant differences between them (odds ratio [OR] = 0.90, 95% CI = 0.35-2.28, p = .82). The within-group effect sizes were h = 1.22 for CBT and h = 1.18 for PDT. Significant improvements in all secondary outcome measures were found for both CBT (d = 0.51-0.82) and PDT (d = 0.24-1.10). The improvements remained stable at the 12-month follow-up in both groups. There were small between-group effect sizes for binge eating (d = 0.23) and purging (d = 0.26) in favor of CBT and for eating concern (d = -0.35) in favor of PDT. CBT and PDT were effective in promoting recovery from BN in female adolescents. The rates of remission for both therapies were similar to those in other studies evaluating CBT. This trial identified differences with small effects in binge eating, purging, and eating concern. Clinical trial registration information-Treating Bulimia Nervosa in Female Adolescents With Either Cognitive-Behavioral Therapy (CBT) or Psychodynamic Therapy (PDT). http://isrctn.com/; ISRCTN14806095. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

ERIC Educational Resources Information Center

van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

2012-01-01

In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing…

A Preliminary Report of Short-Term Cognitive-Behavioral Group Therapy for Inpatients With Personality Disorders

PubMed Central

SPRINGER, TAMAR; LOHR, NAOMI E.; BUCHTEL, HENRY A.; SILK, KENNETH R.

1996-01-01

A randomized, controlled study evaluated the effectiveness of a cognitive-behavioral therapy group, based on Linehan’s dialectical behavior therapy, for inpatients with personality disorders. The treatment, a problem-solving skills group focused on parasuicidality, was compared with a discussion control group. Change was assessed by self-report measures and behavioral observations on the unit. Subjects in both groups improved significantly on most change measures, although no significant between-group differences were found. However, the treatment group patients viewed the intervention as more beneficial to them in their lives outside the hospital. The usefulness of this type of group on a short-term unit is discussed. PMID:22700265

The role of treatment delivery factors in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia.

PubMed

Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Kordt, Anne; Hamm, Alfons O; Gerlach, Alexander L; Alpers, Georg W; Arolt, Volker; Kircher, Tilo; Pauli, Paul; Rief, Winfried; Lang, Thomas

2016-08-01

Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients' interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists' adherence (r=0.54) and therapeutic alliance (r=0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients' interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r=0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of Cognitive-Behavioral Group Therapy for Depressive Mothers of Children with Behavior Problems

ERIC Educational Resources Information Center

Hye Ha, Eun

2006-01-01

The purpose of this study was to develop a cognitive behavioral group therapy (CBT) for depressed mothers of children between 5-12 years old, with behavior problems and to examine the effectiveness of the program. The CBT group met 8 times in total (2-hour weekly sessions for 8 weeks), followed by a booster session 3 months after the program was…

Dilemma-focused intervention for unipolar depression: a treatment manual.

PubMed

Feixas, Guillem; Compañ, Victoria

2016-07-12

This article introduces a new treatment protocol for depression. Based on previous research which indicated the presence of cognitive conflicts in depression, this study created an intervention manual to address these conflicts. The therapy manual for depressive patients followed the guideline for inclusion in clinical trials (stage II), which has received high recognition. A preliminary version (stage I) of this manual was formulated based on other, more general dilemma-focused therapy publications, inspired by personal construct theory (PCT), and input from clinical experience. The resulting version was then applied during the 8-session format of a pilot study with patients diagnosed with major depressive disorder or dysthymia. Finally, feedback was requested from seasoned and highly respected therapists, some of whom were familiar with PCT. According to the mentioned guideline, the intervention manual selected the theoretical framework, in this case PCT, to include its conceptualization of depression and resolution of dilemmas (to foster clinical improvement) as a main treatment goal. The manual was then contrasted with psychoanalytic psychotherapy, cognitive-behavior therapy (CBT), motivational interviewing (MI), and other similar approaches such as cognitive-analytic therapy and coherence therapy. Following these conceptual clarifications, the specific interventions included in the manual were defined according to both categories: their unique and essential components and those conceived as common psychotherapeutic factors. Next, the general structure and content for each session were presented. The structure consisted of seven well-defined individual sessions with an additional session, which could complement any of the former sessions to address the patient's issues in greater depth, if needed. This Dilemma-Focused Intervention manual aimed to improve the treatment outcome for depression by offering an intervention that could be combined with other general

Patient Characteristics and Patient Behavior as Predictors of Outcome in Cognitive Therapy and Exposure Therapy for Hypochondriasis.

PubMed

Richtberg, Samantha; Jakob, Marion; Höfling, Volkmar; Weck, Florian

2017-06-01

Psychotherapy for hypochondriasis has greatly improved over the last decades and cognitive-behavioral treatments are most promising. However, research on predictors of treatment outcome for hypochondriasis is rare. Possible predictors of treatment outcome in cognitive therapy (CT) and exposure therapy (ET) for hypochondriasis were investigated. Characteristics and behaviors of 75 patients were considered as possible predictors: sociodemographic variables (sex, age, and cohabitation); psychopathology (pretreatment hypochondriacal symptoms, comorbid mental disorders, and levels of depression, anxiety, and somatic symptoms); and patient in-session interpersonal behavior. Severity of pretreatment hypochondriacal symptoms, comorbid mental disorders, and patient in-session interpersonal behavior were significant predictors in multiple hierarchical regression analyses. Interactions between the predictors and the treatment (CT or ET) were not found. In-session interpersonal behavior is an important predictor of outcome. Furthermore, there are no specific contraindications to treating hypochondriasis with CT or ET. © 2016 Wiley Periodicals, Inc.

Conventional Cognitive Behavioral Therapy Facilitated by an Internet-Based Support System: Feasibility Study at a Psychiatric Outpatient Clinic.

PubMed

Månsson, Kristoffer Nt; Klintmalm, Hugo; Nordqvist, Ragnar; Andersson, Gerhard

2017-08-24

Cognitive behavioral therapies have been shown to be effective for a variety of psychiatric and somatic disorders, but some obstacles can be noted in regular psychiatric care; for example, low adherence to treatment protocols may undermine effects. Treatments delivered via the Internet have shown promising results, and it is an open question if the blend of Internet-delivered and conventional face-to-face cognitive behavioral therapies may help to overcome some of the barriers of evidence-based treatments in psychiatric care. We evaluated the feasibility of an Internet-based support system at an outpatient psychiatric clinic in Sweden. For instance, the support system made it possible to send messages and share information between the therapist and the patient before and after therapy sessions at the clinic. Nine clinical psychologists participated and 33 patients were enrolled in the current study. We evaluated the usability and technology acceptance after 12 weeks of access. Moreover, clinical data on common psychiatric symptoms were assessed before and after the presentation of the support system. In line with our previous study in a university setting, the Internet-based support system has the potential to be feasible also when delivered in a regular psychiatric setting. Notably, some components in the system were less frequently used. We also found that patients improved on common outcome measures for depressive and anxious symptoms (effect sizes, as determined by Cohen d, ranged from 0.20-0.69). This study adds to the literature suggesting that modern information technology could be aligned with conventional face-to-face services. ©Kristoffer NT Månsson, Hugo Klintmalm, Ragnar Nordqvist, Gerhard Andersson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.08.2017.

An evaluation of cognitive behavioral therapy as a treatment for dissociative seizures: a pilot study.

PubMed

Goldstein, Laura H; Deale, Alicia C; Mitchell-O'Malley, Sara J; Toone, Brian K; Mellers, John D C

2004-03-01

To evaluate in an open trial the effectiveness of cognitive behavioral therapy as a treatment of adults with dissociative seizures (i.e., "pseudoseizures"). Although suggestions have been made concerning the management of patients with dissociative seizures, no studies have previously evaluated the systematic use of cognitive behavioral therapy in the treatment of this disorder. Twenty patients diagnosed with dissociative seizures were offered treatment comprising 12 sessions of cognitive behavioral therapy. Principal outcome measures were dissociative seizure frequency and psychosocial functioning, including improvement in employment status and mood. Measures were administered before treatment, at the end of treatment, and at a 6-month follow-up. Treatment was completed by 16 patients (questionnaire measures were not available for 4 patients who discontinued treatment). Following treatment, there was a highly significant reduction in seizure frequency and an improvement in self-rated psychosocial functioning. These improvements were maintained at the 6-month follow-up. There was also a tendency for patients to have improved their employment status between the start of treatment and the 6-month follow-up period. In this open prospective trial, cognitive behavioral therapy was associated with a reduction in dissociative seizure frequency and an improvement in psychosocial functioning in adults with dissociative seizures.

Cognitive Behavioral Therapy for Insomnia in Posttraumatic Stress Disorder: A Randomized Controlled Trial

PubMed Central

Talbot, Lisa S.; Maguen, Shira; Metzler, Thomas J.; Schmitz, Martha; McCaslin, Shannon E.; Richards, Anne; Perlis, Michael L.; Posner, Donn A.; Weiss, Brandon; Ruoff, Leslie; Varbel, Jonathan; Neylan, Thomas C.

2014-01-01

Study Objectives: Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. Design: Randomized controlled trial with two arms: CBT-I and monitor-only waitlist control. Setting: Department of Veterans Affairs (VA) Medical Center. Participants: Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Interventions: Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measurements and Results: Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Conclusions: Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress

Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial.

PubMed

ter Huurne, Elke D; de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne E L; DeJong, Cornelis A J

2015-06-18

Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous therapeutic support to improve eating disorder psychopathology, and to reduce body dissatisfaction and related health problems among patients with eating disorders. A two-arm open randomized controlled trial comparing a Web-based CBT intervention to a waiting list control condition (WL) was carried out among female patients with bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS). The eating disorder diagnosis was in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and was established based on participants' self-report. Participants were recruited from an open-access website, and the intervention consisted of a structured two-part program within a secure Web-based application. The aim of the first part was to analyze participant's eating attitudes and behaviors, while the second part focused on behavioral change. Participants had asynchronous contact with a personal therapist twice a week, solely via the Internet. Self-report measures of eating disorder psychopathology (primary outcome), body dissatisfaction, physical health, mental health, self-esteem, quality of life, and social functioning were completed at baseline and posttest. A total of 214 participants were randomized to either the Web-based CBT group (n=108) or to the WL group (n=106) stratified by type of eating disorder (BN: n=44; BED: n=85; EDNOS: n=85). Study attrition was low with 94% of the participants completing the posttest assignment. Overall, Web-based CBT showed a significant improvement over time for eating disorder psychopathology (F97=63.07, P<.001, d=.82) and all secondary outcome

Internet-based cognitive-behavior therapy for procrastination: A randomized controlled trial.

PubMed

Rozental, Alexander; Forsell, Erik; Svensson, Andreas; Andersson, Gerhard; Carlbring, Per

2015-08-01

Procrastination can be a persistent behavior pattern associated with personal distress. However, research investigating different treatment interventions is scarce, and no randomized controlled trial has examined the efficacy of cognitive-behavior therapy (CBT). Meanwhile, Internet-based CBT has been found promising for several conditions, but has not yet been used for procrastination. Participants (N = 150) were randomized to guided self-help, unguided self-help, and wait-list control. Outcome measures were administered before and after treatment, or weekly throughout the treatment period. They included the Pure Procrastination Scale, the Irrational Procrastination Scale, the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale-Self-report version, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. The intention-to-treat principle was used for all statistical analyses. Mixed-effects models revealed moderate between-groups effect sizes comparing guided and unguided self-help with wait-list control; the Pure Procrastination Scale, Cohen's d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the Irrational Procrastination Scale, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3-40.0% for guided self-help, compared with 24.0-36.0% for unguided self-help. Neither of the treatment conditions was found to be superior on any of the outcome measures, Fs(98, 65.17-72.55) < 1.70, p > .19. Internet-based CBT could be useful for managing self-reported difficulties due to procrastination, both with and without the guidance of a therapist. (c) 2015 APA, all rights reserved).

Trauma-Focused Cognitive Behavioral Therapy for Commercially Sexually Exploited Youth.

PubMed

Cohen, Judith A; Mannarino, Anthony P; Kinnish, Kelly

2017-06-01

Commercially sexually exploited children and adolescents ("commercially exploited youth")present numerous clinical challenges that have led some mental health providers to question whether current evidence-based treatments are adequate to address the needs of this population. This paper 1) addresses commonalities between the trauma experiences, responses and treatment challenges of commercially exploited youth and those of youth with complex trauma; 2) highlights the importance of careful assessment to guide case conceptualization and treatment planning for commercially exploited youth; and 3) describes strategies for implementing Trauma-Focused Cognitive Behavioral Therapy for complex trauma specific to these youth.

A Randomized Trial of Mindfulness-Based Cognitive Therapy for Children: Promoting Mindful Attention to Enhance Social-Emotional Resiliency in Children

ERIC Educational Resources Information Center

Semple, Randye J.; Lee, Jennifer; Rosa, Dinelia; Miller, Lisa F.

2010-01-01

Mindfulness-based cognitive therapy for children (MBCT-C) is a manualized group psychotherapy for children ages 9-13 years old, which was developed specifically to increase social-emotional resiliency through the enhancement of mindful attention. Program development is described along with results of the initial randomized controlled trial. We…

Group Cognitive-Behavioral Therapy for Auditory Hallucinations: A Pilot Study

ERIC Educational Resources Information Center

Pinkham, Amy E.; Gloege, Andrew T.; Flanagan, Steven; Penn, David L.

2004-01-01

In this article, we describe a pilot study that investigated the effectiveness of group cognitive behavioral therapy (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…

A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder.

PubMed

Gregory, Robert J; Remen, Anna L

2008-03-01

The authors introduce a manual-based treatment, labeled dynamic deconstructive psychotherapy, developed for those patients with borderline personality disorder who are most difficult to engage in therapy, such as those having co-occurring substance use disorders. This treatment model is based on the hypothesis that borderline pathology and related behaviors reflect impairment in specific neurocognitive functions, including association, attribution, and alterity that form the basis for a coherent and differentiated self. Dynamic deconstructive psychotherapy aims to activate and remediate neurocognitive self-capacities by facilitating elaboration of affect-laden interpersonal experiences and integration of attributions, as well as providing novel experiences in the patient-therapist relationship that promote self-other differentiation. Treatment involves weekly individual sessions for a predetermined period of time and follows sequential stages. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The Evolution of "Enhanced" Cognitive Behavior Therapy for Eating Disorders: Learning from Treatment Nonresponse

ERIC Educational Resources Information Center

Cooper, Zafra; Fairburn, Christopher G.

