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Sample records for behavioural therapy cbt

  1. Cognitive behavioural therapy (CBT – case studies

    Directory of Open Access Journals (Sweden)

    Martyna Głuszek-Osuch

    2016-04-01

    Full Text Available The objective of the present study is to further elucitate the specifics cognitive behavioural therapy (CBT based on the treatment of 2 patients. The theoretical background of the therapy is based on the idea that the learning processes determine behaviour (behavioural therapy, acquisition and consolidation of beliefs and view of the world (cognitive therapy. The CBT is short-term (usually 12–20 weekly sessions. It assumes close links between the patient’s thoughts (about self, the world and the future and his/her emotions, behaviour and physiology. The patient’s work in between sessions consists in observation of their own thoughts, behaviours, and emotions, and introduction of changes within the scope of their thoughts and behaviours. The goal of cognitive behavioural therapy is autonomy and independence of a patient, attainment of the patient’s objectives, and remedying the most important problems of the patient. The therapist should be active, warm and empathic. Cognitive behavioural therapy is structured and active. Between sessions, the patient receives homework assignments to complete. During therapy, information is collected by experiments and verification of hypotheses. It should be emphasized that for changes to occur in the process of psychotherapy it is necessary to establish a strong therapeutic alliance.

  2. Yoga-enhanced cognitive behavioural therapy (Y-CBT) for anxiety management: a pilot study.

    Science.gov (United States)

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

    2015-01-01

    Cognitive behavioural therapy (CBT) is an effective treatment for generalized anxiety disorder, but there is still room for improvement. The aim of the present study was to examine the potential benefit of enriching 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 programme. 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 generalized anxiety disorder. Yoga-enhanced cognitive behavioural therapy (Y-CBT) may be a promising new treatment for those suffering from generalized anxiety disorder. Y-CBT may also reduce depression in those suffering from generalized anxiety. Y-CBT may reduce depression and anxiety in a clinic population where clients suffer from multiple diagnoses including generalized anxiety disorder. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Using cognitive behaviour therapy with South Asian Muslims: Findings from the culturally sensitive CBT project.

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    Naeem, Farooq; Phiri, Peter; Munshi, Tariq; Rathod, Shanaya; Ayub, Muhhhamad; Gobbi, Mary; Kingdon, David

    2015-01-01

    It has been suggested that cognitive behaviour therapy (CBT) needs adaptation for it to be effective for patients from collectivistic cultures, as currently CBT is underpinned by individualistic values. In prior studies we have demonstrated that CBT could be adapted for Pakistani patients in Southampton, UK, and for local populations in Pakistan. Findings from these studies suggest that CBT can be adapted for patients from collectivistic cultures using a series of steps. In this paper we focus on these steps, and the process of adapting CBT for specific groups. The adaptation process should focus on three major areas of therapy, rather than simple translation of therapy manuals. These include (1) awareness of relevant cultural issues and preparation for therapy, (2) assessment and engagement, and (3) adjustments in therapy. We also discuss the best practice guidelines that evolved from this work to help therapists working with this population. We reiterate that CBT can be adapted effectively for patients from traditional cultures. This is, however, an emerging area in psychotherapy, and further work is required to refine the methodology and to test adapted CBT.

  4. Staff Expectations and Views of Cognitive Behaviour Therapy (CBT) for Adults with Intellectual Disabilities

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    Kroese, Biza Stenfert; Jahoda, Andrew; Pert, Carol; Trower, Peter; Dagnan, Dave; Selkirk, Mhairi

    2014-01-01

    Background: The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated. Method: To explore their views and expectations of cognitive behaviour therapy (CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were…

  5. Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials.

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    Dèttore, Davide; Pozza, Andrea; Andersson, Gerhard

    2015-01-01

    Cognitive behavioural therapy (CBT) is a well-established treatment for obsessive-compulsive disorder (OCD). However, few patients receive CBT, due to factors such as geographic limitations, perceived stigmatization, and lack of CBT services. Technology-delivered cognitive behavioural therapy (T-CBT) could be an effective strategy to improve patients' access to CBT. To date, a meta-analysis on the effectiveness of T-CBT for OCD has not been conducted. This study used meta-analytic techniques to summarize evidence on the efficacy of T-CBT for OCD versus control conditions and therapist-administered CBT. A meta-analysis according to Prisma guidelines was conducted on randomized controlled trials (RCTs) of T-CBT for OCD. Treatment was classified as T-CBT if evidence-based CBT active ingredients for OCD were included (psychoeducation, ERP, and cognitive restructuring), delivered through health technologies (e.g. self-help books, leaflets, and other forms of bibliotherapy) or remote communication technologies (e.g. the Internet, web-cameras, telephones, telephone-interactive voice response systems, and CD-ROMS). Studies using validated outcomes for OCD or depression were included. Eight trials were included (N = 420). Two trials were classified as at high risk of bias. T-CBT seemed to be superior to control conditions on OCD symptom outcomes at post-treatment (d = 0.82, 99% CI = 0.55-1.08, p = 0.001), but not on comorbid depression (d = 0.33, 99% CI = - 0.01-0.67, p = 0.020). Difference in the efficacy on OCD symptoms between T-CBT and therapist-administered CBT was not significant, despite a trend favouring therapist-administered CBT emerged (d = 0.45, 95% CI = 0.03-0.87, p = 0.033). Directions for research are discussed. Further RCTs are warranted to examine the efficacy of T-CBT for OCD.

  6. Reductions in negative repetitive thinking and metacognitive beliefs during transdiagnostic internet cognitive behavioural therapy (iCBT) for mixed anxiety and depression

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    Newby, Jill M; Williams, Alishia D; Andrews, Gavin

    2014-01-01

    We explored whether transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) for mixed anxiety and depression effectively reduces repetitive negative thinking (RNT), and whether reductions in RNT and positive metacognitive beliefs mediate symptom improvement during iCBT. Participants

  7. Exploring the Use of Cognitive Behavioural Therapy (CBT for Reducing Rider Stress and Stress-Related Anxiety, Anger, and Worry

    Directory of Open Access Journals (Sweden)

    Kristen Fernández-Medina

    2016-10-01

    Full Text Available Stress can have serious implications on road safety and evidence suggests that it could lead to increases in driving errors, lapses, and even crashes. Motorcyclists are a vulnerable road user group, and lapses in attention and risky behaviours resulting from stress could increase the risk of collision. However, few safety interventions for reducing stress have been developed and evaluated, especially in motorcyclists. The purpose of this research was to develop and pilot a Cognitive Behavioural Therapy (CBT course for the treatment of rider stress. Five motorcyclists experiencing a range of life and work stressors completed the CBT course between January and March 2015. Findings from the Driver Stress Inventory and Driver Behaviour Questionnaire showed positive trends in the overall reduction of rider stress traits, such as aggression, thrill seeking, and dislike of riding. Qualitative data showed that participants engaged well with the intervention and believed it had aided them in their riding-related stress. Although these results are promising, the results warrant further investigation in order to validate CBT as a viable means of reducing the collision risk both for this already vulnerable road user group and other driver categories.

  8. Feasibility of guided cognitive behaviour therapy (CBT) self-help for childhood anxiety disorders in primary care.

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    Creswell, Cathy; Hentges, Francoise; Parkinson, Monika; Sheffield, Paul; Willetts, Lucy; Cooper, Peter

    2010-03-01

    Anxiety disorders in childhood are common, disabling and run a chronic course. Cognitive behaviour therapy (CBT) is effective but expensive and trained therapists are scarce. Guided self-help treatments may be a means of widening access to treatment. This study aimed to examine the feasibility of guided CBT self-help in primary care for childhood anxiety disorders, specifically in terms of therapist adherence, patient and therapist satisfaction and clinical gain.Participants were children aged between five and 12 years referred to two primary child and adolescent mental health services (PCAMHSs) in Oxfordshire, UK, who met diagnostic criteria for a primary anxiety disorder. Of the 52 eligible children, 41 anxious children were assessed for anxiety severity and interference before and after receiving CBT self-help delivered via a parent (total therapy time = five hours) by primary mental health workers (PMHWs). Therapy sessions were rated for treatment adherence and parents and PMHWs completed satisfaction questionnaires after treatment completion. Over 80% of therapy sessions were rated at a high level of treatment adherence. Parents and PMHWs reported high satisfaction with the treatment. Sixty-one percent of the children assessed no longer met the criteria for their primary anxiety disorder diagnosis following treatment, and 76% were rated as 'much'/'very much' improved on the Clinical Global Impression-Improvement (CGI-I) scale. There were significant reductions on parent and child report measures of anxiety symptoms, interference and depression. Preliminary exploration indicated that parental anxiety was associated with child treatment outcome. The findings suggest that guided CBT self-help represents a promising treatment for childhood anxiety in primary care.

  9. Effectiveness of cognitive behavioural therapy (CBT) programmes for anxiety or depression in adults with intellectual disabilities: A review of the literature.

    Science.gov (United States)

    Unwin, Gemma; Tsimopoulou, Ioanna; Kroese, Biza Stenfert; Azmi, Sabiha

    2016-01-01

    Relatively little is known about the application of cognitive behavioural therapy (CBT) to people with intellectual disabilities (ID). This review sought to synthesise available evidence on the effectiveness of CBT for anxiety or depression to assess the current level of evidence and make recommendations for future research. A comprehensive systematic literature search was conducted to identify qualitative and quantitative studies. Robust criteria were applied to select papers that were relevant to the review. Included papers were subject to quality appraisal. Eleven out of the 223 studies considered met our inclusion criteria and were included in the review in which CBT was used with participants with ID and anxiety (n=3), depression (n=4) or a mixed clinical presentation (n=4). There remains a paucity of evidence of effectiveness, however, the studies indicate that CBT is feasible and well-tolerated and may be effective in reducing symptoms of depression among adults with mild ID. Qualitative data reflect a positive perception of CBT amongst clients and carers. Further research is required to investigate the components of CBT, suitability for CBT, and requisite skills for CBT, which uses valid, sensitive and more holistic outcome measures.

  10. Internet-based cognitive behavioural therapy (iCBT) for posttraumatic stress disorder versus waitlist control: study protocol for a randomised controlled trial

    OpenAIRE

    Allen, Adrian R; Jill M. Newby; Smith, Jessica; Andrews, Gavin

    2015-01-01

    Background This randomised controlled trial (RCT) with two parallel arms will evaluate the efficacy of an internet-delivered six-lesson 10-week cognitive behavioural therapy (iCBT) intervention for posttraumatic stress disorder (PTSD). It will also investigate the association between changes in PTSD symptoms, intolerance of uncertainty (IU) and emotion regulation. Methods/Design Patients with PTSD will be recruited via the research arm of a not-for-profit clinical and research unit in Austral...

  11. Cognitive behaviour therapy for generalized anxiety disorder: Is CBT equally efficacious in adults of working age and older adults?

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    Kishita, Naoko; Laidlaw, Ken

    2017-03-01

    The current meta-analysis compared the efficacy of CBT for GAD between adults of working age and older people. In addition, we conducted a qualitative content analysis of treatment protocols used in studies with older clients to explore potential factors that may enhance treatment outcomes with this particular client group. Applying the inclusion criteria resulted in the identification of 15 studies with 22 comparisons between CBT and control groups (770 patients). When examining overall effect sizes for CBT for GAD between older people and adults of working age there were no statistically significant differences in outcome. However, overall effect size of CBT for GAD was moderate for older people (g=0.55, 95% CI 0.22-0.88) and large for adults of working age (g=0.94, 95% CI 0.52-1.36), suggesting that there is still room for improvement in CBT with older people. The main difference in outcome between CBT for GAD between the two age groups was related to methodological quality in that no older people studies used an intention-to-treat design. The content analysis demonstrated that studies with older clients were conducted according to robust CBT protocols but did not take account of gerontological evidence to make them more age-appropriate. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  12. Caring For Me and You: the co-production of a computerised cognitive behavioural therapy (cCBT) package for carers of people with dementia.

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    Hales, Susie A; Fossey, Jane

    2017-07-10

    Carers of people with dementia face barriers in accessing therapy for mental health difficulties. Computerised cognitive behavioural therapy (cCBT) packages can be effective in treating a range of presentations; however, tailored packages for carers' unique needs are lacking. Our aim was to design a cCBT package for carers to address the limitations of previous online interventions, by including users and experts as consultants and collaborators throughout the project. We adopted a three-phase approach to the development process. Firstly, a data-gathering phase in which current literature and best practice was reviewed, and semi-structured interviews conducted with service users, academic and clinical experts. Secondly, a co-production and refinement phase with carers testing materials and providing feedback. Thirdly, a pilot field testing phase of service users and the research team testing the package. The 'Caring For Me and You' package adopted a transdiagnostic approach to take account of the range of difficulties that carers face. The package consisted of 20 short sessions with features built in to engage users and personalise content to meet individuals' needs. User involvement was central to the design of the 'Caring For Me and You' package which is currently being evaluated in a three-arm randomised controlled trial.

  13. Feasibility randomised controlled trial of Recovery-focused Cognitive Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA): study protocol.

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    Tyler, Elizabeth; Lobban, Fiona; Sutton, Chris; Depp, Colin; Johnson, Sheri; Laidlaw, Ken; Jones, Steven H

    2016-03-03

    Bipolar disorder is a severe and chronic mental health problem that persists into older adulthood. The number of people living with this condition is set to rise as the UK experiences a rapid ageing of its population. To date, there has been very little research or service development with respect to psychological therapies for this group of people. A parallel two-arm randomised controlled trial comparing a 14-session, 6-month Recovery-focused Cognitive-Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA) plus treatment as usual (TAU) versus TAU alone. Participants will be recruited in the North-West of England via primary and secondary mental health services and through self-referral. The primary objective of the study is to evaluate the feasibility and acceptability of RfCBT-OA; therefore, a formal power calculation is not appropriate. It has been estimated that randomising 25 participants per group will be sufficient to be able to reliably determine the primary feasibility outcomes (eg, recruitment and retention rates), in line with recommendations for sample sizes for feasibility/pilot trials. Participants in both arms will complete assessments at baseline and then every 3 months, over the 12-month follow-up period. We will gain an estimate of the likely effect size of RfCBT-OA on a range of clinical outcomes and estimate parameters needed to determine the appropriate sample size for a definitive, larger trial to evaluate the effectiveness and cost-effectiveness of RfCBT-OA. Data analysis is discussed further in the Analysis section in the main paper. This protocol was approved by the UK National Health Service (NHS) Ethics Committee process (REC ref: 15/NW/0330). The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations and local, participating NHS trusts. ISRCTN13875321; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  14. Internet-based cognitive behavioural therapy (iCBT) for posttraumatic stress disorder versus waitlist control: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Allen, Adrian R; Newby, Jill M; Smith, Jessica; Andrews, Gavin

    2015-12-01

    This randomised controlled trial (RCT) with two parallel arms will evaluate the efficacy of an internet-delivered six-lesson 10-week cognitive behavioural therapy (iCBT) intervention for posttraumatic stress disorder (PTSD). It will also investigate the association between changes in PTSD symptoms, intolerance of uncertainty (IU) and emotion regulation. Patients with PTSD will be recruited via the research arm of a not-for-profit clinical and research unit in Australia and randomised to a treatment group or waitlist control group. The minimum sample size for each group (alpha 0.05, power 0.80 for a g of 0.47) was identified as 72, but 10 % more will be recruited to hedge against expected attrition. PTSD diagnosis will be determined using the PTSD module from the Mini International Neuropsychiatric Interview version 5.0.0. The PTSD Checklist - Civilian version (PCL-C) will be used to measure PTSD symptoms (the primary outcome measure), with the Intolerance of Uncertainty Scale 12-item version (IUS-12) and the Emotion Regulation Questionnaire (ERQ) used to measure intolerance of uncertainty and emotion regulation, respectively. The PCL-C will be administered to the treatment group before each lesson of the PTSD program and at 3-month follow-up. The IUS-12 and ERQ will be administered before lessons 1 and 4, at post-treatment and at 3-month follow-up. The waitlist control group will complete these measures at week 1, week 5 and week 11 of the waitlist period. PTSD program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at 3-month follow-up. Mediation analyses using PROCESS will be used to examine the association between change in PTSD symptoms over treatment and change in each of IU and emotion regulation ability in separate analyses. The current RCT seeks to replicate previous efficacy findings of iCBT for PTSD in a formally assessed PTSD sample from the general population. Findings may point to future lines of

  15. Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders.

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    Carter, Olivia; Pannekoek, Louise; Fursland, Anthea; Allen, Karina L; Lampard, Amy M; Byrne, Susan M

    2012-08-01

    Between 30 and 70% of patients with eating disorders drop out from outpatient treatment. However, research has been unable to identify factors that consistently predict dropout from eating disorder treatment. Most studies have exclusively investigated the role that individual patient characteristics play in dropout and have ignored more process-based factors such as expectations about treatment, the therapeutic alliance, or time spent on a treatment waiting list. This study aimed to investigate the roles of both individual patient characteristics and process-based factors in dropout from outpatient treatment for eating disorders. The study involved data collected from consecutive eating disorder referrals to the only public specialist eating disorder service for youth and adults in Perth, Western Australia. The standard treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty five percent of this sample dropped out of treatment. Results showed that, in this sample, two individual factors, lowest reported weight and the tendency to avoid affect, and one process-based factor, time spent on the wait list for treatment, were significant predictors of dropout. These findings are valuable because a process-based factor, such as wait-list time, may be easier to address and modify than a patient's weight history or the trait of mood intolerance. Increased resources for eating disorder services may reduce waiting list times which would help to reduce dropout and maximize treatment outcomes.