2011-01-01

In recent years there has been widespread acceptance that cognitive behavior therapy (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…

Individual Versus Group Cognitive-Behavioral Therapy for Partner-Violent Men: A Preliminary Randomized Trial.

PubMed

Murphy, Christopher M; Eckhardt, Christopher I; Clifford, Judith M; Lamotte, Adam D; Meis, Laura A

2017-04-01

A randomized clinical trial tested the hypothesis that a flexible, case formulation-based, individual treatment approach integrating motivational interviewing strategies with cognitive-behavioral therapy (ICBT) is more efficacious than a standardized group cognitive-behavioral approach (GCBT) for perpetrators of intimate partner violence (IPV). Forty-two men presenting for services at a community domestic violence agency were randomized to receive 20 sessions of ICBT or a 20-week group cognitive-behavioral therapy (CBT) program. Participants and their relationship partners completed assessments of relationship abuse and relationship functioning at baseline and quarterly follow-ups for 1 year. Treatment uptake and session attendance were significantly higher in ICBT than GCBT. However, contrary to the study hypothesis, GCBT produced consistently equivalent or greater benefits than ICBT. Participant self-reports revealed significant reductions in abusive behavior and injuries across conditions with no differential benefits between conditions. Victim partner reports revealed more favorable outcomes for group treatment, including a statistically significant difference in psychological aggression, and differences exceeding a medium effect size for physical assault, emotional abuse, and partner relationship adjustment. In response to hypothetical relationship scenarios, GCBT was associated with greater reductions than ICBT (exceeding a medium effect) in articulated cognitive distortions and aggressive intentions. Treatment competence ratings suggest that flexible, individualized administration of CBT creates challenges in session agenda setting, homework implementation, and formal aspects of relationship skills training. Although caution is needed in generalizing findings from this small-scale trial, the results suggest that the mutual support and positive social influence available in group intervention may be particularly helpful for IPV perpetrators.

Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders.

PubMed

Coffey, Scott F; Banducci, Anne N; Vinci, Christine

2015-11-01

Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, obsessive-compulsive and tic disorders, personality disorders, eating disorders, and insomnia. CBT uses targeted strategies to help patients adopt more adaptive patterns of thinking and behaving, which leads to positive changes in emotions and decreased functional impairments. Strategies include identifying and challenging problematic thoughts and beliefs, scheduling pleasant activities to increase environmental reinforcement, and extended exposure to unpleasant thoughts, situations, or physiologic sensations to decrease avoidance and arousal associated with anxiety-eliciting stimuli. CBT can be helpful in the treatment of posttraumatic stress disorder by emphasizing safety, trust, control, esteem, and intimacy. Prolonged exposure therapy is a CBT technique that includes a variety of strategies, such as repeated recounting of the trauma and exposure to feared real-world situations. For attention-deficit/hyperactivity disorder, CBT focuses on establishing structures and routines, and clear rules and expectations within the home and classroom. Early intensive behavioral interventions should be initiated in children with autism before three years of age; therapy consists of 12 to 40 hours of intensive treatment per week, for at least one year. In many disorders, CBT can be used alone or in combination with medications. However, CBT requires a significant commitment from patients. Family physicians are well suited to provide collaborative care for patients with psychiatric disorders, in concert with cognitive behavior therapists.

Evolution of cognitive-behavioral therapy for eating disorders.

PubMed

Agras, W Stewart; Fitzsimmons-Craft, Ellen E; Wilfley, Denise E

2017-01-01

The evolution of cognitive-behavioral therapy (CBT) for the treatment of bulimic disorders is described in this review. The impacts of successive attempts to enhance CBT such as the addition of exposure and response prevention; the development of enhanced CBT; and broadening the treatment from bulimia nervosa to binge eating disorder are considered. In addition to developing advanced forms of CBT, shortening treatment to guided self-help was the first step in broadening access to treatment. The use of technology such as computer-based therapy and more recently the Internet, promises further broadening of access to self-help and to therapist guided treatment. Controlled studies in this area are reviewed, and the balance of risks and benefits that accompany the use of technology and lessened therapist input are considered. Looking into the future, more sophisticated forms of treatment delivered as mobile applications ("apps") may lead to more personalized and efficacious treatments for bulimic disorders, thus enhancing the delivery of treatments for eating disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies.

PubMed

Kobak, Kenneth A; Wolitzky-Taylor, Kate; Craske, Michelle G; Rose, Raphael D

2017-04-01

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT.

Cognitive mediators of treatment for social anxiety disorder: comparing acceptance and commitment therapy and cognitive-behavioral therapy.

PubMed

Niles, Andrea N; Burklund, Lisa J; Arch, Joanna J; Lieberman, Matthew D; Saxbe, Darby; Craske, Michelle G

2014-09-01

To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n=25) or ACT (n=25) for DSM-IV social anxiety disorder. Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms. Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT. Copyright © 2014. Published by Elsevier Ltd.

Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy

PubMed Central

Niles, Andrea N.; Burklund, Lisa J.; Arch, Joanna J.; Lieberman, Matthew D.; Saxbe, Darby; Craske, Michelle G.

2016-01-01

Objective To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Method Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n = 25) for DSM-IV social anxiety disorder. Results Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms. Conclusions Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT. PMID:25022777

Evaluation of Group Cognitive Behavioral Therapy for Adults with ADHD

ERIC Educational Resources Information Center

Bramham, Jessica; Young, Susan; Bickerdike, Alison; Spain, Deborah; McCartan, Denise; Xenitidis, Kiriakos

2009-01-01

Objective: A brief cognitive behavioral therapy (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 Beck Initiative: Training School-Based Mental Health Staff in Cognitive Therapy

ERIC Educational Resources Information Center

Creed, Torrey A.; Jager-Hyman, Shari; Pontoski, Kristin; Feinberg, Betsy; Rosenberg, Zachary; Evans, Arthur; Hurford, Matthew O.; Beck, Aaron T.

2013-01-01

A growing literature supports cognitive therapy (CT) as an efficacious treatment for youth struggling with emotional or behavioral problems. Recently, work in this area has extended the dissemination of CT to school-based settings. The current study has two aims: 1) to examine the development of therapists' knowledge and skills in CT, an…

An Open Trial of Intensive Family Based Cognitive-Behavioral Therapy in Youth with Obsessive-Compulsive Disorder Who Are Medication Partial Responders or Nonresponders

ERIC Educational Resources Information Center

Storch, Eric A.; Lehmkuhl, Heather D.; Ricketts, Emily; Geffken, Gary R.; Marien, Wendi; Murphy, Tanya K.

2010-01-01

This study reports an open-trial of family-based cognitive-behavioral therapy (CBT) in children and adolescents with obsessive-compulsive disorder (OCD). Thirty primarily Caucasian youth with OCD (range = 7-19 years; 15 girls) who were partial responders or nonresponders to two or more medication trials that were delivered either serially or…

Distinguishing integrative from eclectic practice in cognitive behavioral therapies.

PubMed

Petrik, Alexandra M; Kazantzis, Nikolaos; Hofmann, Stefan G

2013-09-01

In psychotherapy research, practice, and training, there remains marked controversy about the merits of theoretical purism (i.e., model specific), versus integration, as well as how such principles may be represented in practice. Adding to the confusion is that many attributes of the therapeutic relationship, processes in therapy, and techniques have been popularized in the context of one or two theoretical approaches, but are incorporated into the practice of many approaches. This article demonstrates the various ways in which three core interventions (i.e., activity scheduling, self-monitoring, and identification, evaluation, and modification of thoughts) can be applied within the context of different cognitive and behavioral therapeutic models. It also demonstrates the role of in-session therapist language in describing the theoretical basis and processes underpinning therapeutic interventions. Case examples are presented to illustrate therapy provided by two hypothetical clinicians, Therapist A and Therapist B. Whether or not a practitioner elects to practice integrative psychotherapy, we advocate for consistency in the theoretical approach through the course of a service for a particular patient. Implications are outlined and discussed within the context of the current state of cognitive and behaviorally focused psychotherapies and integrative psychotherapy. 2013 APA, all rights reserved

Meditation for Depression: A Systematic Review of Mindfulness-Based Cognitive Therapy for Major Depressive Disorder

DTIC Science & Technology

2015-10-01

studies. Physical Therapy Reviews, 13(5), 355-365. Systematic review Piet, J., and Hougaard, E. (2011). The effect of mindfulness-based cognitive...Rutger I. and Probst, M. (2013). A systematic review on physical therapy interventions for patients with binge eating disorder. Disability and...disorder; persistent antisocial behavior; persistent self-injury requiring clinical management/ therapy ; unable to engage with MBCT for physical

A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder.

PubMed

Mendes, Deise D; Mello, Marcelo Feijó; Ventura, Paula; Passarela, Cristiane De Medeiros; Mari, Jair de Jesus

2008-01-01

Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy were unable to detect differences between CBT and other psychotherapies. The purpose of this study was to conduct systematic review on the efficacy ofCBT in comparison with studies that used other psychotherapy techniques. Databases were searched using the following terms: posttraumatic stress disorder/stress disorder, treatment/psychotherapy/behavior cognitive therapy, randomized trials, and adults. Randomized clinical trials published between 1980 and 2005 and that compared CBT with other treatments for PTSD was included. The main outcomes were remission, clinical improvement, dropout rates and changes in symptoms. The 23 clinical trials included in the review comprised 1923 patients: 898 in the treatment group and 1,025 in the control group. CBT had better remission rates than EMDR (RR = 0.35; 95% CI: 0.16; 0.79; p = 0.01) or supportive therapies (RR = 0.43; 95% CI: 0.25; 0.74; p = 0.002, completer analysis). CBT was comparable to Exposure Therapy (ET) (RR = 0.90; 95% CI: 0.58; 1.40; p = 0.64), and cognitive therapy (CT) (RR = 1.01; 95% CI: 0.67; 1.51; p = 0.98) in terms of efficacy and compliance. These findings suggest that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.

The evolution of cognitive behavior therapy for schizophrenia: current practice and recent developments.

PubMed

Tai, Sara; Turkington, Douglas

2009-09-01

Cognitive behavior therapy (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.

The Evolution of Cognitive Behavior Therapy for Schizophrenia: Current Practice and Recent Developments

PubMed Central

Tai, Sara; Turkington, Douglas

2009-01-01

Cognitive behavior therapy (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 impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder.

PubMed

Price, Matthew; Anderson, Page L

2011-02-01

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 behavioral therapy (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. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Impact of Cognitive Behavioral Therapy on Post Event Processing Among Those with Social Anxiety Disorder

PubMed Central

Price, Matthew; Anderson, Page L.

2011-01-01

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 behavioral therapy (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

Controlled Comparison of Family Cognitive Behavioral Therapy and Psychoeducation/Relaxation Training for Child Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Piacentini, John; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Peris, Tara; Wood, Jeffrey J.; McCracken, James

2011-01-01

Objective: To examine the efficacy of exposure-based cognitive-behavioral therapy (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…

ADHD Symptom Severity following Participation in a Pilot, 10-Week, Manualized, Family-Based Behavioral Intervention

ERIC Educational Resources Information Center

Curtis, David F.

2010-01-01

This investigation examined the effectiveness of a pilot, manualized 10-week intervention of family skills training for ADHD-related symptoms. The intervention combined behavioral parent training and child focused behavioral activation therapy. Participants were families with children ages 7-10 diagnosed with ADHD-Combined Type. This pilot…

[Treatment of substance dependence by a bio-cognitive model based on behavioral pharmacology].

PubMed

Hori, Toru; Komiyama, Tokutaro; Harada, Seiichi; Matsumoto, Takenori

2005-01-01

We have introduced cognitive behavior therapy (CBT) into the treatment of substance dependence patients, which involves disease education and focused group therapy to obtain insight into the taking behavior and to establish concrete countermeasures to prevent relapse. We have created a bio-cognitive model based on biological aspects to explain the pathology of substance dependence. 'Dependence' is a term in behavioral pharmacology defined as reinforced drug seeking and taking behavior. Changes in taking behavior are thought to occur due to the repetition of the reinforcement action of psychoactive substances in the reward system of the brain. Therefore, when intake desire is strong, it is hard for patients to control themselves, and there is a feature of difficulties considering the process of thinking in CBT. In other words, when craving becomes strong, a chain of behavior happens spontaneously, without schema, involving automatic thoughts. We think that the improvement of protracted withdrawal syndrome (PWS) and entire frontal lobe function are important in learning to discern distortion of cognition. When PWS is improved, a conflict is easy to bring about in the process of drug seeking and taking behavior. And, it is easy to execute avoidance plans (coping skills) which are established to cope with craving in advance. We think that a goal for treatment is to discern drug seeking and taking behavior with natural emotion. The recovery of PWS and frontal lobe dysfunction takes a long time with a serious dependence, so we must perform repetition of CBT. As the treatment introduction of involuntary admission cases is adequate or cases of 1 to 3 months of admission treatment based on voluntary admission are hard to treat, treatment to obtain insights into patients while carrying out repeated CBT using a bio-cognitive model and to improve PWS could be a possibility as one treatment for the pathology of diversified substance dependence.

Cognitive Therapy for Obsessive-Compulsive Disorder: A Case Example

ERIC Educational Resources Information Center

Chosak, Anne; Marques, Luana; Fama, Jeanne; Renaud, Stefanie; Wilhelm, Sabine

2009-01-01

Cognitive therapy for OCD is an empirically validated alternative to the more widely used and validated behavioral therapy for OCD. The cognitive approach is based on the premise that belief systems contribute importantly to the development and maintenance of all types of OCD. By identifying and challenging maladaptive thoughts, beliefs, and core…

Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis.

PubMed

Zhang, Yingshi; Cai, Jiayi; An, Li; Hui, Fuhai; Ren, Tianshu; Ma, Hongda; Zhao, Qingchun

2017-05-01

Demographic aging is a worldwide phenomenon, cognitive and behavioral impairment is becoming global burden of nerve damage. However, the effect of pharmacological treatment is not satisfying. Therefore, we analyzed the efficacy of music therapy in elderly dementia patients, and if so, whether music therapy can be used as first-line non-pharmacological treatment. A comprehensive literature search was performed on PubMed, EMbase and the Cochrane Library from inception to September 2016. A total of 34 studies (42 analyses, 1757 subjects) were included; all of them had an acceptable quality based on the PEDro and CASP scale scores. Studies based on any type of dementia patient were combined and analyzed by subgroup. The standardized mean difference was -0.42 (-0.74 to -0.11) for disruptive behavior and 0.20 (-0.09 to 0.49) for cognitive function as primary outcomes in random effect models using controls as the comparator; the secondary outcomes were depressive score, anxiety and quality of life. No evidence of publication bias was found based on Begg's and Egger's test. The meta-analysis confirmed that the baseline differences between the two groups were balanced. Subgroup analyses showed that disease sub-type, intervention method, comparator, subject location, trial design, trial period and outcome measure instrument made little difference in outcomes. The meta-regression may have identified the causes of heterogeneity as the intervention method, comparator and trial design. Music therapy was effective when patients received interactive therapy with a compared group. There was positive evidence to support the use of music therapy to treat disruptive behavior and anxiety; there were positive trends supporting the use of music therapy for the treatment of cognitive function, depression and quality of life. This study is registered with PROSPERO, number CRD42016036153. Copyright © 2016 Elsevier B.V. All rights reserved.

Development and Validation of the Cognitive-Behavioral Therapy Skills Questionnaire

ERIC Educational Resources Information Center

Jacob, Karen L.; Christopher, Michael S.; Neuhaus, Edmund C.

2011-01-01

Although several theories exist to describe why patients improve in cognitive-behavioral therapy (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,…

Moderators and non-specific predictors of treatment outcome for anxiety disorders: a comparison of cognitive behavioral therapy to acceptance and commitment therapy.

PubMed

Wolitzky-Taylor, Kate B; Arch, Joanna J; Rosenfield, David; Craske, Michelle G

2012-10-01

Understanding for whom, and under what conditions, treatments exert their greatest effects is essential for developing personalized medicine. Research investigating moderators of outcome among evidence-based treatments for anxiety disorders is lacking. The current study examined several theory-driven and atheoretical putative moderators of outcome in cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Eighty-seven patients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) anxiety disorder completed 12 sessions of ACT or CBT and were assessed with a self-report measure of anxiety at baseline, post-treatment, and 6- and 12-month follow-up assessments. CBT outperformed ACT among those at moderate levels of baseline anxiety sensitivity, and among those with no comorbid mood disorder. ACT outperformed CBT among those with comorbid mood disorders. Higher baseline neuroticism was associated with poorer outcome across treatment conditions. Neither moderation nor general prediction was observed for baseline anxiety disorder comorbidity, race/ethnicity, gender, age, or baseline severity of the principal anxiety disorder. When including all randomized participants who completed the pre-treatment assessment (N = 121), a similar pattern was observed. Prescriptive recommendations for clinical practice and directions for future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Cognitive Behavioral Therapy for Depressed Adults with Mild Intellectual Disability: A Pilot Study

PubMed Central

Hartley, Sigan L; Esbensen, Anna J; Shalev, Rebecca; Vincent, Lori B; Mihaila, Iulia; Bussanich, Paige

2015-01-01

Background There is a paucity of research on psychosocial treatments for depression in adults with intellectual disability (ID). In this pilot study, we explored the efficacy of a group CBT treatment that involved a caregiver component in adults with mild ID with a depressive disorder. Method Sixteen adults with mild ID and a depressive disorder participated in a 10-week group CBT treatment and 8 adults with mild ID with a depressive disorder served as a treatment as usual (TAU) control group. Adults with mild ID and caregivers completed measures of depressive symptoms, behavior problems, and social skills at pre-treatment, post-treatment, and a 3-month follow-up. Adults with mild ID also completed a series of tasks to measure their understanding of the principles of cognitive therapy pre- and post-treatment. Results The CBT group demonstrated significant decreases in depressive symptoms and behavior problems from pre-treatment to post-treatment and these effects were maintained at a 3-month follow-up. The CBT group demonstrated significant improvements in their ability to infer emotions and thoughts based on various situation-thought-emotion pairings from pre-treatment to post-treatment. Conclusions Findings indicate that adults with mild ID with a depressive disorder benefitted from a group CBT treatment with a caregiver component. Moreover, adults with mild ID appeared to benefit, at least in part, from the cognitive therapy components of the treatment, in addition to the behavior therapy components. PMID:26925187

Extending Cognitive-Behavioral Therapy for Late-Life Anxiety to Home Care: Program Development and Case Examples

ERIC Educational Resources Information Center

Diefenbach, Gretchen J.; Tolin, David F.; Gilliam, Christina M.; Meunier, Suzanne A.

2008-01-01

Data suggesting that cognitive-behavioral therapy (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…

Cognitive-Behavior Therapy for Disaster-Exposed Youth with Posttraumatic Stress: Results from a Multiple-Baseline Examination

ERIC Educational Resources Information Center

Taylor, Leslie K.; Weems, Carl F.

2011-01-01

Youth traumatized by natural disasters report high levels of posttraumatic stress such as symptoms of posttraumatic stress disorder, other anxiety disorders, and depression. Research suggests that cognitive behavioral therapies are promising interventions for symptom reduction; however, few cognitive behavioral treatments have been systematically…

Yoga-Enhanced Cognitive Behavioral Therapy (Y-CBT) for Anxiety Management: A Pilot Study

PubMed Central

Khalsa, Manjit K.; Greiner-Ferris, Julie M.; Hofmann, Stefan G.; Khalsa, Sat Bir S.

2014-01-01

Cognitive behavioral therapy is an effective treatment for generalized anxiety disorder (GAD), but there is still room for improvement. The aim of the present study was to examine the potential benefit of enriching cognitive behavioral therapy (CBT) with Kundalini Yoga (Y-CBT). Participants consisted of treatment resistant clients at a community mental health clinic. A total of 32 participants enrolled in the study and 22 completed the program. After the Y-CBT intervention, pre-post comparisons showed statistically significant improvements in state and trait anxiety, depression, panic, sleep, and quality of life. Results from this preliminary study suggest that Y-CBT may have potential as a promising treatment for those suffering from GAD. PMID:24804619

Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial.

PubMed

Brakemeier, Eva-Lotta; Merkl, Angela; Wilbertz, Gregor; Quante, Arnim; Regen, Francesca; Bührsch, Nicole; van Hall, Franziska; Kischkel, Eva; Danker-Hopfe, Heidi; Anghelescu, Ion; Heuser, Isabella; Kathmann, Norbert; Bajbouj, Malek

2014-08-01

Although electroconvulsive therapy (ECT) is the most effective acute antidepressant intervention, sustained response rates are low. It has never been systematically assessed whether psychotherapy, continuation ECT, or antidepressant medication is the most efficacious intervention to maintain initial treatment response. In a prospective, randomized clinical trial, 90 inpatients with major depressive disorder (MDD) were treated with right unilateral ultra-brief acute ECT. Electroconvulsive therapy responders received 6 months guideline-based antidepressant medication (MED) and were randomly assigned to add-on therapy with cognitive-behavioral group therapy (CBT-arm), add-on therapy with ultra-brief pulse continuation electroconvulsive therapy (ECT-arm), or no add-on therapy (MED-arm). After the 6 months of continuation treatment, patients were followed-up for another 6 months. The primary outcome parameter was the proportion of patients who remained well after 12 months. Of 90 MDD patients starting the acute phase, 70% responded and 47% remitted to acute ECT. After 6 months of continuation treatment, significant differences were observed in the three treatment arms with sustained response rates of 77% in the CBT-arm, 40% in the ECT-arm, and 44% in the MED-arm. After 12 months, these differences remained stable with sustained response rates of 65% in the CBT-arm, 28% in the ECT-arm, and 33% in the MED-arm. These results suggest that ultra-brief pulse ECT as a continuation treatment correlates with low sustained response rates. However, the main finding implicates cognitive-behavioral group therapy in combination with antidepressants might be an effective continuation treatment to sustain response after successful ECT in MDD patients. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Cognitive remediation therapy and cognitive behavioral therapy with an older adult with anorexia nervosa: A brief case report.

PubMed

Darcy, Alison M; Fitzpatrick, Kara K; Lock, James

2016-06-01

Cognitive remediation therapy represents a new approach to the treatment of anorexia nervosa (AN) emerging from research, suggesting that adults with chronic AN have specific neurocognitive inefficiencies. Specifically, adults with AN demonstrate an overly detailed cognitive processing bias (Roberts, Tchanturia, & Treasure, 2013) and difficulties shifting set quickly and efficiently (Roberts, Tchanturia, Stahl, Southgate, & Treasure, 2007). These characteristics manifest as rigid, rule-bound, and detail-focused cognitions, beliefs, and behaviors. Versions of these problems appear to persist after weight restoration (Tchanturia et al., 2004) and are observable in patient's healthy sisters (Roberts et al., 2013). Thus, central coherence difficulties and set-shifting problems have been proposed as endophenotypes and maintaining factors of AN (Roberts et al., 2013). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.

2006-01-01

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 behavioral therapy based on…

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies

PubMed Central

Kobak, Kenneth A.; Wolitzky-Taylor, Kate; Craske, Michelle G.; Rose, Raphael D.

2016-01-01

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT. PMID:28435174

Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial

PubMed Central

de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne EL; DeJong, Cornelis AJ

2015-01-01

Background Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. Objective This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous therapeutic support to improve eating disorder psychopathology, and to reduce body dissatisfaction and related health problems among patients with eating disorders. Methods A two-arm open randomized controlled trial comparing a Web-based CBT intervention to a waiting list control condition (WL) was carried out among female patients with bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS). The eating disorder diagnosis was in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and was established based on participants’ self-report. Participants were recruited from an open-access website, and the intervention consisted of a structured two-part program within a secure Web-based application. The aim of the first part was to analyze participant’s eating attitudes and behaviors, while the second part focused on behavioral change. Participants had asynchronous contact with a personal therapist twice a week, solely via the Internet. Self-report measures of eating disorder psychopathology (primary outcome), body dissatisfaction, physical health, mental health, self-esteem, quality of life, and social functioning were completed at baseline and posttest. Results A total of 214 participants were randomized to either the Web-based CBT group (n=108) or to the WL group (n=106) stratified by type of eating disorder (BN: n=44; BED: n=85; EDNOS: n=85). Study attrition was low with 94% of the participants completing the posttest assignment. Overall, Web-based CBT showed a significant improvement over time for eating disorder psychopathology (F 97

Web-based therapist training on cognitive behavior therapy for anxiety disorders: a pilot study.

PubMed

Kobak, Kenneth A; Craske, Michelle G; Rose, Raphael D; Wolitsky-Taylor, Kate

2013-06-01

The need for clinicians to use evidence-based practices (such as cognitive behavior therapy [CBT]) is now well recognized. However, a gap exists between the need for empirically based treatments and their availability. This is due, in part, to a shortage of clinicians formally trained on CBT. To address this problem, we developed a Web-based therapist CBT training program, to increase accessibility to this training. The program uses a two-step approach: an interactive multimedia online tutorial for didactic training on CBT concepts, followed by live remote observation through a videoconference of trainees conducting CBT, with immediate feedback in real time during critical moments to enhance learning through iterative guidance and practice. Thirty-nine clinicians from around the county completed the online didactic training and 22 completed the live remote training. Results found a significant increase in knowledge of CBT concepts and a significant increase in clinical skills, as judged by a blind rater. User satisfaction was high for both the online tutorial and the videoconference training. Utilization of CBT by trainees increased after training. Results support the acceptability and effectiveness of this Web-based approach to training.

Brief Cognitive-Behavioral Therapy for Anxious Youth: The Inner Workings

ERIC Educational Resources Information Center

Beidas, Rinad S.; Mychailyszyn, Matthew P.; Podell, Jennifer L.; Kendall, Philip C.

2013-01-01

We provide a detailed description of the clinical application of brief cognitive-behavioral therapy (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…

A Randomized Controlled Trial of Cognitive-Behavioral Therapy, Light Therapy, and Their Combination for Seasonal Affective Disorder

ERIC Educational Resources Information Center

Rohan, Kelly J.; Roecklein, Kathryn A.; Tierney Lindsey, Kathryn; Johnson, Leigh G.; Lippy, Robert D.; Lacy, Timothy J.; Barton, Franca B.

2007-01-01

This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive-behavioral therapy (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…

Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers.

PubMed

Pratt, Rebekah; Ahmed, Nimo; Noor, Sahra; Sharif, Hiba; Raymond, Nancy; Williams, Chris

2017-02-01

To test the feasibility and acceptability of implementing an evidence-based, peer-delivered mental health intervention for Somali women in Minnesota, and to assess the impact of the intervention on the mental health of those who received the training. In a feasibility study, 11 Somali female community health workers were trained to deliver an 8-session cognitive behavioral therapy intervention. Each of the trainers recruited 5 participants through community outreach, resulting in 55 participants in the intervention. Self-assessed measures of mood were collected from study participants throughout the intervention, and focus groups were conducted. The 55 Somali women who participated recorded significant improvements in mood, with self-reported decreases in anxiety and increases in happiness. Focus group data showed the intervention was well received, particularly because it was delivered by a fellow community member. Participants reported gaining skills in problem solving, stress reduction, and anger management. Participants also felt that the intervention helped to address some of the stigma around mental health in their community. Delivery of cognitive behavioral therapy by a community health workers offered an acceptable way to build positive mental health in the Somali community.

Cost Effectiveness of Individual versus Group Cognitive Behavior Therapy for Problems of Depression and Anxiety in an HMO Population.

ERIC Educational Resources Information Center

Shapiro, Joan; And Others

1982-01-01

Compared the cost effectiveness of cognitive behavior group therapy, traditional process-oriented interpersonal group, and individual cognitive behavior therapy in dealing with depression and anxiety in a health maintenance organization population (N=44). Results suggest that cost considerations can become relatively important when decisions are…

The Role of Homework in Cognitive-Behavioral Therapy for Cocaine Dependence

ERIC Educational Resources Information Center

Gonzalez, Vivian M.; Schmitz, Joy M.; DeLaune, Katherine A.

2006-01-01

This study examines the effect of homework compliance on treatment outcome in 123 participants receiving cognitive-behavioral therapy (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…

Coping Styles, Homework Compliance, and the Effectiveness of Cognitive-Behavioral Therapy.

ERIC Educational Resources Information Center

Burns, David D.; Nolen-Hoeksema, Susan

1991-01-01

Factor analysis of Self-Help Inventory from 307 outpatients receiving cognitive-behavioral therapy for affective disorders revealed 3 factors that assessed frequency of active coping strategies use when depressed, helpfulness of strategies, and willingness to learn new strategies. Frequency and Helpfulness scales were not correlated with patient…

Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial.