  16. Effectiveness and cost effectiveness of cognitive behavioral therapy (CBT) in clinically depressed adolescents: individual CBT versus treatment as usual (TAU)

    NARCIS (Netherlands)

    Stikkelbroek, Y.; Bodden, D.H.M.; Dekoviç, M.; Baar, A.L. van

    2013-01-01

    Background: Depressive disorders occur in 2 to 5% of the adolescents and are associated with a high burden of disease, a high risk of recurrence and a heightened risk for development of other problems, like suicide attempts. The effectiveness of cognitive behaviour therapy (CBT), cost-effectiveness

  17. Web-based cognitive behavioural therapy (W-CBT) for diabetes patients with co-morbid depression

    DEFF Research Database (Denmark)

    van Bastelaar, Kim M P; Pouwer, Frans; Cuijpers, Pim

    2008-01-01

    on an individual basis. Participants receive feedback on their homework assignments by e-mail from their coach. We aim to include 286 patients (143/143), as power analyses showed that this number is needed to detect an effect size of 0.35, with measurements at baseline, directly after completing the web......-based intervention and at 1, 3, 4 and 6 months follow-up. Patients in the control condition are placed on a waiting list, and follow the course 12 weeks after randomisation. Primary outcomes are depressive symptoms and diabetes-specific emotional distress. Secondary outcomes are satisfaction with the course......, perceived health status, self-care behaviours, glycaemic control, and days in bed/absence from work. Questionnaires are administered via the Internet. DISCUSSION: The intervention being trialled is expected to help improve mood and reduce diabetes-specific emotional distress in diabetes patients...

  18. A feasibility open trial of internet-delivered cognitive-behavioural therapy (iCBT among consumers of a non-governmental mental health organisation with anxiety

    Directory of Open Access Journals (Sweden)

    Terry Kirkpatrick

    2013-11-01

    Full Text Available Background. To date the efficacy and acceptability of internet-delivered cognitive behavioural treatments (iCBT has been examined in clinical trials and specialist facilities. The present study reports the acceptability, feasibility and preliminary efficacy of an established iCBT treatment course (the Wellbeing Course administered by a not-for-profit non-governmental organisation, the Mental Health Association (MHA of New South Wales, to consumers with symptoms of anxiety.Methods. Ten individuals who contacted the MHA’s telephone support line or visited the MHA’s website and reported at least mild symptoms of anxiety (GAD-7 total scores ≥5 were admitted to the study. Participants were provided access to the Wellbeing Course, which comprises five online lessons and homework assignments, and brief weekly support from an MHA staff member via telephone and email. The MHA staff member was an experienced mental health professional and received minimal training in administering the intervention.Results. All 10 participants completed the course within the 8 weeks. Post-treatment and two month follow-up questionnaires were completed by all participants. Mean within-group effect sizes (Cohen’s d for the Generalized Anxiety Disorder 7 Item (GAD-7 and Patient Health Questionnaire 9 Item (PHQ-9 were large (i.e., > .80 and consistent with previous controlled research. The Course was also rated as highly acceptable with all 10 participants reporting it was worth their time and they would recommend it to a friend.Conclusions. These results provide support for the potential clinical utility of iCBT interventions and the acceptability and feasibility of employing non-governmental mental health organisations to deliver these treatments. However, further research is needed to examine the clinical efficacy and cost-effectiveness of delivering iCBT via such organisations.

  19. Cognitive behavioural therapies versus other psychological therapies for depression.

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    Churchill, Rachel; Moore, Theresa Hm; Caldwell, Deborah; Davies, Philippa; Jones, Hannah; Furukawa, Toshi A; Lewis, Glyn; Hunot, Vivien

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all CBT approaches compared with all other psychological therapy approaches for acute depressionTo examine the effectiveness and acceptability of different CBT approaches (cognitive therapy, rational emotive behaviour therapy, problem-solving therapy, self-control therapy and Coping with Depression course) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all CBT approaches compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, third wave CBT) for acute depression.

  20. After the Assessment: Introducing Adolescents to Cognitive-Behavioural Therapy

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    Cosgrave, Elizabeth; Keating, Vanessa

    2006-01-01

    The objective of this article is to describe the practical aspects involved in adapting cognitive-behavioural therapy (CBT) to an adolescent population in Australia. Some effective ways to use CBT with adolescents include preparing them for CBT by providing a thorough cognitive-behavioural formulation, describing the cognitive-behavioural approach…

  1. The evolution of behaviour therapy and cognitive behaviour therapy.

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    Rachman, S

    2015-01-01

    The historical background of the development of behaviour therapy is described. It was based on the prevailing behaviourist psychology and constituted a fundamentally different approach to the causes and treatment of psychological disorders. It had a cold reception and the idea of treating the behaviour of neurotic and other patients was regarded as absurd. The opposition of the medical profession and psychoanalysts is explained. Parallel but different forms of behaviour therapy developed in the US and UK. The infusion of cognitive concepts and procedures generated a merger of behaviour therapy and cognitive therapy, cognitive behaviour therapy (CBT). The strengths and limitations of the early and current approaches are evaluated.

  2. The efficacy of Cognitive-Behavioural Therapy (CBT) as related to sleep quality and hyperarousal level in the treatment of primary insomnia

    National Research Council Canada - National Science Library

    Gałuszko-Węgielnik, Maria; Jakuszkowiak-Wojten, Katarzyna; Wiglusz, Mariusz Stanisław; Cubała, Wiesław Jerzy; Landowski, Jerzy

    2012-01-01

    .... The aim of the study was to determine the efficacy of a CBT-protocol in the treatment of PI by means of sleep onset latency and the number of awakenings during night parameters along with sleep...

  3. The efficacy of Cognitive-Behavioural Therapy (CBT) as related to sleep quality and hyperarousal level in the treatment of primary insomnia.

    Science.gov (United States)

    Gałuszko-Węgielnik, Maria; Jakuszkowiak-Wojten, Katarzyna; Wiglusz, Mariusz Stanisław; Cubała, Wiesław Jerzy; Landowski, Jerzy

    2012-09-01

    Primary insomnia (PI) is a common sleep disorder affecting diurnal functioning. It may contribute to the development of several comorbidities such as major depression or arterial hypertension. It affects about 7% of the adult population. Pharmacotherapy remains the most common treatment for insomnia. However, many studies suggest CBT may be a supreme therapeutic approach resulting in a better long-term outcome. The aim of the study was to determine the efficacy of a CBT-protocol in the treatment of PI by means of sleep onset latency and the number of awakenings during night parameters along with sleep quality and the level of psychophysiological hyperarousal. The secondary outcomes were focused on CBT efficacy as determined by the predisposition to insomnia as related to higher vulnerability to stress (measured with FIRST) MATERIAL AND METHODS: Twenty-six individuals from a tertiary reference sleep disorders outpatients' clinic (22 women; mean age 41.4; 4 men; mean age 42.5) with primary insomnia (DSM-IV-TR) were included in the study. The exclusion covered other primary sleep disorders, secondary insomnia (psychiatric illness, unstable somatic illness, shift work), substance abuse/dependence, high results in HADS-M scale (score above 11). The participants were scored with HADS-M, Ford Insomnia Response to Stress Test (FIRST) at the beginning of the study. The Athens Insomnia Scale (AIS), Hyperarousal Scale, Leeds Sleep Questionnaire (LSEQ) were applied at the beginning, at the end and three months after the end of the study. The participants were also examined by 7 days actigraphic records before and after treatment. During the course of the treatment patients completed a Sleep Diary (SD). The CBT program employed was based on the Perlis protocol. Standard individual sessions of 50 minutes were provided on a weekly basis for 8-10 weeks by a board certified CBT therapist. After 3 months a follow-up session was scheduled. The significant improvement as related to

  4. A pilot evaluation on a stress management programme using a combined approach of cognitive behavioural therapy (CBT) and complementary and alternative medicine (CAM) for elementary school teachers.

    Science.gov (United States)

    Tsang, Hector W H; Cheung, W M; Chan, Alan H L; Fung, Kelvin M T; Leung, Ada Y; Au, Doreen W H

    2015-02-01

    The aim of this study is to explore the efficacy of implementing a stress management programme based on a combined approach using cognitive behavioural therapy and complementary and alternative medicine for elementary school teachers who experienced mild level of stress, anxiety and/or depressive symptoms in Hong Kong. A 12-h programme involving cognitive behavioural therapy, self-management, relaxation techniques (diaphragmatic breathing and progressive muscle relaxation), mindful exercises (qigong and yoga), aromatherapy and acupressure was conducted. A quasi-experimental design was used to compare the intervention groups (n = 47) with the wait-list control groups (n = 46). The primary outcome measures were depression, anxiety and stress. Results indicated that the intervention group had significant reduction in depression [(F = 3.93; degrees of freedom (df) = 2.90; p = 0.023)], anxiety (F = 3.37; df = 2.90; p = 0.039) and stress (F = 3.63; df = 2.89; p = 0.031) when compared with the control group. Participants in both groups demonstrated lowered level of salivary cortisol at the post-assessment. The pilot results provided preliminary support to the multi-component stress management programme in relieving affective symptoms of teachers. The programme may be considered as an initial strategy to empower teachers with the abilities to cope with their affective symptoms. Further evaluation using a better designed randomized study with a larger sample size is warranted. (word: 198; max.: 200).

  5. Protocol for a randomised controlled trial of a school based cognitive behaviour therapy (CBT intervention to prevent depression in high risk adolescents (PROMISE

    Directory of Open Access Journals (Sweden)

    Sayal Kapil

    2010-11-01

    Full Text Available Abstract Background Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Relatively few adolescents with depression are identified and referred for treatment indicating the need to investigate alternative preventive approaches. Study Design A pragmatic cluster randomised controlled trial evaluating the effectiveness of a school based prevention programme on symptoms of depression in "high risk" adolescents (aged 12-16. The unit of allocation is year groups (n = 28 which are assigned to one of three conditions: an active intervention based upon cognitive behaviour therapy, attention control or treatment as usual. Assessments will be undertaken at screening, baseline, 6 months and 12 months. The primary outcome measure is change on the Short Mood and Feeling Questionnaire at 12 months. Secondary outcome measures will assess changes in negative thoughts, self esteem, anxiety, school connectedness, peer attachment, alcohol and substance misuse, bullying and self harm. Discussion As of August 2010, all 28 year groups (n = 5023 had been recruited and the assigned interventions delivered. Final 12 month assessments are scheduled to be completed by March 2011. Trial Registration ISRCTN19083628

  6. Web-based cognitive behavioural therapy (W-CBT for diabetes patients with co-morbid depression: Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pouwer Frans

    2008-02-01

    Full Text Available Abstract Background Depression is common among people with diabetes, negatively affecting quality of life, treatment adherence and diabetes outcomes. In routine clinical care, diabetes patients have limited access to mental health services and depression therefore often remains untreated. Web-based therapy could potentially be an effective way to improve the reach of psychological care for diabetes patients, at relatively low costs. This study seeks to test the effectiveness of a web-based self-help depression programme for people with diabetes and co-morbid depression. Methods/Design The effectiveness of a web-based self-help course for adults with diabetes with co-morbid depression will be tested in a randomised trial, using a wait-list controlled design. The intervention consists of an 8-week, moderated self-help course that is tailored to the needs of persons living with diabetes and is offered on an individual basis. Participants receive feedback on their homework assignments by e-mail from their coach. We aim to include 286 patients (143/143, as power analyses showed that this number is needed to detect an effect size of 0.35, with measurements at baseline, directly after completing the web-based intervention and at 1, 3, 4 and 6 months follow-up. Patients in the control condition are placed on a waiting list, and follow the course 12 weeks after randomisation. Primary outcomes are depressive symptoms and diabetes-specific emotional distress. Secondary outcomes are satisfaction with the course, perceived health status, self-care behaviours, glycaemic control, and days in bed/absence from work. Questionnaires are administered via the Internet. Discussion The intervention being trialled is expected to help improve mood and reduce diabetes-specific emotional distress in diabetes patients with depression, with subsequent beneficial effects on diabetes self-care and glycaemic outcomes. When proven efficacious, the intervention could be

  7. Cognitive behavioral therapy (CBT) for preventing Alzheimer's disease.

    Science.gov (United States)

    Reid, Larry D; Avens, Faith E; Walf, Alicia A

    2017-09-15

    This review provides the rationale for implementing cognitive behavioral therapy (CBT) for the prevention of Alzheimer's disease (AD). There are known risk factors associated with the development of AD, some of which may be ameliorated with CBT. We posit that treating the risk factors of inactivity, poor diet, hyposmia and anosmia, sleep disorders and lack of regularly engaged challenging cognitive activity will modify the physiology of the brain sufficiently to avoid the accumulation of excess proteins, including amyloid beta, causal events in the development of AD. Further, the successful treatment of the listed risk factors is well within our technology to do so and, even further, it is cost effective. Also, there is considerable scientific literature to support the proposition that, if implemented by well-established practices, CBT will be effective and will be engaged by those of retirement age. That is, we present a biologically informed CBT for the prevention of the development of AD, i.e., an aspect of applied behavioral neuroscience. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The Effect of Cognitive Behavioral Therapy (CBT) on Depression: The Role of Problem-Solving Appraisal

    Science.gov (United States)

    Chen, Szu-Yu; Jordan, Catheleen; Thompson, Sanna

    2006-01-01

    Objective: Many studies have confirmed the efficacy of cognitive behavioral therapy (CBT) as a treatment for depression. However, the mechanism of CBT for depression reduction is still not well understood. This study explored the mechanism of CBT from the perspective of individuals' problem-solving appraisal. Method: A one-group pretest-posttest…

  9. The Effect of Cognitive Behavioral Therapy (CBT) on Depression: The Role of Problem-Solving Appraisal

    Science.gov (United States)

    Chen, Szu-Yu; Jordan, Catheleen; Thompson, Sanna

    2006-01-01

    Objective: Many studies have confirmed the efficacy of cognitive behavioral therapy (CBT) as a treatment for depression. However, the mechanism of CBT for depression reduction is still not well understood. This study explored the mechanism of CBT from the perspective of individuals' problem-solving appraisal. Method: A one-group pretest-posttest…

  10. Enhancing CBT for Chronic Insomnia: A Randomised Clinical Trial of Additive Components of Mindfulness or Cognitive Therapy.

    Science.gov (United States)

    Wong, Mei Yin; Ree, Melissa J; Lee, Christopher W

    2016-09-01

    Although cognitive behavioural therapy (CBT) for insomnia has resulted in significant reductions in symptoms, most patients are not classified as good sleepers after treatment. The present study investigated whether additional sessions of cognitive therapy (CT) or mindfulness-based therapy (MBT) could enhance CBT in 64 participants with primary insomnia. All participants were given four sessions of standard CBT as previous research had identified this number of sessions as an optimal balance between therapist guidance and patient independence. Participants were then allocated to further active treatment (four sessions of CT or MBT) or a no further treatment control. The additional treatments resulted in significant improvements beyond CBT on self-report and objective measures of sleep and were well tolerated as evidenced by no dropouts from either treatment. The effect sizes for each of these additional treatments were large and clinically significant. The mean scores on the primary outcome measure, the Insomnia Severity Index, were 5.74 for CT and 6.69 for MBT, which are within the good-sleeper range. Treatment effects were maintained at follow-up. There were no significant differences between CT and MBT on any outcome measure. These results provide encouraging data on how to enhance CBT for treatment of insomnia. Copyright © 2015 John Wiley & Sons, Ltd. CBT treatments for insomnia can be enhanced using recent developments in cognitive therapy. CBT treatments for insomnia can be enhanced using mindfulness-based treatments. Both cognitive therapy and mindfulness produce additional clinically significant change. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Mindfulness-based 'third wave' cognitive and behavioural therapies versus other psychological therapies for depression.

    Science.gov (United States)

    Hunot, Vivien; Moore, Theresa Hm; Caldwell, Deborah; Davies, Philippa; Jones, Hannah; Lewis, Glyn; Churchill, Rachel

    2010-09-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all third wave CBT approaches compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different third wave CBT approaches (ACT,compassionate mind training, functional analytic psychotherapy, extended behavioural activation and meta-cognitive therapy) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all third wave CBT approaches compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression.