PubMed

Talbot, Lisa S; Maguen, Shira; Metzler, Thomas J; Schmitz, Martha; McCaslin, Shannon E; Richards, Anne; Perlis, Michael L; Posner, Donn A; Weiss, Brandon; Ruoff, Leslie; Varbel, Jonathan; Neylan, Thomas C

2014-02-01

Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. RANDOMIZED CONTROLLED TRIAL WITH TWO ARMS: CBT-I and monitor-only waitlist control. Department of Veterans Affairs (VA) Medical Center. Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress disorder should include behavioral sleep medicine. TRIAL NAME: Cognitive Behavioral Treatment Of Insomnia

Neural substrates of treatment response to cognitive-behavioral therapy in panic disorder with agoraphobia.

PubMed

Lueken, Ulrike; Straube, Benjamin; Konrad, Carsten; Wittchen, Hans-Ulrich; Ströhle, Andreas; Wittmann, André; Pfleiderer, Bettina; Uhlmann, Christina; Arolt, Volker; Jansen, Andreas; Kircher, Tilo

2013-11-01

Although exposure-based cognitive-behavioral therapy (CBT) is an effective treatment option for panic disorder with agoraphobia, the neural substrates of treatment response remain unknown. Evidence suggests that panic disorder with agoraphobia is characterized by dysfunctional safety signal processing. Using fear conditioning as a neurofunctional probe, the authors investigated neural baseline characteristics and neuroplastic changes after CBT that were associated with treatment outcome in patients with panic disorder with agoraphobia. Neural correlates of fear conditioning and extinction were measured using functional MRI before and after a manualized CBT program focusing on behavioral exposure in 49 medication-free patients with a primary diagnosis of panic disorder with agoraphobia. Treatment response was defined as a reduction exceeding 50% in Hamilton Anxiety Rating Scale scores. At baseline, nonresponders exhibited enhanced activation in the right pregenual anterior cingulate cortex, the hippocampus, and the amygdala in response to a safety signal. While this activation pattern partly resolved in nonresponders after CBT, successful treatment was characterized by increased right hippocampal activation when processing stimulus contingencies. Treatment response was associated with an inhibitory functional coupling between the anterior cingulate cortex and the amygdala that did not change over time. This study identified brain activation patterns associated with treatment response in patients with panic disorder with agoraphobia. Altered safety signal processing and anterior cingulate cortex-amygdala coupling may indicate individual differences among these patients that determine the effectiveness of exposure-based CBT and associated neuroplastic changes. Findings point to brain networks by which successful CBT in this patient population is mediated.

Effectiveness of cognitive behavioral therapy on health-related quality of life: An evaluation of therapies provided by trainee therapists.

PubMed

Henriksson, Sophie; Anclair, Malin; Hiltunen, Arto J

2016-06-01

The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health-related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

[Parental involvement in cognitive-behavioral therapy for children with anxiety disorders].

PubMed

Aydın, Arzu

2014-01-01

A growing body of literature suggests that parents play a critical role in the development and/or maintenance of child anxiety. One of the main purposes of this article is to identify common parental involvement techniques and most common obstacles derived from parents in cognitive behavioral therapy (CBT) with anxious children. Another purpose of the present study is to revise empirical studies comparing child-focused CBT with and without parental involvement. The PsycARTICLES, MEDLINE and PubMed databases were searched to identify articles in English that were published between the years of 1990 and 2012 (October) using the following keywords; (1) anxiety, (2) cognitive behavioral therapy, (3) parental involvement. Studies were only included in this review if they were comparing the treatment effect of child-only CBT and CBT with additional parental components. Thirteen studies were introduced in the context of method (diagnosis of children, age range of children, follow-up, results, etc.) and therapy characteristics (number of sessions, frequency of sessions, treatment components both child focused CBT and CBT with parental involvement, etc.). The common techniques of therapy with parental involvement are psychoeducation, contingency management, cognitive restructuring, reducing parental anxiety, improving parent-child relationship, and relapse prevention. Parental psychopathology, parental inappropriate expectations and family dysfunctions are important difficulties derived from parents in CBT with anxious children. The results of the studies suggested that parental involvement have increased the efficacy of the treatment in CBT especially working with young children and having at least one anxious parent.

Using a digital game for training desirable behavior in cognitive-behavioral therapy of burnout syndrome: a controlled study.

PubMed

Zielhorst, Thomas; van den Brule, Daphne; Visch, Valentijn; Melles, Marijke; van Tienhoven, Sam; Sinkbaek, Helle; Schrieken, Bart; Tan, Eduard S-H; Lange, Alfred

2015-02-01

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-behavioral therapy (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.

Comparing systemic therapy and cognitive behavioral therapy for social anxiety disorders: study protocol for a randomized controlled pilot trial.

PubMed

Hunger, Christina; Hilzinger, Rebecca; Koch, Theresa; Mander, Johannes; Sander, Anja; Bents, Hinrich; Schweitzer, Jochen

2016-03-31

Social anxiety disorders are among the most prevalent anxiety disorders in the general population. The efficacy of cognitive behavioral therapy (CBT) for social anxiety disorders is well demonstrated. However, only three studies point to the efficacy of systemic therapy (ST) in anxiety disorders, and only two of them especially focus on social anxiety disorders. These ST studies either do not use a good comparator but minimal supportive therapy, they do not use a multi-person ST but a combined therapy, or they do not especially focus on social anxiety disorders but mood and anxiety disorders in general. Though ST was approved as evidence based in Germany for a variety of disorders in 2008, evidence did not include anxiety disorders. This is the first pilot study that will investigate multi-person ST, integrating a broad range of systemic methods, specifically for social anxiety disorders and that will compare ST to the "gold standard" CBT. This article describes the rationale and protocol of a prospective, open, interventive, balanced, bi-centric, pilot randomized controlled trial (RCT). A total of 32 patients with a primary SCID diagnosis of social anxiety disorder will be randomized to either CBT or ST. Both treatments will be manualized. The primary outcome will include social anxiety symptoms at the end of therapy. Therapy will be restricted to no more than 26 hours (primary endpoint). Secondary outcomes will include psychological, social systems and interpersonal functioning, symptom adjustment, and caregiver burden, in addition to change measures, therapist variables and treatment adherence. At the secondary endpoints, 9 and 12 months after the beginning of therapy, we will again assess all outcomes. The study is expected to pilot test a RCT which will be the first to directly compare CBT and multi-person ST, integrating a broad range of systemic methods, for social anxiety disorders, and it will provide empirical evidence for the calculation of the number of

Effects of cognitive-behavioral conjoint therapy for PTSD on partners' psychological functioning.

PubMed

Shnaider, Philippe; Pukay-Martin, Nicole D; Fredman, Steffany J; Macdonald, Alexandra; Monson, Candice M

2014-04-01

A number of studies have documented that posttraumatic stress disorder (PTSD) symptoms in "one" partner are negatively associated with their intimate partner's psychological functioning. The present study investigated intimate partners' mental health outcomes (i.e., depression, anxiety, and anger) in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioral conjoint therapy for PTSD (Monson & Fredman, 2012). There were no significant differences between active treatment and waitlist in intimate partners' psychological functioning at posttreatment. Subgroup analyses, however, of partners exhibiting clinical levels of distress at pretreatment on several measures showed reliable and clinically significant improvements in their psychological functioning at posttreatment and no evidence of worsening. Results suggest that cognitive-behavioral conjoint therapy for PTSD may have additional benefits for partners presenting with psychological distress. Copyright © 2014 International Society for Traumatic Stress Studies.

Randomized controlled trial of false safety behavior elimination therapy: a unified cognitive behavioral treatment for anxiety psychopathology.

PubMed

Schmidt, Norman B; Buckner, Julia D; Pusser, Andrea; Woolaway-Bickel, Kelly; Preston, Jennifer L; Norr, Aaron

2012-09-01

We tested the efficacy of a unified cognitive-behavioral therapy protocol for anxiety disorders. This group treatment protocol, termed false safety behavior elimination therapy (F-SET), is a cognitive-behavioral approach designed for use across various anxiety disorders such as panic disorder (PD), social anxiety disorder (SAD), and generalized anxiety disorder (GAD). F-SET simplifies, as well as broadens, key therapeutic elements of empirically validated treatments for anxiety disorders to allow for easier delivery to heterogeneous groups of patients with anxiety psychopathology. Patients with a primary anxiety disorder diagnosis (N=96) were randomly assigned to F-SET or a wait-list control. Data indicate that F-SET shows good efficacy and durability when delivered to mixed groups of patients with anxieties (i.e., PD, SAD, GAD) by relatively inexperienced clinicians. Findings are discussed in the context of balancing treatment efficacy and clinical utility. Copyright © 2012. Published by Elsevier Ltd.

Cognitive-behavioral therapy induces sensorimotor and specific electrocortical changes in chronic tic and Tourette's disorder.

PubMed

Morand-Beaulieu, Simon; O'Connor, Kieron P; Sauvé, Geneviève; Blanchet, Pierre J; Lavoie, Marc E

2015-12-01

Tic disorders, such as the Gilles de la Tourette syndrome and persistent tic disorder, are neurodevelopmental movement disorders involving impaired motor control. Hence, patients show repetitive unwanted muscular contractions in one or more parts of the body. A cognitive-behavioral therapy, with a particular emphasis on the psychophysiology of tic expression and sensorimotor activation, can reduce the frequency and intensity of tics. However, its impact on motor activation and inhibition is not fully understood. To study the effects of a cognitive-behavioral therapy on electrocortical activation, we recorded the event-related potentials (ERP) and lateralized readiness potentials (LRP), before and after treatment, of 20 patients with tic disorders and 20 healthy control participants (matched on age, sex and intelligence), during a stimulus-response compatibility inhibition task. The cognitive-behavioral therapy included informational, awareness training, relaxation, muscle discrimination, cognitive restructuration and relapse prevention strategies. Our results revealed that prior to treatment; tic patients had delayed stimulus-locked LRP onset latency, larger response-locked LRP peak amplitude, and a frontal overactivation during stimulus inhibition processing. Both stimulus-locked LRP onset latency and response-locked LRP peak amplitude normalized after the cognitive behavioral therapy completion. However, the frontal overactivation related to inhibition remained unchanged following therapy. Our results showed that P300 and reaction times are sensitive to stimulus-response compatibility, but are not related to tic symptoms. Secondly, overactivity of the frontal LPC and impulsivity in TD patients were not affected by treatment. Finally, CBT had normalizing effects on the activation of the pre-motor and motor cortex in TD patients. These results imply specific modifications of motor processes following therapy, while inhibition processes remained unchanged. Given

Cost-Effectiveness of Group and Internet Cognitive Behavioral Therapy for Insomnia in Adolescents: Results from a Randomized Controlled Trial

PubMed Central

De Bruin, Eduard J.; van Steensel, Francisca J.A.; Meijer, Anne Marie

2016-01-01

Study Objectives: To investigate cost-effectiveness of adolescent cognitive behavioral therapy for insomnia (CBTI) in group- and Internet-delivered formats, from a societal perspective with a time horizon of 1 y Methods: Costs and effects data up to 1-y follow-up were obtained from a randomized controlled trial (RCT) comparing Internet CBTI to face-to-face group CBTI. The study was conducted at the laboratory of the Research Institute of Child Development and Education at the University of Amsterdam, and the academic youth mental health care center UvAMinds in Amsterdam. Sixty-two participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for insomnia were randomized to face-to-face group CBTI (GT; n = 31, age = 15.6 y ± 1.8, 71.0% girls) or individual Internet CBTI (IT; n = 31, age = 15.4 y ± 1.5, 83.9% girls). The intervention consisted of six weekly sessions and a 2-mo follow up booster-session of CBTI, consisting of psychoeducation, sleep hygiene, restriction of time in bed, stimulus control, cognitive therapy, and relaxation techniques. GT sessions were held in groups of six to eight adolescents guided by two trained sleep therapists. IT consisted of individual Internet therapy with preprogrammed content similar to GT, and guided by trained sleep therapists. Results: Outcome measures were subjective sleep efficiency (SE) ≥ 85%, and quality-adjusted life-years (QALY). Analyses were conducted from a societal perspective. Incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling, and presented in cost-effectiveness planes. Primary analysis showed costs over 1 y were higher for GT but effects were similar for IT and GT. Bootstrapped ICERs demonstrated there is a high probability of IT being cost-effective compared to GT. Secondary analyses confirmed robustness of results. Conclusions: Internet CBTI is a cost-effective treatment compared to group CBTI for adolescents, although

Unraveling the Mechanisms of Manual Therapy: Modeling an Approach.

PubMed

Bialosky, Joel E; Beneciuk, Jason M; Bishop, Mark D; Coronado, Rogelio A; Penza, Charles W; Simon, Corey B; George, Steven Z

2018-01-01

Synopsis Manual therapy interventions are popular among individual health care providers and their patients; however, systematic reviews do not strongly support their effectiveness. Small treatment effect sizes of manual therapy interventions may result from a "one-size-fits-all" approach to treatment. Mechanistic-based treatment approaches to manual therapy offer an intriguing alternative for identifying patients likely to respond to manual therapy. However, the current lack of knowledge of the mechanisms through which manual therapy interventions inhibit pain limits such an approach. The nature of manual therapy interventions further confounds such an approach, as the related mechanisms are likely a complex interaction of factors related to the patient, the provider, and the environment in which the intervention occurs. Therefore, a model to guide both study design and the interpretation of findings is necessary. We have previously proposed a model suggesting that the mechanical force from a manual therapy intervention results in systemic neurophysiological responses leading to pain inhibition. In this clinical commentary, we provide a narrative appraisal of the model and recommendations to advance the study of manual therapy mechanisms. J Orthop Sports Phys Ther 2018;48(1):8-18. doi:10.2519/jospt.2018.7476.

Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators.