  12. History of Cognitive-Behavioral Therapy (CBT) in Youth

    OpenAIRE

    Benjamin, Courtney L.; Puleo, Connor M.; Settipani, Cara A.; Brodman, Douglas M; Edmunds, Julie M.; Cummings, Colleen M.; Kendall, Philip C

    2011-01-01

    CBT represents a combination of behavioral and cognitive theories of human behavior and psychopathology, and a melding of emotional, familial, and peer influences. The numerous intervention strategies that comprise CBT reflect its complex and integrative nature and include such topics as extinction, habituation, modeling, cognitive restructuring, problem-solving, and the development of coping strategies, mastery, and a sense of self-control. CBT targets multiple areas of potential vulnerabili...

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

    Science.gov (United States)

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

    2009-01-01

    Objective: To describe the elements of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. Method: The CBT-SP was developed using a risk reduction and relapse prevention approach and…

  14. Anxious Children and Adolescents Non-responding to CBT: Clinical Predictors and Families' Experiences of Therapy.

    Science.gov (United States)

    Lundkvist-Houndoumadi, Irene; Thastum, Mikael

    2017-01-01

    The purpose of the study was to examine clinical predictors of non-response to manualized cognitive behaviour therapy (CBT) among youths (children and adolescents) with anxiety disorders, and to explore families' perspective on therapy, using a mixed methods approach. Non-response to manualized group CBT was determined among 106 youths of Danish ethnicity (7-17 years old) with a primary anxiety disorder, identified with the Clinical Global Impression of Improvement Scale at the 3-month follow-up. Twenty-four youths (22.6 %) had not responded to treatment, and a logistic regression analysis revealed that youths with a primary diagnosis of social phobia were seven times more likely not to respond, whereas youths with a comorbid mood disorder were almost four times more likely. Families of non-responding youths with primary social phobia and/or a comorbid mood disorder (n = 15) were interviewed, and data were analysed through interpretative phenomenological analysis. Two superordinate themes emerged: youths were not involved in therapy work, and manualized group format posed challenges to families. The mixed methods approach provided new perspectives on the difficulties that may be encountered by families of non-responding youths with a primary social phobia diagnosis and youths with a comorbid mood disorder during manualized group CBT. Clinical implications related to youths' clinical characteristics, and families' experience and suggestions are drawn. Copyright © 2015 John Wiley & Sons, Ltd. Youths with an anxiety disorder, who had a primary social phobia diagnosis and those, who had a comorbid mood disorder, were more likely not to respond to manualized group CBT. Parents of those non-responding youths often considered them as motivated to overcome their difficulties, but due to their symptomatology, they were unreceptive, reluctant and ambivalent and therefore not actively involved in therapy. The non-responding youths with social phobia felt evaluated and

  15. Brief intensive CBT for pediatric OCD with E-therapy maintenance.

    Science.gov (United States)

    Farrell, Lara J; Oar, Ella L; Waters, Allison M; McConnell, Harry; Tiralongo, Evelin; Garbharran, Vinay; Ollendick, Thomas

    2016-08-01

    Cognitive behaviour therapy (CBT), incorporating exposure and response prevention (ERP), has received strong empirical support for the treatment of paediatric OCD, and moreover, is considered the first line treatment of choice (Geller & March, 2012). However, despite the availability of effective treatments for this chronic and debilitating disorder, only a small proportion of youth receive these evidence-based approaches. The present study aimed to examine the effectiveness of an intensive ERP-based treatment for youth OCD, using a multiple baseline controlled design. Children and youth (N=10; aged 11-16 years) with a primary diagnosis of OCD were randomly assigned to a 1- or 2-week baseline monitoring condition followed by the intervention. The efficacy of the intensive treatment, involving 1 session psychoeducation, 2-sessions ERP plus e-therapy maintenance was examined across parent- child- and clinician-rated measures at post-treatment and 6-month follow-up. Overall, there were significant reductions across time on almost all measures (except self-report anxiety), and moreover, the majority of the sample (80%) were considered reliably improved, and meeting clinically significant change. At post-treatment, 60% were in remission of symptoms, and at 6-month follow-up this increased to 70%. These findings provide strong support for intensive, time-limited approaches to ERP-based CBT for children and youth with OCD.

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

    Science.gov (United States)

    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%…

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

    Science.gov (United States)

    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%…

  18. Experiences of Enhanced Cognitive Behaviour Therapy for Bulimia Nervosa.

    Science.gov (United States)

    Onslow, Louise; Woodward, Debbie; Hoefkens, Toni; Waddington, Louise

    2016-03-01

    Recent quantitative studies provide support for an "enhanced" transdiagnostic approach of Cognitive Behaviour Therapy (CBT-E) for eating disorders; however it is not yet known how recipients of CBT-E experience therapy. The current study used a qualitative approach to explore service users' experiences of CBT-E. Individuals with a diagnosis of bulimia nervosa and who had completed CBT-E from one service in Wales were invited to participate. Semi-structured interviews were completed with eight individuals and analysed using Interpretative Phenomenological Analysis (IPA). Participants valued both specific and non-specific elements of CBT-E. Therapist specialism in eating disorders was considered to enhance therapist empathy. The most helpful aspects specific to CBT-E were gaining insight into maintenance cycles and experiential learning. The most challenging aspects of CBT-E were changing behaviours and cognitions "in the moment" and in the longer-term. The implication of therapist specialism and empathy is further discussed, as well as the difficulty for CBT-E in changing service users' long-standing core beliefs.

  19. Cognitive Behavioural Therapy for anorexia nervosa: a systematic review.

    Science.gov (United States)

    Galsworthy-Francis, Lisa; Allan, Steven

    2014-02-01

    Evidence for the effectiveness of psychological therapies for anorexia nervosa (AN) is inconsistent. There have been no systematic reviews solely on the effectiveness for Cognitive Behavioural Therapy (CBT) for AN. This review aimed to synthesise and appraise the recent evidence for CBT as a treatment for AN. Using specific search criteria, 16 relevant articles were identified which evaluated CBT alone or as part of a broader randomised/non-randomised trial. Various formats of CBT were utilised in the reviewed papers. Studies were evaluated using established quality criteria. The evidence reviewed suggested that CBT demonstrated effectiveness as a means of improving treatment adherence and minimising dropout amongst patients with AN. While CBT appeared to demonstrate some improvements in key outcomes (body mass index, eating-disorder symptoms, broader psychopathology), it was not consistently superior to other treatments (including dietary counselling, non-specific supportive management, interpersonal therapy, behavioural family therapy). Numerous methodological limitations apply to the available evidence. Further research and ongoing review is needed to evaluate the settings, patient groups and formats in which CBT may be effective as a treatment for AN.

  20. Riding the waves: A functional-cognitive perspective on the relations among behaviour therapy, cognitive behaviour therapy and acceptance and commitment therapy.

    Science.gov (United States)

    De Houwer, Jan; Barnes-Holmes, Yvonne; Barnes-Holmes, Dermot

    2016-02-01

    Different types of therapy explain psychopathology and the effects of psychotherapy differently. Different explanations are, however, not necessarily mutually exclusive. Based on the idea that functional and cognitive explanations are situated at different levels, we argue that functional therapies such as traditional Behaviour Therapy (BT) and Acceptance and Commitment Therapy (ACT) are not necessarily incompatible with Cognitive Behaviour Therapy (CBT). Whether a functional and a cognitive therapy actually align depends on whether they highlight the same type of environmental causes. This functional-cognitive perspective reveals various differences and communalities among BT, CBT and ACT. © 2015 International Union of Psychological Science.

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

    Science.gov (United States)

    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

  2. Cognitive-Behavioural Therapy for Children with Behavioural Difficulties in the Singapore Mainstream School Setting

    Science.gov (United States)

    Yeo, Lay See; Choi, Pui Meng

    2011-01-01

    The present study investigated the effectiveness of a cognitive-behavioural therapy (CBT) programme delivered by a school psychologist for children with behavioural difficulties in Singapore elementary school classrooms. It examined the impact of a 12-session, psychoeducational group intervention in helping misbehaving pupils to control their…

  3. Intensive Outpatient Cognitive Behaviour Therapy for Eating Disorder

    Directory of Open Access Journals (Sweden)

    Riccardo Dalle Grave

    2008-12-01

    Full Text Available The aim of this paper is to describe a novel model of intensive outpatient cognitive-behaviour therapy (CBT indicated for eating disorder patients who are having difficulty modifying their eating habits in response to conventional outpatient CBT. Intensive outpatient CBT is a manual based treatment derived by the CBT-Enhanced (CBT-E for eating disorders. The treatment has four features that distinguish it from the conventional outpatient CBT-E: (1 it is designed to be suitable for both adult and adolescent patients, (2 it is delivered by a multidisciplinary non-eclectic team trained in CBT, (3 there is assistance with eating, (4 there is a family therapy module for patients under the age of 18 years. Preliminary outcome of intensive outpatient CBT-E are encouraging. The treatment has been applied to 20 consecutive underweight eating disorder patients (age 18.2 ± 6.5 years; BMI 14.6 ± 1.5 kg/m2. Thirteen patients (65% concluded the treatment, five (25% were admitted at an eating disorder inpatient unit, and two (10% prematurely interrupted the treatment. Completers obtained significant weight regain and improvement of eating disorder and general psychopathology. Most of the improvements were maintained at six-month follow-up.

  4. Intensive cognitive behavioural therapy for obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Jonsson, H.; Kristensen, M.; Arendt, M.

    2015-01-01

    Despite promising results from intensive formats of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) the format is rarely used. The aim of the study was to systematically review the literature within this area of research and provide a meta-analysis of the effectiveness......-up, mainly due to slight deterioration among patients who had received intensive CBT while patients from weekly conditions changed little. In sum, the meta-analysis indicates that intensive CBT is an effective treatment for youths and adults with OCD, and could be a promising format to enhance immediate...

  5. Comparison of Cognitive-Behavioural Therapy and Psychodynamic Therapy in the Treatment of Anxiety among University Students: An Effectiveness Study

    Science.gov (United States)

    Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico

    2014-01-01

    The aim of the present study was to compare the effectiveness of cognitive-behavioural (CBT) and psychodynamic (PDT) therapies in the treatment of anxiety among university students. To this aim, the Symptom Questionnaire (SQ) was completed by 30 students assigned to CBT and by 24 students assigned to PDT, both at the beginning and at the end of…

  6. Comparison of Cognitive-Behavioural Therapy and Psychodynamic Therapy in the Treatment of Anxiety among University Students: An Effectiveness Study

    Science.gov (United States)

    Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico

    2014-01-01

    The aim of the present study was to compare the effectiveness of cognitive-behavioural (CBT) and psychodynamic (PDT) therapies in the treatment of anxiety among university students. To this aim, the Symptom Questionnaire (SQ) was completed by 30 students assigned to CBT and by 24 students assigned to PDT, both at the beginning and at the end of…

  7. Temporal patterns of change in panic disorder during cognitive behaviour therapy: an Indian study.

    Science.gov (United States)

    Manjula, M; Prasadarao, P S D V; Kumaraiah, V; Raguram, R

    2014-09-01

    CBT has been proven to be effective in the treatment of panic disorder; however, attempts to study the process of change are limited. The study evaluated the temporal patterns of change in the panic symptoms, cognitions, behaviours, and anxiety sensitivity in subjects with panic disorder being treated with CBT. Thirty subjects with panic disorder were allocated to two groups: Cognitive Behaviour Therapy (CBT, n = 15) and Behaviour Therapy (BT, n = 15). Assessments were carried out weekly for five consecutive weeks using the Semi-Structured Interview Schedule, the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire, and the Texas Panic Attack Record Form. The CBT group received comprehensive CBT and the BT group received psycho-education and Applied Relaxation. Following intervention the change was continuous and gradual on all the variables in the CBT group and the scores reduced to a functional range after 4-5 weeks of therapy. Such a change was not evident in the BT group. Significant change was evident in cognitive domains following the introduction of the exposure and cognitive restructuring within the CBT group. Both cognitive and behavioural techniques contributed to the overall change. CBT had an impact on the cognitive domains and significant changes were evident corresponding to the addition of cognitive restructuring and exposure techniques in the 3rd to 5th week. Both cognitive and behavioural components are therefore crucial for overall improvement to occur.

  8. A randomized controlled trial of CBT therapy for adults with ADHD with and without medication

    Directory of Open Access Journals (Sweden)

    Weiss Margaret

    2012-04-01

    Full Text Available Abstract Background Previous studies of psychological treatment in adults with ADHD have not controlled for medication status and include either medicated participants or mixed samples of medicated and unmedicated participants. The objective of this study is to examine whether use of medication improves outcome of therapy. Method This was a secondary analysis comparing 23 participants randomized to CBT and Dextroamphetamine vs. 25 participants randomized to CBT and placebo. Both patients and investigators were blind to treatment assignment. Two co-primary outcomes were used: ADHD symptoms on the ADHD-RS-Inv completed by the investigator and improvement in functioning as reported by the patient on the Sheehan Disability Scale. Results Both groups showed robust improvement in both symptoms and functioning, but the use of medication did not significantly improve outcome over and above use of CBT and placebo. Conclusion This study replicates previous work demonstrating that CBT is an effective treatment for ADHD in adults. Within the limits of this pilot, secondary analysis we were not able to demonstrate that medication significantly augments the outcome of CBT therapy for adults with ADHD. The study was funded by GlaxoSmithKline, Clinical Trials Registry #GSK707.

  9. Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia

    NARCIS (Netherlands)

    Spillekom-van Koulil, S.; Lankveld, W.G.J.M. van; Kraaimaat, F.W.; Helmond, T. van; Vedder, A.; Hoorn, H. van; Donders, A.R.T.; Wirken, L.; Cats, H.; Riel, P.L.C.M. van; Evers, A.W.M.

    2011-01-01

    OBJECTIVES: Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physica

  10. 'Third wave' cognitive and behavioural therapies versus other psychological therapies for depression.

    Science.gov (United States)

    Hunot, Vivien; Moore, Theresa H M; Caldwell, Deborah M; Furukawa, Toshi A; Davies, Philippa; Jones, Hannah; Honyashiki, Mina; Chen, Peiyao; Lewis, Glyn; Churchill, Rachel

    2013-10-18

    So-called 'third wave' cognitive and behavioural therapies represents a new generation of psychological therapies that are increasingly being used in the treatment of psychological problems. However, the effectiveness and acceptability of third wave cognitive and behavioural therapy (CBT) approaches as a treatment for depression compared with other psychological therapies remain unclear. 1. To examine the effects of all third wave CBT approaches compared with all other psychological therapy approaches for acute depression.2. To examine the effects of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, extended behavioural activation and metacognitive therapy) compared with all other psychological therapy approaches for acute depression.3. To examine the effects of all third wave CBT approaches compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression. We searched the Cochrane Depression, Anxiety and Neurosis Group Specialised Register (CCDANCTR to 01/01/12), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. An updated search of CCDANCTR restricted to search terms relevant to third wave CBT was conducted in March 2013 (CCDANCTR to 01/02/13). Randomised controlled trials that compared various third wave CBT with other psychological therapies for acute depression in adults. Two review authors independently identified studies, assessed trial quality and extracted data. Study authors were contacted for additional information where required. We rated the quality of evidence using GRADE methods. A total of three studies involving 144 eligible participants

  11. CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia.

    Science.gov (United States)

    Kuhn, Eric; Weiss, Brandon J; Taylor, Katherine L; Hoffman, Julia E; Ramsey, Kelly M; Manber, Rachel; Gehrman, Philip; Crowley, Jill J; Ruzek, Josef I; Trockel, Mickey

    2016-04-15

    This paper describes CBT-I Coach, a patient-facing smartphone app designed to enhance cognitive behavioral therapy for insomnia (CBT-I). It presents findings of two surveys of U.S. Department of Veterans Affairs (VA) CBT-I trained clinicians regarding their perceptions of CBT-I Coach before it was released (n = 138) and use of it two years after it was released (n = 176). VA-trained CBT-I clinicians completed web-based surveys before and two years after CBT-I Coach was publicly released. Prior to CBT-I Coach release, clinicians reported that it was moderately to very likely that the app could improve care and a majority (87.0%) intended to use it if it were available. Intention to use the app was predicted by smartphone ownership (β = 0.116, p CBT-I practices (β = 0.286, p CBT-I Coach became available, 59.9% of participants reported using it with patients and had favorable impressions of its impact on homework adherence and outcomes. Findings suggest that before release, CBT-I Coach was perceived to have potential to enhance CBT-I and address common adherence issues and clinicians would use it. These results are reinforced by findings two years after it was released suggesting robust uptake and favorable perceptions of its value. © 2016 American Academy of Sleep Medicine.

  12. Psychotherapy for transdiagnostic binge eating: A randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy.

    Science.gov (United States)

    McIntosh, Virginia V W; Jordan, Jennifer; Carter, Janet D; Frampton, Christopher M A; McKenzie, Janice M; Latner, Janet D; Joyce, Peter R

    2016-06-30

    Cognitive-behavioural therapy (CBT) is the recommended treatment for binge eating, yet many individuals do not recover, and innovative new treatments have been called for. The current study compares traditional CBT with two augmented versions of CBT; schema therapy, which focuses on early life experiences as pivotal in the history of the eating disorder; and appetite-focused CBT, which emphasises the role of recognising and responding to appetite in binge eating. 112 women with transdiagnostic DSM-IV binge eating were randomized to the three therapies. Therapy consisted of weekly sessions for six months, followed by monthly sessions for six months. Primary outcome was the frequency of binge eating. Secondary and tertiary outcomes were other behavioural and psychological aspects of the eating disorder, and other areas of functioning. No differences among the three therapy groups were found on primary or other outcomes. Across groups, large effect sizes were found for improvement in binge eating, other eating disorder symptoms and overall functioning. Schema therapy and appetite-focused CBT are likely to be suitable alternative treatments to traditional CBT for binge eating.