PubMed

Craske, Michelle G; Niles, Andrea N; Burklund, Lisa J; Wolitzky-Taylor, Kate B; Vilardaga, Jennifer C Plumb; Arch, Joanna J; Saxbe, Darby E; Lieberman, Matthew D

2014-12-01

Cognitive behavioral therapy (CBT) is an empirically supported treatment for social phobia. However, not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term. Thus, alternative treatments are needed. The current study (N = 87) was a 3-arm randomized clinical trial comparing CBT, acceptance and commitment therapy (ACT), and a wait-list control group (WL) in participants with a diagnosis of social phobia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Participants completed 12 sessions of CBT or ACT or a 12-week waiting period. All participants completed assessments at baseline and posttreatment, and participants assigned to CBT and ACT also completed assessments 6 and 12 months following baseline. Assessments consisted of self-report measures, a public-speaking task, and clinician ratings. Multilevel modeling was used to examine between-group differences on outcomes measures. Both treatment groups outperformed WL, with no differences observed between CBT and ACT on self-report, independent clinician, or public-speaking outcomes. Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-month follow-up in CBT compared with ACT. Self-reported fear of negative evaluation significantly moderated outcomes as well, with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT. Across treatment groups, higher perceived control and extraversion were associated with greater improvement, whereas comorbid depression was associated with poorer outcomes. Implications for clinical practice and future research are discussed.

A randomized trial of videoconference-delivered cognitive behavioral therapy for survivors of breast cancer with self-reported cognitive dysfunction.

PubMed

Ferguson, Robert J; Sigmon, Sandra T; Pritchard, Andrew J; LaBrie, Sharon L; Goetze, Rachel E; Fink, Christine M; Garrett, A Merrill

2016-06-01

Long-term chemotherapy-related cognitive dysfunction (CRCD) affects a large number of cancer survivors. To the authors' knowledge, to date there is no established treatment for this survivorship problem. The authors herein report results of a small randomized controlled trial of a cognitive behavioral therapy (CBT), Memory and Attention Adaptation Training (MAAT), compared with an attention control condition. Both treatments were delivered over a videoconference device. A total of 47 survivors of female breast cancer who reported CRCD were randomized to MAAT or supportive therapy and were assessed at baseline, after treatment, and at 2 months of follow-up. Participants completed self-report measures of cognitive symptoms and quality of life and a brief telephone-based neuropsychological assessment. MAAT participants made gains in perceived (self-reported) cognitive impairments (P = .02), and neuropsychological processing speed (P = .03) compared with supportive therapy controls. A large MAAT effect size was observed at the 2-month follow-up with regard to anxiety concerning cognitive problems (Cohen's d for standard differences in effect sizes, 0.90) with medium effects noted in general function, fatigue, and anxiety. Survivors rated MAAT and videoconference delivery with high satisfaction. MAAT may be an efficacious psychological treatment of CRCD that can be delivered through videoconference technology. This research is important because it helps to identify a treatment option for survivors that also may improve access to survivorship services. Cancer 2016;122:1782-91. © 2016 American Cancer Society. © 2016 American Cancer Society.

Early response in cognitive-behavior therapy for syndromes of medically unexplained symptoms.

PubMed

Kleinstäuber, Maria; Lambert, Michael J; Hiller, Wolfgang

2017-05-25

Early dramatic treatment response suggests a subset of patients who respond to treatment before most of it has been offered. These early responders tend to be over represented among those who are well at termination and at follow-up. Early response patterns in psychotherapy have been investigated only for a few of mental disorders so far. The main aim of the current study was to examine early response after five therapy-preparing sessions of a cognitive behavior therapy (CBT) for syndromes of medically unexplained symptoms (MUS). In the context of a randomized, waiting-list controlled trial 48 patients who suffered from ≥3 MUS over ≥6 months received 5 therapy-preparing sessions and 20 sessions of CBT for somatoform disorders. They completed self-report scales of somatic symptom severity (SOMS-7 T), depression (BDI-II), anxiety (BSI), illness anxiety and behavior (IAS) at pre-treatment, after 5 therapy-preparing sessions (FU-5P) and at therapy termination (FU-20 T). The current analyses are based on data from the treatment arm only. Repeated measure ANOVAs revealed a significant decrease of depression (d = 0.34), anxiety (d = 0.60), illness anxiety (d = 0.38) and illness behavior (d = 0.42), but no change of somatic symptom severity (d = -0.03) between pre-treatment and FU-5P. Hierarchical linear multiple regression analyses showed that symptom improvements between pre-treatment and FU-5P predict a better outcome at therapy termination for depression and illness anxiety, after controlling for pre-treatment scores. Mixed-effect ANOVAs revealed significant group*time interaction effects indicating differences in the course of symptom improvement over the therapy between patients who fulfilled a reliable change (i.e., early response) during the 5 therapy-preparing sessions and patients who did not reach an early reliable change. Demographic or clinical variables at pre-treatment were not significantly correlated with differential scores between pre

Interdisciplinary treatment of bruxism with an occlusal splint and cognitive behavioral therapy.

PubMed

Trindade, Marilene; Orestes-Cardoso, Silvana; de Siqueira, Teresa Cristina

2015-01-01

The etiology of bruxism is associated with exogenous factors, such as occlusal interference, stress, and anxiety, as well as endogenous factors involving neurotransmitters of the basal ganglia. Due to the multifactorial etiology of bruxism, interdisciplinary treatment involving professionals from different healthcare fields has been proposed. The aim of the present study was to compare 2 groups of patients with bruxism (11 in each group) treated with either an occlusal splint combined with cognitive behavioral therapy or an occlusal splint alone. Surface electromyography of the masseter and anterior temporal muscles at rest was performed before and after treatment. The mean amplitude of activity of all muscles was lower after treatment, except for the right anterior temporal muscle in the group treated with an occlusal splint alone. Mean amplitudes were greater in the anterior temporal muscles than in the masseter muscles. Significantly greater improvement was found in the group exposed to cognitive behavioral therapy (P < 0.05; analysis of variance and Student t tests). Therefore, the combination of occlusal splint and psychological therapy was more effective at achieving muscle relaxation than occlusal splint use alone.

Using Research-Informed Pedagogical Practices to Maximize Learning in Youth Cognitive Behavioral Therapy

PubMed Central

Reid, Gerald M.; Grills, Amie E.; Mian, Nicholas D.; Reid, Alexis A.; Merson, Rachel A.; Langer, David A.

2017-01-01

Cognitive-behavioral therapy (CBT) for youth is an evidence-based treatment that typically starts with some form of psychoeducation, during which the patient is taught in a didactic manner about their presenting problems and strategies to ameliorate their symptoms. The learning process continues over the course of treatment as patients consolidate and attempt to utilize their aqcuired knowledge in their daily life. Manuals provide helpful structure and strategies to facilitate this learning process (e.g., using metaphors, personalized coping cards); however, there is variability across patients in terms of what presented content they will be able to access and understand, how they can most effectively transfer what they learn into their everyday life, and why they will become engaged in this learning process. The purpose of this paper is to connect CBT and pedagogy by outlining the research-informed pedagogical framework known as Universal Design for Learning (UDL) as it relates to the teaching and learning that takes place in CBT. First, we describe UDL as a lens through which clinicians can conceptualize evidence-based pedagogical principles that undergird common CBT teaching practices. Second, we recommend that clinicians use UDL as a guiding framework when they are faced with barriers to learning due to the variability that exists in how patients engage in, access and understand, and utilize the material. We posit that UDL can help clinicians ensure that more patients are able to successfully access and benefit from CBT. PMID:28983515

Cognitive Behavior Therapy with Body Image Exposure for Bulimia Nervosa: A Case Example

ERIC Educational Resources Information Center

Delinsky, Sherrie S.; Wilson, G. Terence

2010-01-01

Cognitive behavior therapy (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…

Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy as Treatments for Academic Procrastination: A Randomized Controlled Group Session

ERIC Educational Resources Information Center

Wang, Shuo; Zhou, Ya; Yu, Shi; Ran, Li-Wen; Liu, Xiang-Ping; Chen, Yu-Fei

2017-01-01

Objective: This study tested the efficacy of Acceptance and Commitment Therapy (ACT), compared with Cognitive-Behavioral Therapy (CBT), in alleviating academic procrastination. Method: A total of 60 (53.3% male) undergraduates suffering from academic procrastination were randomly assigned to two treatment groups (ACT and CBT) and a control group.…

[Effectiveness of cognitive-behavioral therapy in children and adolescents with obsessive-compulsive disorders treated in an outpatient clinic].

PubMed

Beig, Inga; Döpfner, Manfred; Goletz, Hildegard; Plück, Julia; Dachs, Lydia; Kinnen, Claudia; Walter, Daniel

2017-01-01

Cognitive-behavioral therapy (CBT) is considered as treatment of first choice for children and adolescents with obsessive-compulsive disorders (OCD). However, its effectiveness has so far mostly been examined in randomized controlled trials with strictly manualized interventions. Only few studies have examined whether the effectiveness of CBT for juvenile OCD generalizes to clinical practice. To test the effectiveness of CBT under routine care conditions, data of n = 53 patients with parent-ratings and n = 53 patients with self-ratings that were treated in a university-based outpatient clinic for child and adolescent psychotherapy was analyzed. Pre-post-mean-comparisons, effect sizes and the clinical significance of changes of the symptoms were examined. OCD and comorbid symptoms were significantly reduced during treatment. Strong effect sizes (Cohen’s d) were found for parent rated (d = 0.91) and patient rated (d = 0.88) OCD symptoms. Moderate to strong pre-post-effect sizes were found for the reduction of parent rated (d = 0.55 to d = 0.87) and patient rated (d = 0.46 to d = 0.74) comorbid symptoms. The percentage of children and adolescents who achieved clinically significant improvements and no longer showed dysfunctional OCD symptoms post-treatment was 46.3 % according to the parent-ratings and 59.4 % according to the self-ratings. Concerning comorbid symptoms the same was reached for between 22.5 % and 45.5 % of the patients (parent-ratings) and between 32.0 % and 81.8 % (self-ratings) respectively. Significant reductions in both OCD and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile OCD disorders in a university outpatient clinic for child and adolescent psychotherapy. These results indicate that routine CBT treatment is an effective way to treat juvenile OCD disorders in clinical practice.

A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.

PubMed

Aslami, Elahe; Alipour, Ahmad; Najib, Fatemeh Sadat; Aghayosefi, Alireza

2017-04-01

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women. The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. .The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. The results of multivariate analysis of variance test and tracking Tokey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group. Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women

PubMed Central

Aslami, Elahe; Alipour, Ahmad; Najib, Fatemeh Sadat; Aghayosefi, Alireza

2017-01-01

ABSTRACT Background: Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women. Methods: The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. .The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. Results: The results of multivariate analysis of variance test and tracking Tokey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group. Conclusion: Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based

Brief cognitive behavioral therapy for depression among patients with alcohol dependence in Thailand.

PubMed

Thapinta, Darawan; Skulphan, Sombat; Kittrattanapaiboon, Phunnapa

2014-09-01

This study evaluated the short-term efficacy of brief cognitive behavioral therapy for reducing depression among Thai general hospital patients with alcohol dependence. A quasi-experimental design was used with a control group and pretest, posttest, and follow-up assessments. Participants were patients with alcohol dependence and depression who were recruited from district and provincial hospitals in northern Thailand. Eighty (N = 80) eligible participants were purposively selected and enrolled, and then randomly assigned into two groups. One group received three weeks of brief six-session cognitive behavioral therapy as the intervention, and the other group received usual care as their treatment. Data were collected at Week 0 (pretest), Week 3 (posttest), and Week 7 (one month follow-up) and included a nine-item depression scale, with analysis through descriptive statistics and t-test. Findings indicated that the mean depression scores decreased significantly (p < .01) in both the experimental (n = 33) and control groups (n = 27) at the one month follow-up (Week 7). However, only the experimental group showed significant differences in their mean depression scores between pre- and posttest. At Week 7, the experimental group showed significantly lower mean depression scores than the control group (p < .05). In summary, the brief six-session cognitive behavioral therapy intervention yielded promising results and may benefit patients with alcohol dependence and depression who are seen in general hospital settings.

Homework compliance counts in cognitive-behavioral therapy.

PubMed

Lebeau, Richard T; Davies, Carolyn D; Culver, Najwa C; Craske, Michelle G

2013-01-01

Prior research has demonstrated that there is some association between treatment engagement and treatment outcome in behavioral therapy for anxiety disorders. However, many of these investigations have been limited by weak measurement of treatment engagement variables, failure to control for potentially important baseline variables, and failure to consider various treatment engagement variables simultaneously. The purpose of the present study is to examine the relationship between two treatment engagement variables (treatment expectancy and homework compliance) and the extent to which they predict improvement from cognitive-behavioral therapy (CBT) for anxiety disorders. 84 adults with a DSM-IV-defined principal anxiety disorder took part in up to 12 sessions of CBT or acceptance and commitment therapy. Pre- and post-treatment disorder severity was assessed using clinical severity ratings from a semi-structured diagnostic interview. Participants made ratings of treatment expectancy after the first session. Homework compliance was assessed each session by the treating clinician. Contrary to hypotheses, treatment expectancy and homework compliance were poorly correlated. Regression analyses revealed that homework compliance, but not treatment expectancy, predicted a significant portion of the variance in treatment outcome (10%). The present research suggests that although treatment expectation and homework compliance likely represent unique constructs of treatment engagement, homework compliance may be the more important treatment engagement variable for outcomes. The present research suggests that improvement of homework compliance has the potential to be a highly practical and effective way to improve clinical outcomes in CBT targeting anxiety disorders.

Client Retrospective Accounts of Corrective Experiences in Motivational Interviewing Integrated With Cognitive Behavioral Therapy for Generalized Anxiety Disorder.

PubMed

Macaulay, Christianne; Angus, Lynne; Khattra, Jasmine; Westra, Henny; Ip, Jennifer

2017-02-01

A corrective experience (CE) is one "in which a person comes to understand or experience affectively an event or relationship in a different and unexpected way" (Castonguay & Hill, 2012, p. 5). CEs disconfirm clients' expectations based on past problematic experiences, and can be emotional, relational, behavioral, and/or cognitive. This qualitative study explored corrective shifts among recovered participants (N = 8) who had received motivational interviewing (MI) integrated with cognitive behavioral therapy (CBT) in a randomized controlled trial comparing CBT alone to MI-CBT for generalized anxiety disorder (Westra, Constantino, & Antony, 2016). We administered a posttherapy interview querying their experience of, and explanations for, any shifts in therapy. Grounded theory analysis yielded three core themes: in command of the worry train, experiencing myself in new ways in therapy, and oriented toward change. Findings are discussed in terms of MI theory, and clinical implications for therapists are provided. © 2016 Wiley Periodicals, Inc.

Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review

PubMed Central

Kar, Nilamadhab

2011-01-01

Background: Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD. Methods: Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites. Results: The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT. Conclusion: There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action. PMID:21552319

Rational emotive behavior therapy: disputing irrational philosophies.

PubMed

Sacks, Susan Bendersky

2004-05-01

This article provides an overview of the concepts and techniques of rational emotive behavior therapy to distinguish it from cognitive-behavioral therapy. Rational emotive behavior therapy proposes that psychological disturbance is largely created and maintained through irrational philosophies consisting of internal absolutistic demands. This therapy strives to produce sustained and profound cognitive, emotive, and behavioral change through active, vigorous disputation of underlying irrational philosophies.

Investigating the Similarities and Differences between Practitioners of Second- and Third-Wave Cognitive-Behavioral Therapies

ERIC Educational Resources Information Center

Brown, Lily A.; Gaudiano, Brandon A.; Miller, Ivan W.

2011-01-01

There has been much discussion in the literature recently regarding the conceptual and technical differences between so-called second- (e.g., Beckian cognitive therapy) and third-wave (e.g., acceptance and commitment therapy) behavioral therapies. Previous research has not addressed the potential similarities and differences among the…

Effectiveness of Cognitive-Behavioral Therapy for Adolescent Depression: A Benchmarking Investigation

ERIC Educational Resources Information Center

Weersing, V. Robin; Iyengar, Satish; Kolko, David J.; Birmaher, Boris; Brent, David A.

2006-01-01

In this study, we examined the effectiveness of cognitive-behavioral therapy (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…

The "RAPID" Cognitive-Behavioral Therapy Program for Inattentive Children: Preliminary Findings

ERIC Educational Resources Information Center

Young, Susan

2013-01-01

Objective: The objectives of the current study were to ascertain feasibility and acceptability of directly delivering a cognitive-behavioral therapy (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…

Changes in Emotion Regulation Following Cognitive-Behavioral Therapy for Anxious Youth

ERIC Educational Resources Information Center

Suveg, Cynthia; Sood, Erica; Comer, Jonathan S.; Kendall, Philip C.

2009-01-01

This study examined emotion-related functioning following cognitive-behavioral therapy (CBT) with 37 youth with anxiety disorders (22 boys, 15 girls) ranging in age from 7 to 15 with a principal diagnosis of generalized anxiety disorder (n = 27), separation anxiety disorder (n = 12), and/or social phobia (n = 13). Treated youth exhibited a…

The Use of Homework in Cognitive Behavior Therapy: Working with Complex Anxiety and Insomnia

ERIC Educational Resources Information Center

Freeman, Arthur

2007-01-01

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…

A Randomized Controlled Comparison of Integrative Cognitive-Affective Therapy and Cognitive-Behavioral Therapy-Enhanced for Bulimia Nervosa

PubMed Central

Wonderlich, Stephen A.; Peterson, Carol B.; Crosby, Ross D.; Smith, Tracey L.; Klein, Marjorie H.; Mitchell, James E.; Crow, Scott J.

2016-01-01

Background The purpose of this investigation was to compare a new psychotherapy for bulimia nervosa, Integrative Cognitive-Affective Therapy (ICAT), with an established treatment, Cognitive-Behavioral Therapy-Enhanced (CBT-E). Method Eighty adults with symptoms of bulimia nervosa were randomized to ICAT or CBT-E for 21 sessions over 19 weeks. Bulimic symptoms, measured by the Eating Disorder Examination, were assessed at baseline, end of treatment, and 4-month follow-up. Treatment outcome, as measured by binge eating frequency, purging frequency, global eating disorder severity, emotion regulation, self-oriented cognition, depression, anxiety, and self-esteem, was determined using generalized estimating equations, logistic regression, and a general linear model (intent-to-treat). Results Both treatments were associated with significant improvement in bulimic symptoms as well as all measures of outcome, and no statistically significant differences were observed between the two conditions at end of treatment or follow-up. Intent-to-treat abstinence rates for ICAT (37.5% at end of treatment, 32.5% at follow-up) and CBT-E (22.5% at both end of treatment and follow-up) were not significantly different. Conclusions ICAT was associated with significant improvements in bulimic and associated symptoms that did not differ from those obtained with CBT-E. This initial randomized controlled trial of a new individual psychotherapy for bulimia nervosa suggests that targeting emotion and self-oriented cognition in the context of nutritional rehabilitation may be efficacious and worthy of further study. PMID:23701891

Successful Treatment of Olfactory Reference Syndrome with Cognitive Behavioral Therapy: A Case Study

ERIC Educational Resources Information Center

Martin-Pichora, Andrea L.; Antony, Martin M.

2011-01-01

Olfactory reference syndrome (ORS) is characterized by a preoccupation with the belief that one's body emits a foul odor. Cognitive behavioral therapy (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…

Is Pelvic-Floor Muscle Training a Physical Therapy or a Behavioral Therapy? A Call to Name and Report the Physical, Cognitive, and Behavioral Elements.

PubMed

Frawley, Helena C; Dean, Sarah G; Slade, Susan C; Hay-Smith, E Jean C

2017-04-01

This perspective article explores whether pelvic-floor muscle training (PFMT) for the management of female urinary incontinence and prolapse is a physical therapy or a behavioral therapy. The primary aim is to demonstrate that it is both. A secondary aim is to show that the plethora of terms used for PFMT is potentially confusing and that current terminology inadequately represents the full intent, content, and delivery of this complex intervention. While physical therapists may be familiar with exercise terms, the details are often incompletely reported; furthermore, physical therapists are less familiar with the terminology used in accurately representing cognitive and behavioral therapy interventions, which results in these elements being even less well reported. Thus, an additional aim is to provide greater clarity in the terminology used in the reporting of PFMT interventions, specifically, descriptions of the exercise and behavioral elements. First, PFMT is described as a physical therapy and as an exercise therapy informed predominantly by the discipline of physical therapy. However, effective implementation requires use of the cognitive and behavioral perspectives of the discipline of psychology. Second, the theoretical underpinning of the psychology-informed elements of PFMT is summarized. Third, to address some identified limitations and confusion in current terminology and reporting, recommendations for ways in which physical therapists can incorporate the psychology-informed elements of PFMT alongside the more familiar exercise therapy-informed elements are made. Fourth, an example of how both elements can be described and reported in a PFMT intervention is provided. In summary, this perspective explores the underlying concepts of PFMT to demonstrate that it is both a physical intervention and a behavioral intervention and that it can and should be described as such, and an example of the integration of these elements into clinical practice is provided

Efficacy of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Randomized Controlled Trial with Internet Therapy, Group Therapy and A Waiting List Condition

PubMed Central

de Bruin, Eduard J.; Bögels, Susan M.; Oort, Frans J.; Meijer, Anne Marie

2015-01-01

Study Objectives: To investigate the efficacy of cognitive behavioral therapy for insomnia (CBTI) in adolescents. Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL), with assessments at baseline, directly after treatment (post-test), and at 2 months follow-up. Setting: Diagnostic interviews were held at the laboratory of the Research Institute of Child Development and Education at the University of Amsterdam. Treatment for GT occurred at the mental health care center UvAMinds in Amsterdam, the Netherlands. Participants: One hundred sixteen adolescents (mean age = 15.6 y, SD = 1.6 y, 25% males) meeting DSM-IV criteria for insomnia, were randomized to IT, GT, or WL. Interventions: CBTI of 6 weekly sessions, consisted of psychoeducation, sleep hygiene, restriction of time in bed, stimulus control, cognitive therapy, and relaxation techniques. GT was conducted in groups of 6 to 8 adolescents, guided by 2 trained sleep therapists. IT was applied through an online guided self-help website with programmed instructions and written feedback from a trained sleep therapist. Measurements and Results: Sleep was measured with actigraphy and sleep logs for 7 consecutive days. Symptoms of insomnia and chronic sleep reduction were measured with questionnaires. Results showed that adolescents in both IT and GT, compared to WL, improved significantly on sleep efficiency, sleep onset latency, wake after sleep onset, and total sleep time at post-test, and improvements were maintained at follow-up. Most of these improvements were found in both objective and subjective measures. Furthermore, insomnia complaints and symptoms of chronic sleep reduction also decreased significantly in both treatment conditions compared to WL. Effect sizes for improvements ranged from medium to large. A greater proportion of participants from the treatment conditions showed high end-state functioning and clinically significant

Effects of Brief Communication Skills Training for Workers Based on the Principles of Cognitive Behavioral Therapy: A Randomized Controlled Trial.

PubMed

Sasaki, Norio; Somemura, Hironori; Nakamura, Saki; Yamamoto, Megumi; Isojima, Manabu; Shinmei, Issei; Horikoshi, Masaru; Tanaka, Katsutoshi

2017-01-01

Stimulating communication is an important workplace issue. We investigated the effects of a brief communication skills training (CST) program based on the principles of cognitive behavioral therapy (CBT). A randomized controlled trial was conducted on 206 white-collar workers. The intervention group underwent a 2-hour CST group training conducted by an occupational physician. The results of the intention-to-treat analysis using a mixed-effects model showed that there was a significant interaction between group and time observed for the item "thinking together to solve problems and issues" (P = 0.02). The effect size (Cohen d) was 0.35 (95% confidence interval, 0.07 to 0.62). The present study suggests that a brief CST based on the principles of CBT could improve the communication behavior of workers.

Cognitive behavior therapy for fear of flying: sustainability of treatment gains after September 11.

PubMed

Anderson, Page; Jacobs, Carli H; Lindner, Gretchen K; Edwards, Shannan; Zimand, Elana; Hodges, Larry; Rothbaum, Barbara Olasov

2006-03-01

This study examines the long-term efficacy of cognitive-behavioral therapy (CBT) for fear of flying (FOF) after a catastrophic fear-relevant event, the September 11, 2001, terrorist attacks. Participants (N = 115) were randomly assigned to and completed treatment for FOF using 8 sessions of either virtual reality exposure therapy (VRE) or standard exposure therapy (SE) prior to September 11, 2001. Individuals were reassessed in June, 2002, an average of 2.3 years after treatment, with a response rate of 48% (n = 55). Analyses were run on the original data and, using multiple imputation procedures, on imputed data for the full sample. Individuals maintained or improved upon gains made in treatment as measured by standardized FOF questionnaires and by number of flights taken. There were no differences between VRE and SE. Thus, results suggest that individuals previously treated for FOF with cognitive-behavioral therapy can maintain treatment gains in the face of a catastrophic fear-relevant event, even years after treatment is completed.

Treatment dropout in web-based cognitive behavioral therapy for patients with eating disorders.

PubMed

Ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; van der Palen, Job; DeJong, Cor A J

2017-01-01

Treatment dropout is an important concern in eating disorder treatments as it has negative implications for patients' outcome, clinicians' motivation, and research studies. Our main objective was to conduct an exploratory study on treatment dropout in a two-part web-based cognitive behavioral therapy with asynchronous therapeutic support. The analysis included 205 female patients with eating disorders. Reasons for dropout, treatment experiences, and predictors of dropout were analyzed. Overall treatment dropout was 37.6%, with 18.5% early dropout (before or during treatment part 1) and 19.0% late dropout (after part 1 or during part 2). Almost half of the participants identified personal circumstances as reason for dropout. The other participants mostly reported reasons related to the online delivery or treatment protocol. Predictors of early dropout included reporting less vigor and smoking at baseline and a longer average duration per completed treatment module of part 1. Late dropout was predicted by reporting less vigor at baseline and uncertainty about recommendation of the treatment to others after completion of treatment part 1. Generally, the web-based treatment and online therapeutic support were evaluated positively, although dropouts rated the treatment as significantly less helpful and effective than completers did. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients.

PubMed

Duarte, Priscila Silveira; Miyazaki, Maria Cristina; Blay, Sergio Luís; Sesso, Ricardo

2009-08-01

Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive-behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). In a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive-behavioral group therapy led by a trained psychologist over 3 months while a control group of 44 patients received the usual treatment offered in the dialysis unit. In both groups, the Beck Depression Inventory, the MINI, and the Kidney Disease and Quality of Life-Short Form questionnaires were administered at baseline, after 3 months of intervention or usual treatment, and after 9 months of follow-up. The intervention group had significant improvements, compared to the control group, in the average scores of the Beck Depression Inventory overall scale, MINI scores, and in quality-of-life dimensions that included the burden of renal disease, sleep, quality of social interaction, overall health, and the mental component summary. We conclude that cognitive-behavioral group therapy is an effective treatment of depression in chronic hemodialysis patients.

The effects of parental components in a trauma-focused cognitive behavioral based therapy for children exposed to interparental violence: study protocol for a randomized controlled trial.

PubMed

Visser, Margreet M; Telman, Machteld D; de Schipper, J Clasien; Lamers-Winkelman, Francien; Schuengel, Carlo; Finkenauer, Catrin

2015-06-23

Interparental violence is both common and harmful and impacts children's lives directly and indirectly. Direct effects refer to affective, behavioral, and cognitive responses to interparental violence and psychosocial adjustment. Indirect effects refer to deteriorated parental availability and parent-child interaction. Standard Trauma Focused Cognitive Behavioral Therapy may be insufficient for children traumatized by exposure to interparental violence, given the pervasive impact of interparental violence on the family system. HORIZON is a trauma focused cognitive behavioral therapy based group program with the added component of a preparatory parenting program aimed at improving parental availability; and the added component of parent-child sessions to improve parent-child interaction. This is a multicenter, multi-informant and multi-method randomized clinical trial study with a 2 by 2 factorial experimental design. Participants (N = 100) are children (4-12 years), and their parents, who have been exposed to interparental violence. The main aim of the study is to test the effects of two parental components as an addition to a trauma focused cognitive behavioral based group therapy for reducing children's symptoms. Primary outcome measures are posttraumatic stress symptoms, and internalizing and externalizing problems in children. The secondary aim of the study is to test the effect of the two added components on adjustment problems in children and to test whether enhanced effects can be explained by changes in children's responses towards experienced violence, in parental availability, and in quality of parent-child interaction. To address this secondary aim, the main parameters are observational and questionnaire measures of parental availability, parent-child relationship variables, children's adjustment problems and children's responses to interparental violence. Data are collected three times: before and after the program and six months later. Both

Effectiveness of Cognitive Behavioral and Supportive-Expressive Group Therapy for Women Diagnosed with Breast Cancer: A Review of the Literature

ERIC Educational Resources Information Center

Boutin, Daniel L.

2007-01-01

A review of the literature revealed 20 studies that examined the extent to which cognitive behavioral therapy (CBT), supportive-expressive group therapy (SEGT), and a combination of these two treatments impact women with breast cancer. Based on this review, it is determined that CBT and SEGT have repeated experimental support for positively…

Intensive Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Applications for Treatment of Medication Partial- or Nonresponders

ERIC Educational Resources Information Center

Marien, Wendi E.; Storch, Eric A.; Geffken, Gary R.; Murphy, Tanya K.

2009-01-01

Serotonin reuptake inhibitor medications and cognitive-behavioral therapy (CBT) are both effective treatments for pediatric obsessive-compulsive disorder (OCD). Despite recommendations that youth with OCD be treated with CBT alone or together with serotonin reuptake inhibitor medication, many youth are treated with medication alone or with non-CBT…

Parental Outcomes Following Participation in Cognitive Behavior Therapy for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Maughan, Andrea L.; Weiss, Jonathan A.

2017-01-01

Children with autism spectrum disorder (ASD) benefit from parent involvement in their therapy, and there is evidence that this involvement may improve parent functioning as well. We examined changes in parent mental health, parenting, and expressed emotion, following participation in a randomized controlled trial of cognitive behavior therapy for…

[Cognitive behavioral therapy for psychosis to promote social recovery].

PubMed

Yamasaki, Syudo

2013-01-01

When conducting cognitive behavioral therapy for psychosis (CBTp), it is essential that therapists aim for the recovery of patients with psychosis. During the sessions, the therapist helps a person with psychosis understand their symptoms, manages his/her residual positive symptoms, and helps them to cope with distress from the positive symptoms by themselves. Such CBTp should be designed to achieve the goals of the patient's social life. Recently, the effect of CBTp on residual positive symptoms of drug resistance has been reported repeatedly. Manifestation, cognitive bias, and activaters of residual positive symptoms differ considerably between individuals with psychosis. In the psychiatric rehabilitation field in Japan today, the symptom self-management module is being used. The symptom self-management module is derived from the techniques of group social skills training. However, there are needs for individual cognitive behavioral therapy for psychosis to meet the marked variation in individual needs. The effect of CBTp by itself on an individual with the initial episode of psychosis is limited. Many individuals with their first episode are teenagers or adolescents. Those patients are usually confronted with the problems of education and employment, which are key developmental tasks in adolescence. In order to meet those needs, a case manager should be assigned to an individual with first-episode psychosis, and CBTp should be implemented within the case management process. The CBTp has been introduced in various forms for the purpose of recovery support of individuals with psychosis. For the future, not only the accumulation of evidence but also the development of a dissemination system of CBTp are required to meet the individual needs of patients.

Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: Acute Outcomes.

PubMed

Rohan, Kelly J; Mahon, Jennifer N; Evans, Maggie; Ho, Sheau-Yan; Meyerhoff, Jonah; Postolache, Teodor T; Vacek, Pamela M

2015-09-01

Whereas considerable evidence supports light therapy for winter seasonal affective disorder (SAD), data on cognitive-behavioral therapy for SAD (CBT-SAD) are promising but preliminary. This study estimated the difference between CBT-SAD and light therapy outcomes in a large, more definitive test. The participants were 177 adults with a current episode of major depression that was recurrent with a seasonal pattern. The randomized clinical trial compared 6 weeks of CBT-SAD (N=88) and light therapy (N=89). Light therapy consisted of 10,000-lux cool-white florescent light, initiated at 30 minutes each morning and adjusted according to a treatment algorithm based on response and side effects. CBT-SAD comprised 12 sessions of the authors' SAD-tailored protocol in a group format and was administered by Ph.D. psychologists in two 90-minute sessions per week. Outcomes were continuous scores on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD Version (SIGH-SAD, administered weekly) and Beck Depression Inventory-Second Edition (BDI-II, administered before treatment, at week 3, and after treatment) and posttreatment remission status based on cut points. Depression severity measured with the SIGH-SAD and BDI-II improved significantly and comparably with CBT-SAD and light therapy. Having a baseline comorbid diagnosis was associated with higher depression scores across all time points in both treatments. CBT-SAD and light therapy did not differ in remission rates based on the SIGH-SAD (47.6% and 47.2%, respectively) or the BDI-II (56.0% and 63.6%). CBT-SAD and light therapy are comparably effective for SAD during an acute episode, and both may be considered as treatment options.

Cognitive and Emotion Regulation Change Processes in Cognitive Behavioural Therapy for Social Anxiety Disorder.

PubMed

O'Toole, Mia S; Mennin, Douglas S; Hougaard, Esben; Zachariae, Robert; Rosenberg, Nicole K

2015-01-01

The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies. Copyright © 2014 John Wiley & Sons, Ltd.

Cognitive-Behavioral Therapy for Depression in Individuals with Intellectual Disabilities: A Review

ERIC Educational Resources Information Center

James, Jessica S.

2017-01-01

Depression is common in individuals with intellectual disabilities, but evidence regarding treatment for this population is lacking. Through a systematic literature review of cognitive-behavioral therapy (CBT) with individuals with intellectual disabilities, a total of six studies were identified that used pretest-post-test nonequivalent control…

Cognitive Behavioral Therapy and the Treatment of Posttraumatic Stress Disorder: Where Counseling and Neuroscience Meet

ERIC Educational Resources Information Center

Makinson, Ryan A.; Young, J. Scott

2012-01-01

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 behavioral therapy and other well-researched cognitive interventions. The purpose of this article is to describe the…

Examining the relation between the therapeutic alliance, treatment adherence, and outcome of cognitive behavioral therapy for children with anxiety disorders.

PubMed

Liber, Juliette M; McLeod, Bryce D; Van Widenfelt, Brigit M; Goedhart, Arnold W; van der Leeden, Adelinde J M; Utens, Elisabeth M W J; Treffers, Philip D A

2010-06-01

Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for youths diagnosed with anxiety disorders. Trained observers rated tapes of therapy sessions for treatment adherence and child-therapist alliance in a sample of 52 children (aged 8 to 12) with anxiety disorders. Self-reported child anxiety was assessed at pre-, mid-, and posttreatment; parent-reported child internalizing symptoms was assessed at pre- and posttreatment. The results showed high levels of treatment adherence and child-therapist alliance in both CBT programs. Neither treatment adherence nor child-therapist alliance predicted traditional measurements of child outcomes in the present study, but a relation between alliance and outcome was found using a more precise estimation of the true pre-post differences. Implications of these findings for expanding our understanding of how treatment processes relate to child outcome in CBT for children with anxiety disorders are discussed. 2009. Published by Elsevier Ltd.

Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy

PubMed Central

Hayes, Steven C.; Levin, Michael E.; Plumb-Vilardaga, Jennifer; Villatte, Jennifer L.; Pistorello, Jacqueline

2012-01-01

A number of recent authors have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (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

Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy.

PubMed

Hayes, Steven C; Levin, Michael E; Plumb-Vilardaga, Jennifer; Villatte, Jennifer L; Pistorello, Jacqueline

2013-06-01

A number of recent authors have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (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. Copyright © 2011. Published by Elsevier Ltd.

Internet-based cognitive behavior therapy for major depressive disorder: A randomized controlled trial.

PubMed

Rosso, Isabelle M; Killgore, William D S; Olson, Elizabeth A; Webb, Christian A; Fukunaga, Rena; Auerbach, Randy P; Gogel, Hannah; Buchholz, Jennifer L; Rauch, Scott L

2017-03-01

Prior research has shown that the Sadness Program, a technician-assisted Internet-based cognitive behavioral therapy (iCBT) intervention developed in Australia, is effective for treating major depressive disorder (MDD). The current study aimed to expand this work by adapting the protocol for an American population and testing the Sadness Program with an attention control group. In this parallel-group, randomized controlled trial, adult MDD participants (18-45 years) were randomized to a 10-week period of iCBT (n = 37) or monitored attention control (MAC; n = 40). Participants in the iCBT group completed six online therapy lessons, which included access to content summaries and homework assignments. During the 10-week trial, iCBT and MAC participants logged into the web-based system six times to complete self-report symptom scales, and a nonclinician technician contacted participants weekly to provide encouragement and support. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), and the secondary outcomes were the Patient Health Questionnaire-9 and Kessler-10. Intent-to-treat analyses revealed significantly greater reductions in depressive symptoms in iCBT compared with MAC participants, using both the self-report measures and the clinician-rated HRSD (d = -0.80). Importantly, iCBT participants also showed significantly higher rates of clinical response and remission. Exploratory analyses did not support illness severity as a moderator of treatment outcome. The Sadness Program led to significant reductions in depression and distress symptoms. With its potential to be delivered in a scalable, cost-efficient manner, iCBT is a promising strategy to enhance access to effective care. © 2016 Wiley Periodicals, Inc.

Effect of cognitive behavior therapy on smokers' compensatory coping skills.

PubMed

Thorndike, Frances P; Friedman-Wheeler, Dara G; Haaga, David A F

2006-09-01

Cognitive behavior therapy for depression has been adapted for use in cigarette smoking cessation groups. CBT appears to be an effective treatment, though results are mixed as to whether it is especially helpful for smokers vulnerable to depression, and little is known about what mediates its effects. Based on the hypothesis that CBT works by way of teaching compensatory skills for coping with negative thinking and emotions, this study compared CBT with a time-matched comparison condition incorporating health education and scheduled, reduced smoking. There was a nonsignificant trend favoring CBT in achieving abstinence, but CBT did not enhance smokers' compensatory coping skills. Discussion focuses on the need to examine a wide range of possible mediating variables in future research on CBT for smoking cessation.

Honoring children, mending the circle: cultural adaptation of trauma-focused cognitive-behavioral therapy for American Indian and Alaska native children.

PubMed

BigFoot, Dolores Subia; Schmidt, Susan R

2010-08-01

American Indians and Alaska Natives are vulnerable populations with significant levels of trauma exposure. The Indian Country Child Trauma Center developed an American Indian and Alaska Native (AI/AN) adaptation of the evidence-based child trauma treatment, trauma-focused cognitive-behavioral therapy. Honoring Children, Mending the Circle (HC-MC) guides the therapeutic process through a blending of AI/AN traditional teachings with cognitive-behavioral methods. The authors introduced the HC-MC treatment and illustrated its therapeutic tools by way of a case illustration.

Efficacy of a specific model for cognitive-behavioral therapy among panic disorder patients with agoraphobia: a randomized clinical trial.

PubMed

King, Anna Lucia Spear; Valença, Alexandre Martins; de Melo-Neto, Valfrido Leão; Freire, Rafael Christophe; Mezzasalma, Marco André; Silva, Adriana Cardoso de Oliveira e; Nardi, Antonio Egidio

2011-01-01

Cognitive-behavioral therapy is frequently indicated for panic disorder. The aim here was to evaluate the efficacy of a model for cognitive-behavioral therapy for treating panic disorder with agoraphobia. Randomized clinical trial at Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro. A group of 50 patients with a diagnosis of panic disorder with agoraphobia was randomized into two groups to receive: a) cognitive-behavioral therapy with medication; or b) medication (tricyclic antidepressants or selective serotonin reuptake inhibitors). Although there was no difference between the groups after the treatment in relation to almost all variables with the exception of some items of the Sheehan disability scale and the psychosocial and environmental problems scale, the patients who received the specific therapy presented significant reductions in panic attacks, anticipatory anxiety, agoraphobia avoidance and fear of body sensations at the end of the study, in relation to the group without the therapy. On the overall functioning assessment scale, overall wellbeing increased from 60.8% to 72.5% among the patients in the group with therapy, thus differing from the group without therapy. Although both groups responded to the treatment and improved, we only observed significant differences between the interventions on some scales. The association between specific cognitive-behavioral therapy focusing on somatic complaints and pharmacological treatment was effective among this sample of patients with panic disorder and the response was similar in the group with pharmacological treatment alone.

Rational emotive behavior therapy versus cognitive therapy versus pharmacotherapy in the treatment of major depressive disorder: Mechanisms of change analysis.

PubMed

Szentagotai, Aurora; David, Daniel; Lupu, Viorel; Cosman, Doina

2008-12-01

Cognitive-behavioral psychotherapies (CBT) are among the first-line interventions for major depressive disorder (MDD), and a significant number of studies indicate their efficacy in the treatment of this disorder. However, differential effects of various forms of CBT have seldom been analyzed in the same experimental design. On the basis of data collected in a randomized clinical trial comparing the efficacy of rational-emotive behavior therapy (REBT), cognitive therapy (CT), and pharmacotherapy (SSRI) in the treatment of MDD, the present article investigates the theory of change advanced by REBT and CT. Measures included to test the two theories of change assess three classes of cognitions: (a) automatic thoughts, (b) dysfunctional attitudes, and (c) irrational beliefs. The results indicate that REBT and CT (and also pharmacotherapy) indiscriminately affect the three classes of cognitions. On the long term (follow-up), a change in implicit demandingness seems more strongly associated with reduced depression and relapse prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Individual cognitive-behavioral therapy and behavioral couples therapy in alcohol use disorder: a comparative evaluation in community-based addiction treatment centers.

PubMed

Vedel, Ellen; Emmelkamp, Paul M G; Schippers, Gerard M

2008-01-01

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 individually focused cognitive-behavioral therapy (CBT) in a clinical community sample. The present study is a randomized clinical trial evaluating the effectiveness of stand-alone BCT (n = 30) compared to individual CBT (n = 34) in the treatment of alcohol use disorders in community treatment centers in Dutch male and female alcoholics and their partners. Results show both BCT and CBT to be effective in changing drinking behavior after treatment. BCT was not found to be superior to CBT. Marital satisfaction of the spouse increased significantly in the BCT condition but not in the CBT condition, the differences being significant at the post-test. Patients' self-efficacy to withstand alcohol-related high-risk situations increased significantly in both treatment conditions, but more so in CBT than in BCT after treatment. Treatment involvement of the spouse did not increase retention. Regular practitioners in community treatment centers can effectively deliver both treatments. Stand-alone BCT is as effective as CBT in terms of reduced drinking and to some extent more effective in terms of enhancing relationship satisfaction. However, BCT is a more costly intervention, given that treatment sessions lasted almost twice as long as individual CBT sessions. Copyright 2008 S. Karger AG, Basel.