  13. Effectiveness of Group Cognitive Behavioral Therapy for Insomnia (CBT-I) in a Primary Care Setting.

    Science.gov (United States)

    Davidson, Judith R; Dawson, Samantha; Krsmanovic, Adrijana

    2017-05-02

    Primary care is where many patients with insomnia first ask for professional help. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia. Although CBT-I's efficacy is well established, its effectiveness in real-life primary care has seldom been investigated. We examined the effectiveness of CBT-I as routinely delivered in a Canadian primary care setting. The patients were 70 women and 11 men (mean age = 57.0 years, SD = 12.3); 83% had medical comorbidity. For the first 81 patients who took the six-session group program we compared initial and postprogram sleep diaries, sleep medication use, Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS), and visits to the family physician. Sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, and ISI scores improved significantly (p sleep medication decreased (p 7). Wait-list data from 42 patients showed minimal sleep and mood improvements with the passage of time. Number of visits to the family physician six months postprogram decreased, although not significantly (p = .108). The CBT-I program was associated with improvement on all sleep and mood measures. Effect sizes were similar to, or larger than, those found in randomized controlled trials, demonstrating the real-world effectiveness of CBT-I in an interdisciplinary primary care setting.

  14. A Randomized Controlled Trial of Cognitive Behavioral Therapy (CBT) for Adjusting to Multiple Sclerosis (The saMS Trial): Does CBT Work and for Whom Does It Work?

    Science.gov (United States)

    Moss-Morris, Rona; Dennison, Laura; Landau, Sabine; Yardley, Lucy; Silber, Eli; Chalder, Trudie

    2013-01-01

    Objective: The aims were (a) to test the effectiveness of a nurse-led cognitive behavioral therapy (CBT) program to assist adjustment in the early stages of multiple sclerosis (MS) and (b) to determine moderators of treatment including baseline distress, social support (SS), and treatment preference. Method: Ninety-four ambulatory people with MS…

  15. Cognitive-behavioural therapy v. usual care in recurrent depression

    NARCIS (Netherlands)

    H.J. Conradi; P. de Jonge; J. Ormel

    2008-01-01

    We examined in a primary care sample whether acute-phase cognitive-behavioural therapy (CBT) would be more effective than usual care for patients with multiple prior episodes of depression. Depression outcome was based on a 3-monthly administered Beck Depression Inventory (BDI) during a 2-year follo

  16. A randomised comparison of cognitive behavioural therapy

    Directory of Open Access Journals (Sweden)

    Carlijn de Roos

    2011-04-01

    Full Text Available Background : Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective : The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT and Eye Movement Desensitisation and Reprocessing (EMDR. Design : Children (n=52, aged 4–18 were randomly allocated to either CBT (n=26 or EMDR (n=26 in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4–8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures were conducted on the intention-to-treat sample and the completers. Results : Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. Conclusion : Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children.For the abstract in other languages, please see Supplementary files under Reading Tools online

  17. The ABCs of CBT (Cognitive Behavior Therapy): Evidence-Based Approaches to Child Anxiety in Public School Settings

    Science.gov (United States)

    Miller, Lynn D.; Short, Christina; Garland, E. Jane; Clark, Sandra

    2010-01-01

    This study evaluated a locally developed cognitive behavior therapy (CBT) intervention program in a public elementary school. In the prevention approach, 118 children were randomly assigned either to an 8-week intervention or to a wait-list control. Results of statistical analysis indicated that the manualized CBT intervention did not reduce…

  18. The ABCs of CBT (Cognitive Behavior Therapy): Evidence-Based Approaches to Child Anxiety in Public School Settings

    Science.gov (United States)

    Miller, Lynn D.; Short, Christina; Garland, E. Jane; Clark, Sandra

    2010-01-01

    This study evaluated a locally developed cognitive behavior therapy (CBT) intervention program in a public elementary school. In the prevention approach, 118 children were randomly assigned either to an 8-week intervention or to a wait-list control. Results of statistical analysis indicated that the manualized CBT intervention did not reduce…

  19. The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and be

  20. The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    OBJECTIVE: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and

  1. The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and

  2. The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and

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

    Science.gov (United States)

    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.

  4. [Third Wave Therapies of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder: A Reasonable Add-on Therapy for CBT? State of the Art].

    Science.gov (United States)

    Külz, AnneKatrin; Barton, Barbara; Voderholzer, Ulrich

    2016-03-01

    Cognitive behavioral therapy (CBT) with exposure is the state of the art and most efficient treatment for obsessive compulsive disorder and recommended as treatment of 1st choice according to guidelines. Therapies of the third wave, such as mindfulness based approaches (ACT, MBCT), metacognitive therapy, CBASP or schema therapy, have become more popular over past few years. A small number of studies that investigated some of these therapies show promising results. However, due to the small number of available studies, small sample sizes and methodologic limitations (only a few available RCTs) the evidence of these therapies is insufficient. Above all no study compared these alternative therapies with the well-proven CBT and exposure. Therefore, therapies of the third wave should only be used as add-on therapies to CBT and exposure if individually needed in the treatment of OCD. Future research is absolutely needed.

  5. Cognitive behavioural therapy and client-centred counselling.

    Science.gov (United States)

    Collins, Findlay; Deady, David

    This article reviews the potential for combining cognitive behavioural therapy (CBT) and client-centred counselling (CCC) in nurse education and practice. Currently, CBT and CCC are practiced independently of one another within mental health care. This project attempted to bring together the unique qualities of each intervention while encouraging a synergistic approach. This was undertaken by developing and delivering a three-day pilot study workshop. The experiential workshops were evaluated using two sets of structured questionnaires and six semi-structured interviews with randomly selected participants. A follow-up questionnaire was used to review the combined approach in practice.

  6. Computerised Cognitive Behavioural Therapy for the Prevention and Treatment of Depression and Anxiety in Children and Adolescents: A Systematic Review

    Science.gov (United States)

    Richardson, Thomas; Stallard, Paul; Velleman, Sophie

    2010-01-01

    Research has shown that computerised cognitive behaviour therapy (cCBT) can be effective in the treatment of depression and anxiety in adults, although the outcomes with children and adolescents are unclear. The aim of the study is to systematically review the literature on the effectiveness of cCBT for the prevention and treatment of depression…

  7. Computerised Cognitive Behavioural Therapy for the Prevention and Treatment of Depression and Anxiety in Children and Adolescents: A Systematic Review

    Science.gov (United States)

    Richardson, Thomas; Stallard, Paul; Velleman, Sophie

    2010-01-01

    Research has shown that computerised cognitive behaviour therapy (cCBT) can be effective in the treatment of depression and anxiety in adults, although the outcomes with children and adolescents are unclear. The aim of the study is to systematically review the literature on the effectiveness of cCBT for the prevention and treatment of depression…

  8. Evaluation of the Sustainability and Clinical Outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a Child Protection Center

    Science.gov (United States)

    Kolko, David J.; Iselin, Anne-Marie R.; Gully, Kevin J.

    2011-01-01

    This paper examines the sustainability and outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) as delivered by practitioners in a community-based child protection program who had received training in the model several years earlier. Formerly described as Abuse-Focused CBT, AF-CBT is an evidence-based treatment (EBT) for…

  9. Integrating Research, Theory-Building, Training, and Practice in CBT Group Therapy for Children and Adolescents with anxiety

    DEFF Research Database (Denmark)

    Thastum, Mikael

    This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents. The res......This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents....... The resulting Youth CBT Therapy Program at Aarhus is organized around a short-term, 10-session, evidence-based, manualized, family-based, cognitive behavioral therapy (CBT) group program, called "Cool Kids" for children and "Chilled Adolescents" for adolescents, and derived from Ronald Rapee's work in Australia....... A distinctive aspect of the work of the Youth CBT Therapy Program is their incorporation of a case-study perspective into a series of group designs, including:(a) a randomized treatment vs. waitlist-control efficacy study (n=120); (b) an open, naturalistic effectiveness study of the program in two mental health...

  10. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    OpenAIRE

    Schene, A.H.; Baas, K.D.; Koeter, M; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K. F.; van Weert, H.C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and protocolised according to current evidence based guidelines for depression. So far this has not been the case. We studied whether a protocolised 8 session CBT is more effective than optimised and prot...

  11. Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders

    DEFF Research Database (Denmark)

    Reinholt, Nina; Krogh, Jesper

    2014-01-01

    Transdiagnostic approaches to cognitive behaviour therapy (TCBT) of anxiety disorders have drawn increasing interest and empirical testing over the past decade. In this paper, we review evidence of the overall efficacy of TCBT for anxiety disorders, as well as TCBT efficacy compared with wait......-list, treatment-as-usual, and diagnosis-specific cognitive behaviour therapy (CBT) controls. A total of 11 studies reporting 12 trials (n = 1933) were included in the systematic review. Results from the meta-analysis of 11 trials suggest that TCBT was generally associated with positive outcome; TCBT patients did...

  12. Does emotional reasoning change during cognitive behavioural therapy for anxiety?

    Science.gov (United States)

    Berle, David; Moulds, Michelle L; Starcevic, Vladan; Milicevic, Denise; Hannan, Anthony; Dale, Erin; Viswasam, Kirupamani; Brakoulias, Vlasios

    2016-01-01

    Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies.

  13. Cognitive Behavioural Therapy & Training

    DEFF Research Database (Denmark)

    Spaten, Ole Michael; Hansen, Tia G. B.; Gulbrandsen, Knut Arild

    coaching module in the graduate curriculum for students of psychology is a rewarding introduction to cognitive behavioural approaches, since it allows combination of traditional lectures with “action-reflection-learning” workshops, during which students train cognitive behavioural techniques in their own......Coaching is an expanding area of professional work, and recent years have brought forward the notion of cognitive coaching (Costa, 2006; Oestrich, 2005) which adapts theory and techniques from cognitive therapy to serve self-enhancement in non-clinical populations. We suggest that a cognitive...... repertoire. The skills needed for cognitive coaching reflect all therapeutic techniques but at a less advanced psychotherapeutic level, and still prepare for future clinical work and development. In the poster, we summarise a cognitive coaching course syllabus as well as results from data collected...

  14. Cognitive Behavioural Therapy & Training

    DEFF Research Database (Denmark)

    Spaten, Ole Michael; Hansen, Tia G. B.; Gulbrandsen, Knut Arild

    Coaching is an expanding area of professional work, and recent years have brought forward the notion of cognitive coaching (Costa, 2006; Oestrich, 2005) which adapts theory and techniques from cognitive therapy to serve self-enhancement in non-clinical populations. We suggest that a cognitive...... coaching module in the graduate curriculum for students of psychology is a rewarding introduction to cognitive behavioural approaches, since it allows combination of traditional lectures with “action-reflection-learning” workshops, during which students train cognitive behavioural techniques in their own...... repertoire. The skills needed for cognitive coaching reflect all therapeutic techniques but at a less advanced psychotherapeutic level, and still prepare for future clinical work and development. In the poster, we summarise a cognitive coaching course syllabus as well as results from data collected...

  15. Adherence to Internet-based and face-to-face cognitive behavioural therapy for depression: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Wouter van Ballegooijen

    Full Text Available BACKGROUND: Internet-based cognitive behavioural therapy (iCBT is an effective and acceptable treatment for depression, especially when it includes guidance, but its treatment adherence has not yet been systematically studied. We conducted a meta-analysis, comparing the adherence to guided iCBT with the adherence to individual face-to-face CBT. METHODS: Studies were selected from a database of trials that investigate treatment for adult depression (see www.evidencebasedpsychotherapies.org, updated to January 2013. We identified 24 studies describing 26 treatment conditions (14 face-to-face CBT, 12 guided iCBT, by means of these inclusion criteria: targeting depressed adults, no comorbid somatic disorder or substance abuse, community recruitment, published in the year 2000 or later. The main outcome measure was the percentage of completed sessions. We also coded the percentage of treatment completers (separately coding for 100% or at least 80% of treatment completed. RESULTS: We did not find studies that compared guided iCBT and face-to-face CBT in a single trial that met our inclusion criteria. Face-to-face CBT treatments ranged from 12 to 28 sessions, guided iCBT interventions consisted of 5 to 9 sessions. Participants in face-to-face CBT completed on average 83.9% of their treatment, which did not differ significantly from participants in guided iCBT (80.8%, P  =  .59. The percentage of completers (total intervention was significantly higher in face-to-face CBT (84.7% than in guided iCBT (65.1%, P < .001, as was the percentage of completers of 80% or more of the intervention (face-to-face CBT: 85.2%, guided iCBT: 67.5%, P  =  .003. Non-completers of face-to-face CBT completed on average 24.5% of their treatment, while non-completers of guided iCBT completed on average 42.1% of their treatment. CONCLUSION: We did not find studies that compared guided iCBT and face-to-face CBT in a single trial. Adherence to guided iCBT appears to be

  16. Discontinuation of hypnotics during cognitive behavioural therapy for insomnia

    Directory of Open Access Journals (Sweden)

    Brunovsky Martin

    2008-09-01

    Full Text Available Abstract Background In practical sleep medicine, therapists face the question of whether or not to discontinue the ongoing use of hypnotics in patients, as well as the possible effects of discontinuation. The aim of this study was to evaluate the effects of discontinuing third-generation hypnotics on the results of cognitive-behavioural therapy (CBT for primary insomnia in patients after long-term abuse. Methods Twenty-eight outpatients were treated by CBT for 8 weeks. The treatment outcome was estimated by means of differences among subjective clinical scales and polysomnography variables assessed before and after the treatment period. The therapeutic effect in a subgroup of 15 patients who had previously received hypnotics and were successively withdrawn during weeks 2–6 was compared to the effect achieved in patients who had not used hypnotics before CBT. Results There were no significant differences in baseline subjective and objective sleep characteristics between the hypnotic abusers and non-abusers. According to clinical scales and most polysomnographic measures, CBT was highly effective in both groups of subjects; it produced the greatest changes in total sleep time, REM sleep and sleep efficiency. Unexpectedly, discontinuation of hypnotics, as a factor in the analysis, was followed by an additional improvement of sleep efficiency and wake after sleep onset parameters. Conclusion Our study confirmed the efficacy of CBT in both hypnotic-abusing and non-abusing patients with chronic insomnia. The results of this study suggest that tapered withdrawal of third-generation hypnotics during CBT therapy for chronic insomnia could be associated with improvement rather than worsening of sleep continuity.

  17. The feasibility and effectiveness of Catch It, an innovative CBT smartphone app

    OpenAIRE

    Kinderman, Peter; Hagan, Paul; King, Sophie; Bowman, James; Chahal, Jasprit; Gan, Li; McKnight, Rebecca; Waldon, Charlotte; Smith, Matthew; Gilbertson, John; Tai, Sara

    2016-01-01

    Background The widespread use of smartphones makes effective therapies such as cognitive–behavioural therapy (CBT) potentially accessible to large numbers of people. Aims This paper reports the usage data of the first trial of Catch It, a new CBT smartphone app. Method Uptake and usage rates, fidelity of user responses to CBT principles, and impact on reported negative and positive moods were assessed. Results A relatively modest proportion of people chose to download the app. Once used, the ...

  18. Using cognitive behavioural therapy with complex cases: using the therapeutic relationship to change core beliefs.

    Science.gov (United States)

    Binnie, James

    2012-07-01

    Cognitive Behavioural Therapy (CBT) is often perceived as a manualised, symptom focused, surface level approach. This article aims to reflect on working with complex clinical presentations and explore how third wave CBT can be effectively integrated into standard cognitive behavioural interventions. To achieve these aims, a case study of a CBT assessment and treatment is presented. The interventions used are described in detail. The focus changes from the more traditional symptom-led interventions to third wave approaches based on the therapeutic relationship. When the focus was redirected towards the therapeutic relationship then real change occurred, quickly and powerfully. Reflections on the process are discussed and the overall approach used was evaluated with an action plan developed to enhance future clinical practice. It is hoped that this study can help CBT be viewed as a comprehensive form of psychotherapy.