Potential Mediators of Cognitive-Behavioral Therapy for Adolescents With Comorbid Major Depression and Conduct Disorder

ERIC Educational Resources Information Center

Kaufman, Noah K.; Rohde, Paul; Seeley, John R.; Clarke, Gregory N.; Stice, Eric

2005-01-01

Several possible mediators of a group cognitive-behavioral therapy (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…

Rational-Emotive Therapy: Research Data That Supports the Clinical and Personality Hypotheses of Ret and Other Modes of Cognitive-Behavior Therapy

ERIC Educational Resources Information Center

Ellis, Albert

1977-01-01

This article examines 32 important clinical and personality hypotheses of rational-emotive therapy (RET) and other modes of cognitive-behavior therapy and lists a large number of research studies that provide empirical confirmation of these hypotheses. (Author)

The Effects of a Brief Acceptance-based Behavior Therapy vs. Traditional Cognitive Behavior Therapy for Public Speaking Anxiety: Differential Effects on Performance and Verbal Working Memory

NASA Astrophysics Data System (ADS)

Glassman, Lisa Hayley

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 Behavioral Therapy (tCBT) and acceptance-based behavior therapy (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

Who benefits from cognitive behavioral therapy for vaginismus?

PubMed

Kabakçi, Elif; Batur, Senar

2003-01-01

The purpose of this study was to investigate the characteristics of a group of Turkish vaginismus patients who benefited from Cognitive Behavioral Therapy (CBT) and to study which factors this treatment model changes. Twenty-eight couples who applied to Psychiatry Clinic of Hacettepe University Hospital, Ankara, for treatment of vaginismus within the 6-month period participated in the study. Fourteen subjects quit the therapy after the initial assessment sessions. Other couples successfully completed the treatment. We assessed all the couples that completed the CBT at three times: during the initial session, at the end of the treatment, and during the follow-up session (4 weeks after the end of the treatment). In terms of anxiety levels, and quality of marital and sexual relationships, the characteristics of the couples that quit the therapy could not be identified. But we found that all of the participants were treated effectively by CBT. At the end of the therapy, anxiety levels of the women decreased. There also were improvements on parameters related to marital harmony and overall sexual functioning of the women. We discuss the findings of our study within a cultural perspective.

Reconceptualising manual therapy skills in contemporary practice.

PubMed

Rabey, Martin; Hall, Toby; Hebron, Clair; Palsson, Thorvaldur Skuli; Christensen, Steffan Wittrup; Moloney, Niamh

2017-06-01

With conflicting evidence regarding the effectiveness of manual therapy calls have arisen within some quarters of the physiotherapy profession challenging the continued use of manual skills for assessment and treatment. A reconceptualisation of the importance of manual examination findings is put forward, based upon a contemporary understanding of pain science, rather than considering these skills only in terms of how they should "guide" manual therapy interventions. The place for manual examination findings within complex, multidimensional presentations is considered using vignettes describing the presentations of five people with low back pain. As part of multidimensional, individualised management, the balance of evidence relating to the effectiveness, mechanisms of action and rationale for manual skills is discussed. It is concluded that if manual examination and therapeutic skills are used in a manner consistent with a contemporary understanding of pain science, multidimensional patient profiles and a person-centred approach, their selective and judicious use still has an important role. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of a Guided Internet-based Psycho-education Intervention Using Cognitive Behavioral Therapy and Self-Management for Individuals with Chronic Pain.

PubMed

Perry, Jennifer; VanDenKerkhof, Elizabeth G; Wilson, Rosemary; Tripp, Dean A

2017-04-01

Evidence-based chronic pain treatment includes nonpharmacologic therapies. When addressing barriers to treatment, there is a need to deliver these therapies in a way that is accessible to all individuals who may benefit. To develop a guided Internet-based intervention for individuals with chronic pain, program content and sequence of evidence-based treatments for chronic pain, traditionally delivered via in-person sessions, were identified to be adapted for Internet delivery. With consideration to historical barriers to treatment, and through use of a concept map, therapeutic components and educational material were situated, in an ordered sequence, into six modules. An Internet-based chronic pain intervention was constructed to improve access to evidence-based chronic pain therapies. Research using this intervention, in the form of a pilot study for intervention refinement, was conducted, and a large-scale study to assess effectiveness is necessary prior to implementation. As clients may face barriers to multimodal treatment for chronic pain, nurses could introduce components of education, cognitive behavioral therapy and self-management to clients and prepare them for the "work" of managing chronic pain, through use of this Internet-based intervention. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Group Cognitive-Behavioral Therapy for Insomnia in a VA Mental Health Clinic

ERIC Educational Resources Information Center

Perlman, Lawrence M.; Arnedt, J. Todd; Earnheart, Kristie L.; Gorman, Ashley A.; Shirley, Katherine G.

2008-01-01

Effective cognitive-behavioral therapies 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…

Cognitive therapy for antisocial and borderline personality disorders: single case study series.

PubMed

Davidson, K M; Tyrer, P

1996-09-01

Cognitive therapy for affective disorders has been recently adapted and developed for the treatment of personality disorders. In the present study, a specific and detailed cognitive therapy treatment manual for borderline and antisocial personality disorders was evaluated in a pilot study. The results of a single case series demonstrate that important clinical changes in dysfunctional behaviour and attitudes can be achieved with short-term cognitive therapy in patients with antisocial and borderline personality disorders, although these were not, on the whole, statistically significant.

Associations between therapy skills and patient experiences of change processes in cognitive behavioral therapy for psychosis.

PubMed

Wittorf, Andreas; Jakobi-Malterre, Ute E; Beulen, Silke; Bechdolf, Andreas; Müller, Bernhard W; Sartory, Gudrun; Wagner, Michael; Wiedemann, Georg; Wölwer, Wolfgang; Herrlich, Jutta; Klingberg, Stefan

2013-12-30

Despite the promising findings in relation to the efficacy of cognitive behavioral therapy for psychosis (CBTp), little attention has been paid to the therapy skills necessary to deliver CBTp and to the influence of such skills on processes underlying therapeutic change. Our study investigated the associations between general and technical therapy skills and patient experiences of change processes in CBTp. The study sample consisted of 79 patients with psychotic disorders who had undergone CBTp. We randomly selected one tape-recorded therapy session from each of the cases. General and technical therapy skills were assessed by the Cognitive Therapy Scale for Psychosis. The Bern Post Session Report for Patients was applied to measure patient experiences of general change processes in the sense of Grawe's psychological therapy. General skills, such as feedback and understanding, explained 23% of the variance of patients' self-esteem experience, but up to 10% of the variance of mastery, clarification, and contentment experiences. The technical skill of guided discovery consistently showed negative associations with patients' alliance, contentment, and control experiences. The study points to the importance of general therapy skills for patient experiences of change processes in CBTp. Some technical skills, however, could detrimentally affect the therapeutic relationship. © 2013 Elsevier Ireland Ltd. All rights reserved.

Treating Acute Insomnia: A Randomized Controlled Trial of a “Single-Shot” of Cognitive Behavioral Therapy for Insomnia

PubMed Central

Ellis, Jason G.; Cushing, Toby; Germain, Anne

2015-01-01

Study Objectives: Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia. Design: A pragmatic parallel group randomized controlled trial. Setting: Community. Participants: Forty adults (mean age 32.9 ± 13.72 y) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defined insomnia disorder, except a self-reported duration of less than 3 mo (i.e., acute insomnia), who reported no previous exposure to CBT-I and were not currently taking medication for sleep. Interventions: A single 60- to 70-min session of CBT-I (n = 20), with an accompanying self-help pamphlet, or wait list control group (n = 20). All subjects were offered a full individual course of CBT-I on completion of the study, regardless of group allocation. Measurements and Results: Subjects completed sleep diaries and the Insomnia Severity Index (ISI) pretreatment and 1 mo following treatment. There were no between-group differences on baseline ISI scores or subjective sleep continuity. The intervention group reported significantly lower ISI scores than controls (t(38) 2.24, P < 0.05) at follow-up. Further, using proposed ISI scores for identifying insomnia caseness (i.e., ≥ 10), 60% of those in the CBT-I group had remitted by 1 mo compared to 15% of those in the control group. Conclusions: This single session of cognitive behavioral therapy for insomnia (CBT-I) is sufficiently efficacious for a significant proportion of those with acute insomnia. The results are discussed in terms of integrating this brief form of CBT-I into the “stepped care” model of insomnia. Trial Registration: Testing the efficacy of an early intervention for acute insomnia (SRCTN05891695) http://www.controlled-trials.com/ISRCTN05891695. Citation

Interdisciplinary Cognitive-Behavioral Therapy as Part of Lumbar Spinal Fusion Surgery Rehabilitation: Experience of Patients With Chronic Low Back Pain.

PubMed

Lindgreen, Pil; Rolving, Nanna; Nielsen, Claus Vinther; Lomborg, Kirsten

2016-01-01

Patients receiving lumbar spinal fusion surgery often have persisting postoperative pain negatively affecting their daily life. These patients may be helped by interdisciplinary cognitive-behavioral therapy which is recognized as an effective intervention for improving beneficial pain coping behavior, thereby facilitating the rehabilitation process of patients with chronic pain. The purpose of this study was to describe the lived experience of patients recovering from lumbar spinal fusion surgery and to explore potential similarities and disparities in pain coping behavior between receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. We conducted semistructured interviews with 10 patients; 5 receiving cognitive-behavioral therapy in connection with their lumbar spinal fusion surgery and 5 receiving usual care. We conducted a phenomenological analysis to reach our first aim and then conducted a comparative content analysis to reach our second aim. Patients' postoperative experience was characterized by the need to adapt to the limitations imposed by back discomfort (coexisting with the back), need for recognition and support from others regarding their pain, a relatively long rehabilitation period during which they "awaited the result of surgery", and ambivalence toward analgesics. The patients in both groups had similar negative perception of analgesics and tended to abstain from them to avoid addiction. Coping behavior apparently differed among receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. Receivers prevented or minimized pain by resting before pain onset, whereas nonreceivers awaited pain onset before resting. The postoperative experience entailed ambivalence, causing uncertainty, worry and insecurity. This ambivalence was relieved when others recognized the patient's pain and offered support. Cognitive-behavioral therapy as part of rehabilitation may have encouraged beneficial pain coping

Setting the Stage for the Integration of Motivational Interviewing with Cognitive Behavioral Therapy in the Treatment of Depression

ERIC Educational Resources Information Center

Flynn, Heather A.

2011-01-01

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 behavioral therapy (CBT), a widely studied and taught psychotherapeutic treatment for depression, is among the recommended evidence-based treatments. Although CBT and other…

Coping Strategies in Bulimia Nervosa Treatment: Impact on Outcome in Group Cognitive-Behavioral Therapy

ERIC Educational Resources Information Center

Binford, Roslyn B.; Mussell, Melissa Pederson; Crosby, Ross D.; Peterson, Carol B.; Crow, Scott J.; Mitchell, James E.

2005-01-01

This study's purpose was to examine the extent to which participants (N = 143) receiving cognitive-behavioral therapy 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…

Integrating Motivational Interviewing and Self-Determination Theory with Cognitive Behavioral Therapy to Prevent Suicide

ERIC Educational Resources Information Center

Britton, Peter C.; Patrick, Heather; Wenzel, Amy; Williams, Geoffrey C.

2011-01-01

Cognitive behavioral therapy (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…

Clinical process examples of cognitive behavioral therapy for psychosis.

PubMed

Sivec, Harry J; Montesano, Vicki L

2013-09-01

Interest in the practice of Cognitive Behavioral Therapy for persistent psychotic symptoms (CBT-p) has increased dramatically in the last decade. Despite the widespread interest, it remains challenging to obtain adequate training in this approach in the United States. This article provides a few hypothetical examples of the types of interventions commonly used in CBT-p. We provide information about the theoretical basis for the techniques and related research support. We also provide references that offer more detailed discussion of the theory and application of the techniques. 2013 APA, all rights reserved

Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia.

PubMed

Yeung, Wing-Fai; Chung, Ka-Fai; Ho, Fiona Yan-Yee; Ho, Lai-Ming

2015-10-01

Dropout from self-help cognitive-behavioral therapy for insomnia (CBT-I) potentially diminishes therapeutic effect and poses clinical concern. We analyzed the characteristics of subjects who did not complete a 6-week internet-based CBT-I program. Receiver operator characteristics (ROC) analysis was used to identify potential variables and cutoff for predicting dropout among 207 participants with self-report insomnia 3 or more nights per week for at least 3 months randomly assigned to self-help CBT-I with telephone support (n = 103) and self-help CBT-I (n = 104). Seventy-two participants (34.4%) did not complete all 6 sessions, while 42 of the 72 (56.9%) dropped out prior to the fourth session. Significant predictors of non-completion are total sleep time (TST) ≥ 6.82 h, Hospital Anxiety and Depression Scale depression score ≥ 9 and Insomnia Severity Index score < 13 at baseline in this ranking order. Only TST ≥ 5.92 h predicts early dropout. Longer TST and less severe insomnia predict dropout in this study of self-help CBT-I, in contrast to shorter TST as a predictor in 2 studies of face-to-face CBT-I, while greater severity of depression predicts dropout in both this study and a study of face-to-face CBT-I. Strategies for minimizing dropout from internet-based CBT-I are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

PubMed Central

Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

2013-01-01

Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P < 0.001) and were classified as “in remission” from insomnia at follow-up (P < 0.05). Posttreatment effect sizes on most daytime symptoms were large (Cohen d = 0.8–2.5) for CBTI-Phone patients and small to moderate (Cohen d = -0.1–0.6) for IPC patients. All CBTI-Phone patients completed posttreatment and 12-wk follow-up assessments, but three IPC patients discontinued the study. Conclusions: The findings provide preliminary support for telephone-delivered CBTI in the treatment of chronic insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J

Cognitive-Behavioral Therapy versus Temporal Pulse Amplitude Biofeedback Training for Recurrent Headache

ERIC Educational Resources Information Center

Martin, Paul R.; Forsyth, Michael R.; Reece, John

2007-01-01

Sixty-four headache sufferers were allocated randomly to cognitive-behavioral therapy (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,…

Family Cognitive Behavioral Therapy for Children and Adolescents with Clinical Anxiety Disorders

ERIC Educational Resources Information Center

Bogels, Susan M.; Siqueland, Lynne

2006-01-01

Objective: A family cognitive-behavioral therapy for children and adolescents ages 8 to 18 years with clinical anxiety disorders was developed and evaluated. Method: Seventeen families were measured before and after waitlist, after treatment, and at 3-month and 1-year follow-up. Results: No children changed their diagnostic status during waitlist,…