  19. Cognitive-behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial.

    Science.gov (United States)

    Losada, Andrés; Márquez-González, María; Romero-Moreno, Rosa; Mausbach, Brent T; López, Javier; Fernández-Fernández, Virginia; Nogales-González, Celia

    2015-08-01

    The differential efficacy of acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) for dementia family caregivers' is analyzed through a randomized controlled trial. Participants were 135 caregivers with high depressive symptomatology who were randomly allocated to the intervention conditions or a control group (CG). Pre-, postintervention, and follow-up measurements assessed depressive symptomatology, anxiety, leisure, dysfunctional thoughts, and experiential avoidance. Depression: Significant effects of interventions compared with CG were found for CBT (p < .001, d = 0.98, number needed to treat [NNT] = 3.61) and ACT (p < .001, d = 1.17, NNT = 3.53) at postintervention, but were maintained only at follow-up for CBT (p = .02, d = 0.74, NNT = 9.71). Clinically significant change was observed in 26.7% participants in CBT, 24.2% in ACT, and 0% in CG. At follow-up, 10.53% in CBT and 4% in ACT were recovered (0% CG). Anxiety: At postintervention, ACT participants showed lower anxiety than CBT participants (p < .05, d = 0.50) and CG participants (p < .01, d = 0.79, NNT = 3.86), with no effects at follow-up. At postintervention, 23.33% in CBT, 36.36% in ACT, and 6.45% in CG showed clinically significant change. At follow-up, 26.32% in CBT, 36% in ACT, and 13.64% in CG were recovered. Significant changes at postintervention were found in leisure and dysfunctional thoughts in both ACT and CBT, with changes in experiential avoidance only for ACT. Similar results were obtained for ACT and CBT. ACT seems to be a viable and effective treatment for dementia caregivers. (c) 2015 APA, all rights reserved).

  20. Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT) for anxiety disorders in youth: Psychometric properties.

    Science.gov (United States)

    Bjaastad, Jon Fauskanger; Haugland, Bente Storm Mowatt; Fjermestad, Krister W; Torsheim, Torbjørn; Havik, Odd E; Heiervang, Einar R; Öst, Lars-Göran

    2016-08-01

    The aim of the present study was to evaluate the psychometric properties of the Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT). The CAS-CBT is an 11-item scale developed to measure adherence and competence in cognitive-behavioral therapy (CBT) for anxiety disorders in youth. A total of 181 videotapes from the treatment sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014) comprising youth (N = 182, M age = 11.5 years, SD = 2.1, range 8-15 years, 53% girls, 90.7% Caucasian) with mixed anxiety disorders were assessed with the CAS-CBT to investigate interitem correlations, internal consistency, and factor structure. Internal consistency was good (Cronbach's alpha = .87). Factor analysis suggested a 2-factor solution with Factor 1 representing CBT structure and session goals (explaining 46.9% of the variance) and Factor 2 representing process and relational skills (explaining 19.7% of the variance). The sum-score for adherence and competence was strongly intercorrelated, r = .79, p .40, n = 10 videotapes) and also good to excellent interrater reliability when compared to expert raters (ICC = .83 for adherence and .64 for competence, n = 26 videotapes). High rater stability was also found (n = 15 videotapes). The findings suggest that the CAS-CBT is a reliable measure of adherence and competence in manualized CBT for anxiety disorders in youth. Further research is needed to investigate the validity of the scale and psychometric properties when used with other treatment programs, disorders and treatment formats. (PsycINFO Database Record

  1. Integrating Research, Theory-Building, Training, and Practice in CBT Group Therapy for Children and Adolescents with anxiety

    DEFF Research Database (Denmark)

    Thastum, Mikael

    This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents. The res......This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents...... centers (n=40); (c) an open study with both group-based and case-based analyses of case-formulation-focused CBT for non-responding clients and their families (n = 20); (d) an explorative study of the treatment program for children with ADHD and comorbid anxiety disorder (n = 12); and (e) etiological...

  2. Effectiveness of Cognitive Behaviour Therapy for Mothers of Children with Food Allergy: A Case Series

    Directory of Open Access Journals (Sweden)

    Rebecca C. Knibb

    2015-11-01

    Full Text Available Background: Food allergy affects quality of life in patients and parents and mothers report high levels of anxiety and stress. Cognitive Behaviour Therapy (CBT may be helpful in reducing the psychological impact of food allergy. The aim of this study was to examine the appropriateness and effectiveness of CBT to improve psychological outcomes in parents of children with food allergy. Methods: Five parents (all mothers from a local allergy clinic requested to have CBT; six mothers acted as controls and completed questionnaires only. CBT was individual and face-to face and lasted 12 weeks. All participants completed measures of anxiety and depression, worry, stress, general mental health, generic and food allergy specific quality of life at baseline and at 12 weeks. Results: Anxiety, depression and worry in the CBT group significantly reduced and overall mental health and QoL significantly improved from baseline to 12 weeks (all p < 0.05 in mothers in the CBT group; control group scores remained stable. Conclusions: CBT appears to be appropriate and effective in mothers of children with food allergy and a larger randomised control trial now needs to be conducted. Ways in which aspects of CBT can be incorporated into allergy clinic visits need investigation.

  3. CBT for Medication Adherence and Depression (CBT-AD) in HIV-Infected Patients Receiving Methadone Maintenance Therapy

    Science.gov (United States)

    Soroudi, Nafisseh; Perez, Giselle K.; Gonzalez, Jeffrey S.; Greer, Joseph A.; Pollack, Mark H.; Otto, Michael W.; Safren, Steven A.

    2008-01-01

    For individuals with HIV who are current or former injection drug users, depression is a common, distressing condition that can interfere with a critical self-care behavior--adherence to antiretroviral therapy. The present study describes the feasibility and outcome, in a case series approach, of cognitive behavioral therapy to improve adherence…

  4. Enhanced effects of combined cognitive bias modification and computerised cognitive behaviour therapy on social anxiety

    Directory of Open Access Journals (Sweden)

    Emma Butler

    2015-12-01

    Full Text Available This study examines whether combined cognitive bias modification for interpretative biases (CBM-I and computerised cognitive behaviour therapy (C-CBT can produce enhanced positive effects on interpretation biases and social anxiety. Forty socially anxious students were randomly assigned into two conditions, an intervention group (positive CBM-I + C-CBT or an active control (neutral CBM-I + C-CBT. At pre-test, participants completed measures of social anxiety, interpretative bias, cognitive distortions, and social and work adjustment. They were exposed to 6 × 30 min sessions of web-based interventions including three sessions of either positive or neutral CBM-I and three sessions of C-CBT, one session per day. At post-test and two-week follow-up, participants completed the baseline measures. A combined positive CBM-I + C-CBT produced less negative interpretations of ambiguous situations than neutral CBM-I + C-CBT. The results also showed that both positive CBM-I + C-CBT and neutral CBM-I + C-CBT reduced social anxiety and cognitive distortions as well as improving work and social adjustment. However, greater effect sizes were observed in the positive CBM-I + C-CBT condition than the control. This indicates that adding positive CBM-I to C-CBT enhanced the training effects on social anxiety, cognitive distortions, and social and work adjustment compared to the neutral CBM-I + C-CBT condition.

  5. Effectiveness of Transdiagnostic Cognitive Behaviour Therapy for Anxiety and Depression in Adults: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Andersen, Philip; Toner, Paul; Bland, Martin; McMillan, Dean

    2016-11-01

    Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.

  6. Mindfulness-based 'third wave' cognitive and behavioural therapies versus treatment as usual for depression.

    Science.gov (United States)

    Churchill, Rachel; Moore, Theresa Hm; Davies, Philippa; Caldwell, Deborah; Jones, Hannah; Lewis, Glyn; Hunot, Vivien

    2010-09-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all third wave CBT approaches compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, meta-cognitive therapy, dialectical behaviour therapy, MBCT, extended behavioural activation and meta-cognitive therapy) compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of all third wave CBT approaches compared with different types of comparator (standard care, no treatment, waiting list, attention placebo) for acute depression.

  7. Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Jong, Martie; Korrelboom, Kees; van der Meer, Iris; Deen, Mathijs; Hoek, Hans W.; Spinhoven, Philip

    2016-01-01

    Background: While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and

  8. Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Jong, M.; Korrelboom, C.W.; van der Meer, I.; Deen, M.; Hoek, H.W.; Spinhoven, P.

    2016-01-01

    Background While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and

  9. Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Jong, Martie; Korrelboom, Kees; van der Meer, Iris; Deen, Mathijs; Hoek, Hans W.; Spinhoven, Philip

    2016-01-01

    Background: While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and

  10. Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? : A meta-analysis

    NARCIS (Netherlands)

    Cuijpers, P.; Hollon, S.D.; van Straten, A.; Bockting, Claudi; Berking, Matthias; Andersson, G.

    2013-01-01

    OBJECTIVES: Although cognitive behaviour therapy (CBT) and pharmacotherapy are equally effective in the acute treatment of adult depression, it is not known how they compare across the longer term. In this meta-analysis, we compared the effects of acute phase CBT without any subsequent treatment wit

  11. Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults.

    Science.gov (United States)

    DiNapoli, Elizabeth A; Pierpaoli, Christina M; Shah, Avani; Yang, Xin; Scogin, Forrest

    2017-01-01

    We examined the effects of home-delivered cognitive-behavioral therapy (CBT) for depression on anxiety symptoms in an ethnically diverse, low resource, and medically frail sample of rural, older adults. This was a secondary analysis of a randomized clincial trial with 134 rural-dwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist-90-Revised (SCL-90-R). Compared to a minimal support control condition, CBT for depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre-treatment to post-treatment. Home-delivered CBT for depression can be an effective treatment for anxiety in a hard-to-reach older populations. Additional research should explore integrated anxiety and depression protocols and other treatment modalities, including bibliotherapy or telehealth models of CBT, to reduce costs associated with its in home delivery. Flexibility in administration and adaptations to the CBT protocol may be necessary for use with vulnerable, rural older adults.

  12. Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial.

    Science.gov (United States)

    Richards, David A; Ekers, David; McMillan, Dean; Taylor, Rod S; Byford, Sarah; Warren, Fiona C; Barrett, Barbara; Farrand, Paul A; Gilbody, Simon; Kuyken, Willem; O'Mahen, Heather; Watkins, Ed R; Wright, Kim A; Hollon, Steven D; Reed, Nigel; Rhodes, Shelley; Fletcher, Emily; Finning, Katie

    2016-08-27

    Depression is a common, debilitating, and costly disorder. Many patients request psychological therapy, but the best-evidenced therapy-cognitive behavioural therapy (CBT)-is complex and costly. A simpler therapy-behavioural activation (BA)-might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression. In this randomised, controlled, non-inferiority trial, we recruited adults aged 18 years or older meeting Diagnostic and Statistical Manual of Mental Disorders IV criteria for major depressive disorder from primary care and psychological therapy services in Devon, Durham, and Leeds (UK). We excluded people who were receiving psychological therapy, were alcohol or drug dependent, were acutely suicidal or had attempted suicide in the previous 2 months, or were cognitively impaired, or who had bipolar disorder or psychosis or psychotic symptoms. We randomly assigned participants (1:1) remotely using computer-generated allocation (minimisation used; stratified by depression severity [Patient Health Questionnaire 9 (PHQ-9) score of inferiority margin was 1·9 PHQ-9 points. This trial is registered with the ISCRTN registry, number ISRCTN27473954. Between Sept 26, 2012, and April 3, 2014, we randomly allocated 221 (50%) participants to BA and 219 (50%) to CBT. 175 (79%) participants were assessable for the primary outcome in the mITT population in the BA group compared with 189 (86%) in the CBT group, whereas 135 (61%) were assessable in the PP population in the BA group compared with 151 (69%) in the CBT group. BA was non-inferior to CBT (mITT: CBT 8·4 PHQ-9 points [SD 7·5], BA 8·4 PHQ-9 points [7·0], mean difference 0·1 PHQ-9 points [95% CI -1·3 to 1·5], p=0·89; PP: CBT 7·9 PHQ-9 points [7·3]; BA 7·8 [6·5], mean difference 0·0 PHQ-9 points [-1·5 to 1·6], p=0·99). Two (1%) non-trial-related deaths (one [1%] multidrug toxicity in the BA group and one [1

  13. Measures of readiness for cognitive behavioural therapy in people with intellectual disability: A systematic review.

    Science.gov (United States)

    Stott, Joshua; Charlesworth, Georgina; Scior, Katrina

    2017-01-01

    Cognitive behavioural therapy (CBT) is a promising treatment for mental health problems in people with intellectual disabilities but some may not be suited or ready. This review critically evaluates the quality and utility of measures of CBT readiness in people with intellectual disabilities. Twelve studies of six measures based on three aspects of CBT readiness were identified through systematic review. Across measures, measurement quality was largely poor or un-assessed. Only one study evaluated measurement change over the course of CBT. Not all participants with intellectual disabilities could 'pass' readiness measures and performance may be affected by levels of language and cognitive functioning. There was some evidence that CBT readiness is trainable with brief interventions. Before using readiness measures in a clinical context, further work is needed to extend initial evidence on recognising cognitive mediation as a CBT readiness ability. Given the lack of consensus as to the definition of CBT readiness and the heterogeneity of CBT interventions, future research could also focus on developing readiness measures using a bottom up approach, developing measures within the context of CBT interventions themselves, before further refining and establishing their psychometric properties. This paper is the first to systematically review measures of skills thought necessary to be ready for cognitive behavioural therapy in intellectual disabilities. The findings suggest that while readiness skills may be trainable with brief interventions, the available measures of these skills have not been fully evaluated for quality. Levels of functioning on these measures have yet to be established relative to those without intellectual disabilities and critically, there is very little evidence as to whether these skills are important in cognitive behavioural therapy process and outcome. We suggest that future research could focus on those constructs where there is preliminary

  14. Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

    NARCIS (Netherlands)

    F.J. van Apeldoorn; W.J.P.J. Hout; P.P.A. Mersch; M. Huisman; B.R. Slaap; W.W., III Hale; S. Visser; R. van Dyck; J.A. den Boer

    2008-01-01

    Objective: To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the monotreatments. Method: Patients with PD (n = 150) w

  15. Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

    NARCIS (Netherlands)

    van Apeldoorn, F. J.; van Hout, W. J. P. J.; Huisman, J.M.E.; Slaap, B. R.; Hale, W. W.; Visser, S.; van Dyck, R.; den Boer, J. A.; Mersch, P.P.A.

    2008-01-01

    Objective: To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments. Method: Patients with PD (n = 150)

  16. A Brief Cognitive Behavioural Therapy Psychoeducational Group for Chinese People with Chronic Illnesses: An Evaluation Study

    Science.gov (United States)

    Wong, Daniel F. K.; Ip, Priscilla S. Y.; Lee, Kim Man

    2017-01-01

    This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life…

  17. Treatment of Depression and Anxiety in Parkinson's Disease: A Pilot Study Using Group Cognitive Behavioural Therapy

    Science.gov (United States)

    Feeney, Farah; Egan, Sarah; Gasson, Natalie

    2005-01-01

    Depression and anxiety affect up to 50% of people with Parkinson's Disease (PD) (Marsh, 2000; Murray, 1996), however, few studies have examined the effectiveness of psychological treatment. This study examined the effectiveness of group cognitive behaviour therapy (CBT) in treating depression and anxiety in PD. Four participants, aged between 56…

  18. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    NARCIS (Netherlands)

    Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and pro

  19. Brief Cognitive Behavioural Therapy compared to optimised general practitioners’ care for depression : A randomised trial

    NARCIS (Netherlands)

    Schene, A.H.; Baas, K.D.; Koeter, M.W.J.; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K.A.; Huyser, J.; van Weert, H.C.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and pro

  20. Cognitive-Behavioural Therapies for Young People in Outpatient Treatment for Non-Opioid Drug Use:

    DEFF Research Database (Denmark)

    Filges, Trine; Knudsen, Anne-Sofie Due; Svendsen, Majken

    2015-01-01

    BACKGROUND Youth drug use is a severe problem worldwide. This review focuses on Cognitive-Behavioural Therapy (CBT) as a treatment for young people who misuse non-opioid drugs, such as cannabis, amphetamines, ecstasy and cocaine, which are strongly associated with a range of health and social pro...

  1. How Does Cognitive Behaviour Therapy Work with Opioid-Dependent Clients? Results of the UKCBTMM Study

    Science.gov (United States)

    Kouimtsidis, Christos; Reynolds, Martina; Coulton, Simon; Drummond, Colin

    2012-01-01

    Introduction: Process research in psychotherapy is important to understand how treatment works. The National Institute of Clinical Excellence guidelines suggest that in methadone maintenance treatment (MMT) for opioid dependence, drug key-working should be based on cognitive behavioural therapy (CBT) principles. This article reports the findings…

  2. Treating prolactinoma and psychosis: medication and cognitive behavioural therapy.

    Science.gov (United States)

    Nieman, D H; Sutterland, A L; Otten, J; Becker, H E; Drent, M L; van der Gaag, M; Birchwood, M; de Haan, L

    2011-02-09

    The patient in this case report had two severe medical conditions that require oppositional treatment: prolactinoma and psychosis. A prolactinoma is a benign tumour of the pituitary gland that produces prolactin. Dopamine agonist medication is the first-line treatment in patients with prolactinoma. The psychotic symptoms started after a dosage increase of a dopamine D2-receptor agonist. Several antipsychotic medications were tried with and without the dopamine D2-receptor agonist, but severe command hallucinations remained. Cognitive behavioural therapy (CBT) was added which reduced the impact of the hallucinations to a great extent, indicating that CBT can have an additional positive effect in prolactinoma patients with psychosis that shows incomplete recovery after antipsychotic medication. Future research should be aimed at the severe and prolonged side effects of dopamine agonists in the treatment of prolactinoma patients with multiple risk factors for a psychotic decompensation.

  3. Exploring Learning Outcomes in Cognitive Behaviour Therapy and Existential Therapy in Denmark

    DEFF Research Database (Denmark)

    Sørensen, Anders Dræby

    This is a presentation of a research project, which explores lived experience of psychotherapy in terms of learning outcomes. This includes both Existential therapy (ET) and Cognitive-Behavioural Therapy (CBT) and their possible differences and similarities. I can describe learning as any...... experiential change that occurs in the participants understanding as result of the therapy in which they participate. Learning outcomes are concerned with the achievements of the learner rather than the intentions of the educator, as expressed in the objectives of an educational effort. This research points...

  4. Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; a randomized clinical trial.

    Science.gov (United States)

    Iftene, Felicia; Predescu, Elena; Stefan, Simona; David, Daniel

    2015-02-28

    Major depressive disorder is a highly prevalent and debilitating condition in youth, so developing efficient treatments is a priority for mental health professionals. Psychotherapy (i.e., cognitive behavioral therapy/CBT), pharmacotherapy (i.e., SSRI medication), and their combination have been shown to be effective in treating youth depression; however, the results are still mixed and there are few studies engaging multi-level analyses (i.e., subjective, cognitive, and biological). Therefore, the aims of this randomized control study (RCT) were both theoretical - integrating psychological and biological markers of depression in a multi-level outcome analysis - and practical - testing the generalizability of previous results on depressed Romanian youth population. Eighty-eight (N=88) depressed Romanian youths were randomly allocated to one of the three treatment arms: group Rational Emotive Behavior Therapy (REBT)/CBT (i.e., a form of CBT), pharmacotherapy (i.e., sertraline), and group REBT/CBT plus pharmacotherapy. The results showed that all outcomes (i.e., subjective, cognitive, and biological) significantly change from pre to post-treatment under all treatment conditions at a similar rate and there were no significant differences among conditions at post-test. In case of categorical analysis of the clinical response rate, we found a non-significant trend favoring group REBT/CBT therapy. Results of analyses concerning outcome interrelations are discussed.

  5. Model for implementing cognitive behavioural therapy for smartphone app based smoking cessation program

    Directory of Open Access Journals (Sweden)

    Abdullah Alsharif

    2015-11-01

    Full Text Available Smoking cessation programs are widely implemented to assist smokers in the process of quitting smoking. Cognitive Behavioural Therapy (CBT is a psychological approach that is increasingly used in smoking cessation programs. CBT has also been implemented for smoking cessation programs and has been successful in helping smokers to quit. Another advantage of CBT is that it can be combined with different tools and technologies and hence made to deliver effective health intervention programs. The recent advancements in smartphone technologies have been widely explored to develop smoking cessation apps as tools to assist with quitting smoking. However, most existing smartphone apps lack follow-up and adherence to clinical guidelines for treatment. To date, there are no studies which have explored implementing CBT modules into smoking cessation apps. Therefore, there is a need for implementing behavioural change mechanisms in smoking cessation apps to help smokers quit effectively. In this study, we propose a new approach that combines mobile health technology and CBT methods to provide an effective smoking cessation program. The ubiquitous presence of smartphones and the various communication benefits they provide are utilized by our proposed system to provide a CBT paradigm into smoking cessation app systems and hence enhance their success potential. Currently, the proposed system is at the implementation stage, which is soon to be followed by a clinical trial to study the impact of this system on smoking cessation.

  6. Cost and outcome of behavioural activation versus cognitive behaviour therapy for depression (COBRA): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Rhodes, Shelley; Richards, David A; Ekers, David; McMillan, Dean; Byford, Sarah; Farrand, Paul A; Gilbody, Simon; Hollon, Steven D; Kuyken, Willem; Martell, Christopher; O'Mahen, Heather A; O'Neill, Emer; Reed, Nigel; Taylor, Rod S; Watkins, Ed R; Wright, Kim A

    2014-01-21

    Cognitive behaviour therapy (CBT) is an effective treatment for depression. However, CBT is a complex therapy that requires highly trained and qualified practitioners, and its scalability is therefore limited by the costs of training and employing sufficient therapists to meet demand. Behavioural activation (BA) is a psychological treatment for depression that may be an effective alternative to CBT and, because it is simpler, might also be delivered by less highly trained and specialised mental health workers. COBRA is a two-arm, non-inferiority, patient-level randomised controlled trial, including clinical, economic, and process evaluations comparing CBT delivered by highly trained professional therapists to BA delivered by junior professional or para-professional mental health workers to establish whether the clinical effectiveness of BA is non-inferior to CBT and if BA is cost effective compared to CBT. Four hundred and forty patients with major depressive disorder will be recruited through screening in primary care. We will analyse for non-inferiority in per-protocol and intention-to-treat populations. Our primary outcome will be severity of depression symptoms (Patient Health Questionnaire-9) at 12 months follow-up. Secondary outcomes will be clinically significant change and severity of depression at 18 months, and anxiety (General Anxiety Disorder-7 questionnaire) and health-related quality of life (Short-Form Health Survey-36) at 12 and 18 months. Our economic evaluation will take the United Kingdom National Health Service/Personal Social Services perspective to include costs of the interventions, health and social care services used, plus productivity losses. Cost-effectiveness will explored in terms of quality-adjusted life years using the EuroQol-5D measure of health-related quality of life. The clinical and economic outcomes of this trial will provide the evidence to help policy makers, clinicians and guideline developers decide on the merits of

  7. 'Third wave' cognitive and behavioural therapies versus treatment as usual for depression.

    Science.gov (United States)

    Churchill, Rachel; Moore, Theresa H M; Furukawa, Toshi A; Caldwell, Deborah M; Davies, Philippa; Jones, Hannah; Shinohara, Kiyomi; Imai, Hissei; Lewis, Glyn; Hunot, Vivien

    2013-10-18

    So-called 'third wave' cognitive and behavioural therapies represent a new generation of psychological therapies that are increasingly being used in the treatment of psychological problems. However, the effectiveness and acceptability of third-wave cognitive and behavioural therapy (CBT) approaches as treatment for acute depression remain unclear. 1. To examine the effects of all third wave CBT approaches compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.2. To examine the effects of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, dialectical behaviour therapy, MBCT, extended behavioural activation and metacognitive therapy) compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.3. To examine the effects of all third wave CBT approaches compared with different types of comparators (treatment as usual, no treatment, waiting list, attention placebo, psychological placebo) for acute depression. We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR to 01/01/12), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE, (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. An updated search of CCDANCTR restricted to search terms relevant to third wave CBT therapies was conducted in March 2013 (CCDANCTR to 01/02/13). Randomised controlled trials that compared third wave CBT therapies with control conditions for acute depression in adults. Two review authors independently identified studies, assessed trial quality and extracted data. Study authors were contacted for additional information when required. We rated the

  8. Dealing with Emotional Problems Using Rational-Emotive Cognitive Behaviour Therapy: A Practitioner's Guide

    OpenAIRE

    Dryden, Windy

    2012-01-01

    In this practical companion to the client manual, Windy Dryden draws on Rational-Emotive Cognitive Behaviour Therapy (RECBT) – a form of CBT that focuses on challenging and changing the irrational beliefs that largely determine emotional and behavioural issues – to encourage people to deal with their emotional problems.\\ud \\ud This Practitioner's Guide includes all of the information presented in the Client’s Guide with the addition of helpful hints and tips for the therapist, making it strai...

  9. A Unitary or Binary Model of Emotions: A Discussion on a Fundamental Difference between Cognitive Therapy and Rational Emotive Behaviour Therapy

    OpenAIRE

    Hyland, Philip; Boduszek, Daniel

    2012-01-01

    This primary purpose of this paper is to consider the differential cognitive conceptualization of emotions postulated by the two main schools of cognitive behavioural therapy (CBT), namely Rational Emotive Behaviour Therapy (REBT) and Cognitive Therapy (CT).While CT theory favours a unitary model of emotional distress, REBT theory posits a binary model of emotional distress. This paper will address how the two approaches differ in their conceptualizations of emotional disturbance and the impl...

  10. Evaluation of a Group CBT Early Intervention Program for Adolescents with Comorbid Depression and Behaviour Problems

    Science.gov (United States)

    Wignall, Ann

    2006-01-01

    Depression and externalising behaviour disorders frequently occur together in adolescence and are associated with a marked increase in symptom severity and poorer outcome. Clinical treatment research and early intervention programs for depression have not addressed the specific cognitive and interpersonal deficits associated with comorbidity. This…

  11. Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan

    Directory of Open Access Journals (Sweden)

    Ayub Muhammad

    2010-01-01

    Full Text Available Abstract Background Psychological therapies especially Cognitive Behaviour Therapy (CBT are used widely in the West to help patients with psychiatric problems. Cognitive Behaviour Therapy has an established evidence base for the treatment of different emotional disorders. In spite of these developments in the developed world, patients in most developing countries hardly benefit from non pharmacological interventions. Although a significant number of psychologists are trained in Pakistan each year, psychological interventions play only a minor role in treatment plans in Pakistan. We conducted interviews with psychologists in Pakistan, to explore their experiences and their views on "providing CBT in Pakistan". These interviews were conducted as part of a project whose focus was to try to develop culturally-sensitive CBT in Pakistan. Methods In depth semi structured interviews were conducted with 5 psychologists working in psychiatry departments in Lahore, Pakistan. Results All the psychologists reported that psychotherapies, including CBT, need adjustments for use in Pakistan, although they were not able to elicit on these in details. Four major themes were discovered, hurdles in therapy, therapy related issues, involvement of the family and modification in therapy. The biggest hurdles in therapy were described to be service and resource issues. Conclusions For CBT to be acceptable, accessible and effective in Non Western cultures numerous adjustments need to be made, taking into consideration; factors related to service structure and delivery, patient's knowledge and beliefs about health and the therapy itself. Interviews with the psychologists in these countries can give us insights which can guide development of therapy and manuals to support its delivery.

  12. Evaluation of a multi-component approach to cognitive-behavioral therapy (CBT) using guided visualizations, cranial electrotherapy stimulation, and vibroacoustic sound.

    Science.gov (United States)

    Rogers, Donna R B; Ei, Sue; Rogers, Kim R; Cross, Chad L

    2007-05-01

    This pilot study examines the use of guided visualizations that incorporate both cognitive and behavioral techniques with vibroacoustic therapy and cranial electrotherapy stimulation to form a multi-component therapeutic approach. This multi-component approach to cognitive-behavioral therapy (CBT) was used to treat patients presenting with a range of symptoms including anxiety, depression, and relationship difficulties. Clients completed a pre- and post-session symptom severity scale and CBT skills practice survey. The program consisted of 16 guided visualizations incorporating CBT techniques that were accompanied by vibroacoustic therapy and cranial electrotherapy stimulation. Significant reduction in symptom severity was observed in pre- and post-session scores for anxiety symptoms, relationship difficulties, and depressive symptoms. The majority of the clients (88%) reported use of CBT techniques learned in the guided visualizations at least once per week outside of the sessions.

  13. Motivational interviewing and cognitive behaviour therapy for anxiety following traumatic brain injury: a pilot randomised controlled trial.

    Science.gov (United States)

    Hsieh, Ming-Yun; Ponsford, Jennie; Wong, Dana; Schönberger, Michael; Taffe, John; McKay, Adam

    2012-01-01

    Although cognitive-behavioural therapy (CBT) is the treatment of choice for anxiety, its delivery needs to be adapted for individuals with traumatic brain injury (TBI). It also requires clients' active engagement for maximum benefit. This study was a pilot randomised controlled trial involving an anxiety treatment programme adapted for people with TBI, based on CBT and motivational interviewing (MI). Twenty-seven participants with moderate/severe TBI (aged 21-73 years, 78% males) recruited from a brain injury rehabilitation hospital were randomly allocated to receive MI + CBT (n = 9), non-directive counselling (NDC) + CBT (n = 10) and treatment-as-usual (TAU) (n = 8). CBT and MI were manualised and delivered in 12 weekly individual sessions. Primary outcome was self-reported anxiety symptoms assessed at baseline, at the end of NDC/MI and immediately following CBT. Assessment was conducted by assessors blinded to group assignment. Intention-to-treat analyses showed that the two active treatment groups demonstrated significantly greater anxiety reduction than TAU. Participants receiving MI showed greater response to CBT, in terms of reduction in anxiety, stress and non-productive coping, compared to participants who received NDC. The results provided preliminary support for the adapted CBT programme, and the potential utility of MI as treatment prelude. Longer follow-up data are required to evaluate the maintenance of treatment effects.

  14. Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders: study protocol for a randomized controlled trial.

    Science.gov (United States)

    de Jong, Martie; Korrelboom, Kees; van der Meer, Iris; Deen, Mathijs; Hoek, Hans W; Spinhoven, Philip

    2016-12-03

    While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and put to the test as a transdiagnostic treatment protocol for all EDs, including EDNOS. Initial research in the UK suggests that CBT-E is more effective for EDs, especially bulimia nervosa (BN) and EDNOS, than the earlier version of CBT. These positive results of CBT-E have to be replicated in more detail, preferably by independent researchers in different countries. Being the first Dutch study into CBT-E, the results from this national multicenter study - on three sites specialized in EDs - will deliver important information about the effectiveness of CBT-E in several domains of ED pathology, while providing input for the upcoming update of the Dutch Multidisciplinary Guideline for the Treatment of Eating Disorders. A multicenter randomized controlled trial will be conducted. One hundred and thirty-two adult outpatients (aged 18 years and older) with an ED diagnosis and a Body Mass index (BMI) of between 17.5 and 40 will be randomly allocated to the control or the intervention group. Subjects in the control group will receive Treatment as Usual (standard outpatient treatment provided at the participating sites). Subjects in the intervention group will receive 20 sessions of CBT-E in 20 weeks. The design is a 2 (group) × 5 (time) repeated measures factorial design in which neither therapists nor patients will be blinded for treatment allocation. The primary outcome measure is recovery from the ED. Secondary outcome measures include ED psychopathology, common mental disorders, anxiety and depressive symptoms, health-related quality of life, health care use and productivity loss. Self-esteem, perfectionism and interpersonal problems will be examined as putative predictors and

  15. [MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) AND THE "THIRD WAVE" OF COGNITIVE-BEHAVIORAL THERAPIES (CBT)].

    Science.gov (United States)

    Garay, Cristian Javier; Korman, Guido Pablo; Keegan, Eduardo Gustavo

    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.

  16. A systematic review of the evidence regarding cognitive therapy skills that assist cognitive behavioural therapy in adults who have an intellectual disability.

    Science.gov (United States)

    Cooney, Patricia; Tunney, Conall; O'Reilly, Gary

    2017-05-24

    Cognitive behavioural therapy (CBT) is being increasingly adapted for use with people who have an intellectual disability. However, it remains unclear whether inherent cognitive deficits that are present in adults who have an intellectual disability preclude the use of cognitive-based therapies. This review aims to systematically examine "cognitive therapy skills" in adults who have an intellectual disability that assist engagement in CBT. Two authors independently reviewed titles and abstracts of articles located through electronic database searching. Outcomes of the 18 studies selected for full-text review are mixed and limited by a moderately high risk of bias. The authors suggest eleven findings from research areas of emotion recognition, cognitive mediation, discriminating between thoughts, feelings and behaviours, linking events and emotions that have implications for the design of CBT programmes and future research for this population. © 2017 John Wiley & Sons Ltd.

  17. Positive imagery cognitive bias modification (CBM) and internet-based cognitive behavioral therapy (iCBT): A randomized controlled trial

    Science.gov (United States)

    Williams, Alishia D.; O’Moore, Kathleen; Blackwell, Simon E.; Smith, Jessica; Holmes, Emily A.; Andrews, Gavin

    2015-01-01

    Background Accruing evidence suggests that positive imagery-based cognitive bias modification (CBM) could have potential as a standalone targeted intervention for depressive symptoms or as an adjunct to existing treatments. We sought to establish the benefit of this form of CBM when delivered prior to Internet cognitive behavioral therapy (iCBT) for depression Methods A randomized controlled trial (RCT) of a 1-week Internet-delivered positive CBM vs. an active control condition for participants (N=75, 69% female, mean age=42) meeting diagnostic criteria for major depression; followed by a 10-week iCBT program for both groups. Results Modified intent-to-treat marginal and mixed effect models demonstrated no significant difference between conditions following the CBM intervention or the iCBT program. In both conditions there were significant reductions (Cohen׳s d .57–1.58, 95% CI=.12–2.07) in primary measures of depression and interpretation bias (PHQ9, BDI-II, AST-D). Large effect size reductions (Cohen׳s d .81–1.32, 95% CI=.31–1.79) were observed for secondary measures of distress, disability, anxiety and repetitive negative thinking (K10, WHODAS, STAI, RTQ). Per protocol analyses conducted in the sample of participants who completed all seven sessions of CBM indicated between-group superiority of the positive over control group on depression symptoms (PHQ9, BDI-II) and psychological distress (K10) following CBM (Hedges g .55–.88, 95% CI=−.03–1.46) and following iCBT (PHQ9, K10). The majority (>70%) no longer met diagnostic criteria for depression at 3-month follow-up. Limitations The control condition contained many active components and therefore may have represented a smaller ‘dose’ of the positive condition. Conclusions Results provide preliminary support for the successful integration of imagery-based CBM into an existing Internet-based treatment for depression. PMID:25805405

  18. Fatigue In Teenagers on the interNET--the FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. [ISRCTN59878666

    NARCIS (Netherlands)

    Nijhof, S.L.; Bleijenberg, G.; Uiterwaal, C.S.; Kimpen, J.L.L.; Putte, E.M. van de

    2011-01-01

    BACKGROUND: Chronic Fatigue Syndrome (CFS) is increasingly recognized as a cause of disability and inactivity in adolescents in the Netherlands. CFS is characterized by unexplained fatigue lasting more than 6 months. Cognitive Behavioural Therapy (CBT) has proven to be effective. However, CBT availa

  19. Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive-behavioural therapy for depression and anxiety: a randomised controlled trial.

    Science.gov (United States)

    Terides, Matthew D; Dear, Blake F; Fogliati, Vincent J; Gandy, Milena; Karin, Eyal; Jones, Michael P; Titov, Nickolai

    2017-07-20

    Cognitive-behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients' usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.

  20. Help-seeking characteristics of Chinese- and English-speaking Australians accessing Internet-delivered cognitive behavioural therapy for depression.

    Science.gov (United States)

    Choi, Isabella; Andrews, Gavin; Sharpe, Louise; Hunt, Caroline

    2015-01-01

    Internet treatments may overcome barriers and improve access to mental health services for people who do not access professional help. It may be particularly beneficial for Chinese Australians, a group that tends to delay and underutilize face-to-face treatments. This study explored the appeal of Internet therapy to Chinese- and English-speaking Australians with depression who accessed Internet-delivered cognitive behavioural therapy (iCBT) programs. Data collected from previous randomised controlled trials of iCBT depression programs were used. Using a matched samples design, 55 Chinese- and 55 English-speaking iCBT participants with depression were matched on age, gender, and depression screener scores. They were compared on their symptom severity, previous help-seeking patterns, and reasons for seeking Internet treatment. The Chinese-speaking participants had significantly milder depressive symptoms and were less likely to have previously sought professional help compared to the English-speaking participants (all ps speaking participants were more likely to seek iCBT due to lack of knowledge about face-to-face treatment (p = 0.005), while the English-speaking participants were more likely to report not benefiting from traditional help (p = 0.030). The attraction of iCBT appears to be the reduction of structural barriers to treatment. iCBT may reduce treatment delay and increase access to Chinese Australians who have not sought professional help. English-speaking Australians are seeking iCBT as an additional means of getting help.

  1. Efficacy of cognitive behavioural therapy for children and adolescents with traumatic brain injury.

    Science.gov (United States)

    Pastore, Valentina; Colombo, Katia; Liscio, Mariarosaria; Galbiati, Susanna; Adduci, Anna; Villa, Federica; Strazzer, Sandra

    2011-01-01

    Behavioural and psychological disorders after traumatic brain injury (TBI) are very common. The purposes of this study were to estimate the frequency of these problems in our sample, to evaluate the effectiveness of cognitive behavioural therapy (CBT) and to assess the predictive value of important clinical variables for the treatment outcome. Forty patients aged 4-18 years were included in this study. Twenty-eight patients received CBT at our Institute (clinical group), while 12 patients did not receive any treatment at all (control group). The CBCL/4-18 and the VABS were administered to parents at the beginning of the study and after 12 months. A high frequency of psychological and behavioural problems was found in both groups of patients. After CBT, the clinical group showed a significant advantage on several CBCL scales and a greater increase in adaptive behaviour on the VABS Socialisation domain. The Glasgow Coma Scale score, days of unconsciousness and age at injury were not predictors of the severity of psychological problems at the follow-up for the patients of the clinical group. Our results suggest that CBT is an effective intervention for young patients with psychological problems after TBI.

  2. The effect of Korean-group cognitive behavioural therapy among patients with panic disorder in clinic settings.

    Science.gov (United States)

    Choi, Y S; Lee, E J; Cho, Y

    2017-02-01

    WHAT IS KNOWN ON THE SUBJECT?: Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients. Moreover, few Korean researchers have attempted to assess the effects of CBT on such patients. WHAT THIS PAPER ADD TO EXISTING KNOWLEDGE?: In a strategy combining CBT and routine treatments, patients with panic disorder can experience greater positive effects in the acute treatment phase than those they experience when receiving only routine treatment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals, especially psychiatric nurses in local clinics who operate most special mental health programmes for panic disorder patients, should apply a panic disorder management programme that integrates CBT and routine treatments. The integrated approach is more effective for reducing the number of panic attacks and cognitive misinterpretation in patients than providing routine treatment alone. For patients with panic disorder, the objective of CBT is to understand the relationship between psychological panic disorder sensations, emotions, thoughts and behaviours. Therefore, nurses can help patients address and improve biological, social and psychological aspects of physical health problems as well as help them improve their coping skills in general. Introduction In panic disorder, sensitivity to bodily sensations increases due to the patient's cognitive vulnerability. Cognitive behavioural therapy (CBT) can help to decrease sensitivity to bodily sensations

  3. A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for bulimia nervosa.

    Science.gov (United States)

    Wonderlich, S A; Peterson, C B; Crosby, R D; Smith, T L; Klein, M H; Mitchell, J E; Crow, S J

    2014-02-01

    The purpose of this investigation was to compare a new psychotherapy for bulimia nervosa (BN), integrative cognitive-affective therapy (ICAT), with an established treatment, 'enhanced' cognitive-behavioral therapy (CBT-E). Eighty adults with symptoms of BN were randomized to ICAT or CBT-E for 21 sessions over 19 weeks. Bulimic symptoms, measured by the Eating Disorder Examination (EDE), were assessed at baseline, at the end of treatment (EOT) and at the 4-month follow-up. Treatment outcome, 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 (GEEs), logistic regression and a general linear model (intent-to-treat). Both treatments were associated with significant improvement in bulimic symptoms and in all measures of outcome, and no statistically significant differences were observed between the two conditions at EOT or follow-up. Intent-to-treat abstinence rates for ICAT (37.5% at EOT, 32.5% at follow-up) and CBT-E (22.5% at both EOT and follow-up) were not significantly different. 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 BN suggests that targeting emotion and self-oriented cognition in the context of nutritional rehabilitation may be efficacious and worthy of further study.

  4. A systematic review of the effectiveness of CBT/ERP group therapy of OCD: A meta-analysis

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Hougaard, Esben; Bennedsen, Birgit;

    , as well as reviewers of the literature have focused on within single treatments effect sizes rather between group effect sizes. OBJECTIVES To make a systematic review, and by methods of meta analysis compute a pooled within effect size of studies of group CBT of OCD and compare these to previously.......05 and 1.25 respectively, with an overall combined pooled within effect size across the categories at 1.18. Finally a between effect sizes of the four studies comparing group therapy to waitlist control group was reported at.1.12 CONCLUSION The reported within effect sizes in this meta-analysis (range 1...

  5. Talking more about talking cures: cognitive behavioural therapy and informed consent.

    Science.gov (United States)

    Blease, C R

    2015-09-01

    Cognitive behavioural therapy (CBT) has risen to prominence as an orthodox treatment option which is commonly recommended to patients with anxiety and depressive disorders. Mainstream healthcare institutions (including the National Health Service in the UK (NHS) and National Institute for Mental Health (NIMH)) assume that CBT works by helping patients to challenge and overcome 'faulty cognition'. Even if we accept the empirical evidence which shows that CBT (like other forms of psychotherapy) is a beneficial treatment there are still problems with this therapy: mainstream medicine and psychotherapy are continuing to ignore established research that CBT does not work according to its core theoretical tenets. This paper presents evidence that psychotherapy is entrenched in such conventional 'wisdom' and that practitioners are failing to meet their own codified requirement of informed consent. I examine ethical arguments for and against upholding current informed consent procedures and focus, in particular, on the relationship between respect for patient autonomy and the duty of beneficence. I argue that (so far) there are no strong grounds for the claim that patient autonomy undermines therapeutic outcome. The modest conclusion of this paper is that psychotherapy (including CBT) needs to begin to adapt informed consent procedures to comply with ongoing scientific research into its efficacy.

  6. Cognitive behavioural therapy versus other psychosocial treatments for schizophrenia

    Science.gov (United States)

    Jones, Christopher; Hacker, David; Cormac, Irene; Meaden, Alan; Irving, Claire B

    2014-01-01

    Background Cognitive behavioural therapy (CBT) is now a recommended treatment for people with schizophrenia. This approach helps to link the person’s distress and problem behaviours to underlying patterns of thinking. Objectives To review the effects of CBT for people with schizophrenia when compared with other psychological therapies. Search methods We searched the Cochrane Schizophrenia Group Trials Register (March 2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. We inspected all references of the selected articles for further relevant trials, and, where appropriate, contacted authors. Selection criteria All relevant randomised controlled trials (RCTs) of CBT for people with schizophrenia-like illnesses. Data collection and analysis Studies were reliably selected and assessed for methodological quality. Two review authors, working independently, extracted data. We analysed dichotomous data on an intention-to-treat basis and continuous data with 65% completion rate are presented. Where possible, for dichotomous outcomes, we estimated a risk ratio (RR) with the 95% confidence interval (CI) along with the number needed to treat/harm. Main results Thirty one papers described 20 trials. Trials were often small and of limited quality. When CBT was compared with other psychosocial therapies, no difference was found for outcomes relevant to adverse effect/events (2 RCTs, n = 202, RR death 0.57 CI 0.12 to 2.60). Relapse was not reduced over any time period (5 RCTs, n = 183, RR long-term 0.91 CI 0.63 to 1.32) nor was rehospitalisation (5 RCTs, n = 294, RR in longer term 0.86 CI 0.62 to 1.21). Various global mental state measures failed to show difference (4 RCTs, n = 244, RR no important change in mental state 0.84 CI 0.64 to 1.09). More specific measures of mental state failed to show differential effects on positive or negative symptoms of schizophrenia but there may be some longer term effect for affective symptoms (2 RCTs, n = 105

  7. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Christopher Williams

    Full Text Available BACKGROUND: Access to Cognitive behavioural therapy (CBT for depression is limited. One solution is CBT self-help books. Trial Objectives: To assess the impact of a guided self-help CBT book (GSH-CBT on mood, compared to treatment as usual (TAU. HYPOTHESES: GSH-CBT will have improved mood and knowledge of the causes and treatment of depression compared to the control receiving TAUGuided self-help will be acceptable to patients and staff. METHODS AND FINDINGS: PARTICIPANTS: Adults attending seven general practices in Glasgow, UK with a BDI-II score of ≥14. 141 randomised to GSH-CBT and 140 to TAU. INTERVENTIONS: RCT comparing 'Overcoming Depression: A Five Areas Approach' book plus 3-4 short face to face support appointments totalling up to 2 hours of guided support, compared with general practitioner TAU. PRIMARY OUTCOME: The BDI (II score at 4 months. Numbers analysed: 281 at baseline, 203 at 4 months (primary outcome, 117 at 12 months. OUTCOME: Mean BDI-II scores were lower in the GSH-CBT group at 4 months by 5.3 points (2.6 to 7.9, p<0.001. At 4 and 12 months there were also significantly higher proportions of participants achieving a 50% reduction in BDI-II in the GSH-CBT arm. The mean support was 2 sessions with 42.7 minutes for session 1, 41.4 minutes for session 2 and 40.2 minutes of support for session 3. Adverse effects/Harms: Significantly less deterioration in mood in GSH-CBT (2.0% compared to 9.8% in the TAU group for BDI-II category change. LIMITATIONS: Weaknesses: Our follow-up rate of 72.2% at 4 months is better than predicted but is poorer at 12 months (41.6%. In the GSH-CBT arm, around 50% of people attended 2 or fewer sessions. 22% failed to take up treatment. CONCLUSIONS: GSH-CBT is substantially more effective than TAU. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN13475030.

  8. Sleep Disturbances in Individuals with Alcohol-Related Disorders: A Review of Cognitive-Behavioral Therapy for Insomnia (CBT-I) and Associated Non-Pharmacological Therapies.

    Science.gov (United States)

    Brooks, Alyssa T; Wallen, Gwenyth R

    2014-01-01

    Sleep disturbances are common among alcohol-dependent individuals and are often associated with relapse. The utility of behavioral therapies for sleep disturbances, including cognitive-behavioral therapy for insomnia (CBT-I), among those with alcohol-related disorders is not well understood. This review systematically evaluates the evidence of CBT-I and related behavioral therapies applied to those with alcohol-related disorders and accompanying sleep disturbances. A search of four research databases (PubMed, PsycINFO, Embase, and CINAHL Plus) yielded six studies that met selection criteria. Articles were reviewed using Cochrane's Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) scoring system. A majority of the studies demonstrated significant improvements in sleep efficiency among behavioral therapy treatment group(s), including but not limited to CBT-I. While behavioral sleep interventions have been successful in varied populations, they may not be utilized to their full potential among those with alcohol-related disorders as evidenced by the low number of studies found. These findings suggest a need for mixed-methods research on individuals' sleep experience to inform interventions that are acceptable to the target population.

  9. Treating Problem Gambling Samples with Cognitive Behavioural Therapy and Mindfulness-Based Interventions: A Clinical Trial.

    Science.gov (United States)

    McIntosh, C C; Crino, R D; O'Neill, K

    2016-12-01

    The problem gambling (PG) intervention literature is characterised by a variety of psychological treatments and approaches, with varying levels of evidence (PGRTC in Guideline for screening, assessment and treatment in problem and pathological gambling. Monash University, Melbourne, 2011). A recent PG systematic review (Maynard et al. in Res Soc Work Pract, 2015. doi: 10.1177/1049731515606977 ) and the success of mindfulness-based interventions to effectively treat disorders commonly comorbid with PG suggested mindfulness-based interventions may be effective for treating PG. The current study tested the effectiveness of three interventions to treat PGs: 1. case formulation driven Cognitive Behaviour Therapy (CBT); 2. manualised CBT; and 3. mindfulness-based treatment. All three interventions tested returned large effect size improvements in PG behaviour after seven sessions (Cohen's d range 1.46-2.01), at post-treatment and at 3 and 6-month follow-up. All of the interventions were rated as acceptable by participants at post-treatment. This study suggests that the mindfulness-based and TAU interventions used in the current study appear to be effective at reducing PG behavior and associated distress and they also appear to generalise to improvements in other measures such as quality of life-mental functioning and certain mindfulness facets more effectively than the manualised form of CBT utilised used here. Secondly, a brief mindfulness intervention delivered after psycho-education and a brief CBT intervention may be a useful supplement to traditional CBT treatments by addressing transdiagnostic processes such as rumination and thought suppression. Thirdly, CBT interventions continue to report effectiveness in reducing PG behaviour and associated distress consistent with the prevailing literature and clinical direction.

  10. The clinical practice of Cognitive Behavioural Therapy for children and young people with a diagnosis of Asperger's Syndrome.

    Science.gov (United States)

    Donoghue, Kate; Stallard, Paul; Kucia, Joanna

    2011-01-01

    Children and young people diagnosed with Asperger's Syndrome (AS) have significant social-communication difficulties and impaired empathy and theory of mind skills. These difficulties place them at risk of developing mental health problems, particularly anxiety, depression and obsessive compulsive disorder. Although Cognitive Behavioural Therapy (CBT) is recognised as an effective intervention for these problems in both child and adult populations, little research has specifically looked at the use of CBT with children and young people with an AS diagnosis. However, limited evidence suggests that CBT, if suitably adapted, is a feasible and potentially helpful treatment option. This paper focuses on the clinical practice of CBT and explores how the underpinning therapeutic relationship can be modified to meet the cognitive needs of this particular group of young clients.

  11. Group Cognitive Behavioural Therapy Program Shows Potential in Reducing Symptoms of Depression and Stress among Young People with ASD

    Science.gov (United States)

    McGillivray, J. A.; Evert, H. T.

    2014-01-01

    We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a…

  12. Genome-wide association study of response to cognitive–behavioural therapy in children with anxiety disorders

    NARCIS (Netherlands)

    Coleman, J.R.I.; Lester, K.J.; Keers, R.; Roberts, S.; Curtis, C.; Arendt, K.; Bögels, S.; Cooper, P.; Creswell, C.; Dalgleish, T.; Hartman, C.A.; Heiervang, E.R.; Hötzel, K.; Hudson, J.L.; In-Albon, T.; Lavallee, K.; Lyneham, H.J.; Marin, C.E.; Meiser-Stedman, R.; Morris, T.; Nauta, M.H.; Rapee, R.M.; Schneider, S.; Schneider, S.C.; Silverman, W.K.; Thastum, M.; Thirlwall, K.; Waite, P.; Wergeland, G.J.; Breen, G.; Eley, T.C.

    Background Anxiety disorders are common, and cognitive–behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. Aims To perform the first genome-wide association study (GWAS) of

  13. Genome-wide association study of response to cognitive-behavioural therapy in children with anxiety disorders

    NARCIS (Netherlands)

    Coleman, Jonathan R I; Lester, Kathryn J; Keers, Robert; Roberts, Susanna; Curtis, Charles; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Dalgleish, Tim; Hartman, Catharina A; Heiervang, Einar R; Hötzel, Katrin; Hudson, Jennifer L; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J; Marin, Carla E; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Breen, Gerome; Eley, Thalia C

    2016-01-01

    BACKGROUND: Anxiety disorders are common, and cognitive-behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. AIMS: To perform the first genome-wide association study (GWAS) of

  14. Do People with Intellectual Disabilities and Psychosis Have the Cognitive Skills Required to Undertake Cognitive Behavioural Therapy?

    Science.gov (United States)

    Oathamshaw, Stephen C.; Haddock, Gillian

    2006-01-01

    Background: Cognitive skills thought to be necessary to undertake cognitive-behavioural therapy (CBT) include the ability to recognize emotions, link events and emotions, and recognize cognitive mediation. These skills have been assessed in people with intellectual disabilities, but not in those who also have psychosis. Materials and methods:…

  15. Predicting Outcomes Following Cognitive Behaviour Therapy in Child Anxiety Disorders: The Influence of Genetic, Demographic and Clinical Information

    Science.gov (United States)

    Hudson, Jennifer L.; Lester, Kathryn J.; Lewis, Cathryn M.; Tropeano, Maria; Creswell, Cathy; Collier, David A.; Cooper, Peter; Lyneham, Heidi J.; Morris, Talia; Rapee, Ronald M.; Roberts, Susanna; Donald, Jennifer A.; Eley, Thalia C.

    2013-01-01

    Background: Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; "5HTTLPR" and marker rs6330 in Nerve Growth Factor gene; "NGF" is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety…

  16. Group Cognitive Behavioural Therapy Program Shows Potential in Reducing Symptoms of Depression and Stress among Young People with ASD

    Science.gov (United States)

    McGillivray, J. A.; Evert, H. T.

    2014-01-01

    We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a…

  17. Genome-wide association study of response to cognitive-behavioural therapy in children with anxiety disorders

    NARCIS (Netherlands)

    Coleman, Jonathan R I; Lester, Kathryn J; Keers, Robert; Roberts, Susanna; Curtis, Charles; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Dalgleish, Tim; Hartman, Catharina A; Heiervang, Einar R; Hötzel, Katrin; Hudson, Jennifer L; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J; Marin, Carla E; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Breen, Gerome; Eley, Thalia C

    2016-01-01

    BACKGROUND: Anxiety disorders are common, and cognitive-behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. AIMS: To perform the first genome-wide association study (GWAS) of psychologi

  18. Genome-wide association study of response to cognitive–behavioural therapy in children with anxiety disorders

    NARCIS (Netherlands)

    Coleman, J.R.I.; Lester, K.J.; Keers, R.; Roberts, S.; Curtis, C.; Arendt, K.; Bögels, S.; Cooper, P.; Creswell, C.; Dalgleish, T.; Hartman, C.A.; Heiervang, E.R.; Hötzel, K.; Hudson, J.L.; In-Albon, T.; Lavallee, K.; Lyneham, H.J.; Marin, C.E.; Meiser-Stedman, R.; Morris, T.; Nauta, M.H.; Rapee, R.M.; Schneider, S.; Schneider, S.C.; Silverman, W.K.; Thastum, M.; Thirlwall, K.; Waite, P.; Wergeland, G.J.; Breen, G.; Eley, T.C.

    2016-01-01

    Background Anxiety disorders are common, and cognitive–behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. Aims To perform the first genome-wide association study (GWAS) of psychologica

  19. Predicting Outcomes Following Cognitive Behaviour Therapy in Child Anxiety Disorders: The Influence of Genetic, Demographic and Clinical Information

    Science.gov (United States)

    Hudson, Jennifer L.; Lester, Kathryn J.; Lewis, Cathryn M.; Tropeano, Maria; Creswell, Cathy; Collier, David A.; Cooper, Peter; Lyneham, Heidi J.; Morris, Talia; Rapee, Ronald M.; Roberts, Susanna; Donald, Jennifer A.; Eley, Thalia C.

    2013-01-01

    Background: Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; "5HTTLPR" and marker rs6330 in Nerve Growth Factor gene; "NGF" is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety…

  20. Cognitive behavioural therapy for psychopathology in relatives of missing persons : Study protocol for a pilot randomised controlled trial

    NARCIS (Netherlands)

    Lenferink, Lonneke I.M.; Wessel, Ineke; de Keijser, Jos; Boelen, Paul A.

    2016-01-01

    Background It is hypothesized that the grieving process of relatives of missing persons is complicated by having to deal with uncertainty about the fate of their loved one. We developed a cognitive behavioural therapy (CBT) with mindfulness that focuses on dealing with this uncertainty. In this arti

  1. Cognitive behavioural therapy for psychopathology in relatives of missing persons: study protocol for a pilot randomised controlled trial

    NARCIS (Netherlands)

    Lenferink, L.I.M.; Wessel, Ineke; de Keijser, Jos; Boelen, P.A.

    2016-01-01

    Background It is hypothesized that the grieving process of relatives of missing persons is complicated by having to deal with uncertainty about the fate of their loved one. We developed a cognitive behavioural therapy (CBT) with mindfulness that focuses on dealing with this uncertainty. In this arti

  2. Cognitive behavioural therapy versus supportive therapy for persistent positive symptoms in psychotic disorders: The POSITIVE Study, a multicenter, prospective, single-blind, randomised controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Sartory Gudrun

    2010-12-01

    Full Text Available Abstract Background It has been demonstrated that cognitive behavioural therapy (CBT has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST which does not implement CBT-techniques but provides comparable therapeutic attention. Methods/Design The POSITIVE study is a multicenter, prospective, single-blind, parallel group, randomised clinical trial, comparing CBT and ST with respect to the efficacy in reducing positive symptoms in psychotic disorders. CBT as well as ST consist of 20 sessions altogether, 165 participants receiving CBT and 165 participants receiving ST. Major methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, analysis by intention to treat, data management using remote data entry, measures of quality assurance (e.g. on-site monitoring with source data verification, regular query process, advanced statistical analysis, manualized treatment, checks of adherence and competence of therapists. Research relating the psychotherapy process with outcome, neurobiological research addressing basic questions of delusion formation using fMRI and neuropsychological assessment and treatment research investigating adaptations of CBT for adolescents is combined in this network. Problems of transfer into routine clinical care will be identified and addressed by a project focusing on cost efficiency. Discussion This clinical trial is part of efforts to intensify psychotherapy research in the field of psychosis in Germany, to contribute to the

  3. The effects of cognitive-behavioural therapy on mood-related ruminative response style in depressed adolescents

    Directory of Open Access Journals (Sweden)

    Goodyer Ian M

    2008-01-01

    Full Text Available Abstract Background A mood-related ruminative response style increases the risk of onset and persistence of depression. This preliminary study investigated whether, in depressed adolescents, cognitive-behaviour therapy reduces mood-related ruminative response style. Whether specific factors within the rumination scale were differentially affected by CBT is also reported. Methods 26 depressed adolescents were randomised to receiving serotonin-specific reuptake inhibitor antidepressants (SSRI plus psychosocial treatment as usual or SSRI and psychosocial treatment as usual plus CBT. Ruminative response style and depressive symptoms were measured at baseline and after 30 weeks of treatment, with the Responses to Depression Questionnaire and Mood and Feelings Questionnaire. Results There were significantly greater reductions in ruminations in the CBT group compared to the non-CBT group (p = .002. There was no significant difference in the reduction in self-reported depressive symptoms between the groups. Rumination was reduced to levels of never-depressed controls in adolescents who had recovered from depression and received CBT. There were greater falls in the CBT group in the more pathological 'brooding' factor of rumination. Conclusion These findings suggest that adding CBT to SSRI medication in the presence of active clinical care causes a greater reduction in mood-related ruminative response style in depressed adolescents. This may reduce the risk of future relapse. Trial registration Current Controlled Trials ISRCNT83809224.

  4. Language and Cognitive Behavioural Therapy Practice Paper-Literature Review and Case Example

    Directory of Open Access Journals (Sweden)

    Satwant Singh

    2012-11-01

    Full Text Available This paper addresses the impact of language on cognitive behavioural therapy. Language is emotive and studies carried out in the linguistic field have shown second language is less emotive when describing events occuring in the first language. This paper has been written based on the experiences of a cognitive behavior therapy (CBT service providing therapy to patients from a diverse cultural and ethnic population. Patients whose first language is not English often receive therapy in their second language. Global migration is a common phenomenon and mainly occurs for economic reasons or threat of violence. This paper has been drawn from the results of a literature review on first and second languages and therapy. Despite being an area that is extremely relevant to therapy, there is an apparent lack of literature in relation to cognitive behavioural therapy for depression and other disorders. CBT is one of the recommended therapies by National Institute of Health and Clinical Excellence (NICE for the treatment of depression and anxiety disorders. Findings from the linguistic field highlight the potential short comings providing therapy in a patient’s second language. The aim of this paper is to highlight the importance that therapists working in this field have an understanding of how first and second languages function and the role they play in maintaining patients’ psychological problems. This practice paper discusses measures that can be used in cognitive behavioural therapy to deal with this using a case example.

  5. Evaluation of the effects of individual and group cognitive behavioural therapy and of psychiatric rehabilitation on hopelessness of depressed adults: a comparative analysis.

    Science.gov (United States)

    Gudmundsdottir, R M; Thome, M

    2014-12-01

    The aim of this study is to evaluate the effects of individual and group cognitive behavioural therapy (CBT) and of psychiatric rehabilitation (PR) on hopelessness for depressed patients in a rehabilitation setting. Three groups of patients who underwent PR were allocated to individual CBT combined with PR (n = 43), group CBT combined with PR (n = 52) or PR only (n = 22). Hopelessness was assessed by the Beck Hopelessness Scale (BHS). The majority of the patients (68.4%) suffered from moderate to severe hopelessness before treatment (score ≥ 9-20). Results showed that the pretest mean score on the BHS decreased from 11. 57 (SD = 5.58) to 7.46 (SD = 5.20) at posttest. The mean scores on the BHS decreased in all groups under nine. The combination of individual CBT and PR was significantly more effective in reducing hopelessness than group CBT with PR or PR only. Group CBT combined with PR was not significantly more effective than PR only. It is concluded that individual CBT combined with PR is more effective in alleviating hopelessness among depressed patients than group CBT with PR or PR only. CBT can be delivered by an interdisciplinary team including advanced psychiatric nurses.

  6. Cost-effectiveness of cognitive behaviour therapy versus talking and usual care for depressed older people in primary care

    Directory of Open Access Journals (Sweden)

    Leurent Baptiste E

    2011-02-01

    Full Text Available Abstract Background Whilst evidence suggests cognitive behaviour therapy (CBT may be effective for depressed older people in a primary care setting, few studies have examined its cost-effectiveness. The aim of this study was to compare the cost-effectiveness of cognitive behaviour therapy (CBT, a talking control (TC and treatment as usual (TAU, delivered in a primary care setting, for older people with depression. Methods Cost data generated from a single blind randomised controlled trial of 204 people aged 65 years or more were offered only Treatment as Usual, or TAU plus up to twelve sessions of CBT or a talking control is presented. The Beck Depression Inventory II (BDI-II was the main outcome measure for depression. Direct treatment costs were compared with reductions in depression scores. Cost-effectiveness analysis was conducted using non-parametric bootstrapping. The primary analysis focussed on the cost-effectiveness of CBT compared with TAU at 10 months follow up. Results Complete cost data were available for 198 patients at 4 and 10 month follow up. There were no significant differences between groups in baseline costs. The majority of health service contacts at follow up were made with general practitioners. Fewer contacts with mental health services were recorded in patients allocated to CBT, though these differences were not significant. Overall total per patient costs (including intervention costs were significantly higher in the CBT group compared with the TAU group at 10 month follow up (difference £427, 95% CI: £56 - £787, p Conclusions CBT is significantly more costly than TAU alone or TAU plus TC, but more clinically effective. Based on current estimates, CBT is likely to be recommended as a cost-effective treatment option for this patient group if the value placed on a unit reduction in BDI-II is greater than £115. Trial Registration isrctn.org Identifier: ISRCTN18271323

  7. Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): A prospective, assessor-blind, randomised controlled pilot trial

    OpenAIRE

    Freeman, D; Waite, F.; Startup, H; Myers, E; Lister, R.; McInerney, J; Harvey, AG; Geddes, J.; Zaiwalla, Z; Luengo-Fernandez, R.; Foster, R.; Clifton, L; Yu, LM

    2015-01-01

    Summary Background Sleep disturbance occurs in most patients with delusions or hallucinations and should be treated as a clinical problem in its own right. However, cognitive behavioural therapy (CBT)—the best evidence-based treatment for insomnia—has not been tested in this patient population. We aimed to pilot procedures for a randomised trial testing CBT for sleep problems in patients with current psychotic experiences, and to provide a preliminary assessment of potential benefit. Methods ...

  8. Structural but not functional neuroplasticity one year after effective cognitive behaviour therapy for social anxiety disorder

    DEFF Research Database (Denmark)

    Månsson, Kristoffer N T; Salami, Alireza; Carlbring, Per

    2017-01-01

    , and studies of treatment-induced long-term neuroplasticity are rare. Functional and structural magnetic resonance imaging (using 3T MRI) was performed in 13 subjects with social anxiety disorder on 3 occasions over 1year. All subjects underwent 9 weeks of Internet-delivered cognitive behaviour therapy...... of social anxiety disorder, but only reduced amygdala GM volume, and not functional activity, is associated with a clinical response 1year after CBT....

  9. Cognitive Behavioural Therapy for Insomnia : How, for Whom and What about Acceptance?

    OpenAIRE

    Bothelius, Kristoffer

    2015-01-01

    Sleep is essential for survival but a significant minority of the adult population are dissatisfied with their sleep, and 6-10% meet the criteria for insomnia disorder, characterised by difficulties falling asleep at bedtime, waking up in the middle of the night or too early in the morning, and daytime symptoms. Cognitive behavioural therapy for insomnia (CBT-I), an evidence-based sleep-focused intervention, has been suggested as the treatment of choice for chronic insomnia. However, access t...

  10. Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia: A Randomised Controlled Study

    Directory of Open Access Journals (Sweden)

    L. Bergdahl

    2016-01-01

    Full Text Available Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i. However CBT-i may not suit everyone. Auricular acupuncture (AA is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4, with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI, Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16, Epworth Sleepiness Scale (ESS, and Hospital Anxiety and Depression scale (HAD, were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder. The trial is registered with ClinicalTrials.gov NCT01765959.

  11. Effects of an Internet-based cognitive behavioral therapy (iCBT) program in Manga format on improving subthreshold depressive symptoms among healthy workers: a randomized controlled trial.

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Furukawa, Toshi A; Matsuyama, Yutaka; Shimazu, Akihito; Umanodan, Rino; Kawakami, Sonoko; Kasai, Kiyoto

    2014-01-01

    The purpose of this study was to develop a new Internet-based computerized cognitive behavior therapy (iCBT) program in Manga format, the Japanese cartoon, for workers and to examine the effects of the iCBT program on improving subthreshold depression using a randomized controlled trial (RCT) design among workers employed in private companies in Japan. All workers in a company (n = 290) and all workers in three departments (n = 1,500) at the headquarters of another large company were recruited by an invitation e-mail. Participants who fulfilled the inclusion criteria were randomly allocated to intervention or control groups (N = 381 for each group). A six-week, six-lesson iCBT program using Manga (Japanese comic) story was developed. The program included several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem solving, and relaxation. The intervention group studied the iCBT program at a frequency of one lesson per week. Depression (Beck Depression Inventory II; BDI-II) was assessed as a primary outcome at baseline, and three- and six-month follow-ups for both intervention and control groups were performed. The iCBT program showed a significant intervention effect on BDI-II (t = -1.99, p<0.05) with small effect sizes (Cohen's d: -0.16, 95% Confidence Interval: -0.32 to 0.00, at six-month follow-up). The present study first demonstrated that a computerized cognitive behavior therapy delivered via the Internet was effective in improving depression in the general working population. It seems critical to improve program involvement of participants in order to enhance the effect size of an iCBT program. UMIN Clinical Trials Registry UMIN000006210.

  12. A randomized controlled pilot study of CBT-I Coach: Feasibility, acceptability, and potential impact of a mobile phone application for patients in cognitive behavioral therapy for insomnia.

    Science.gov (United States)

    Koffel, Erin; Kuhn, Eric; Petsoulis, Napoleon; Erbes, Christopher R; Anders, Samantha; Hoffman, Julia E; Ruzek, Josef I; Polusny, Melissa A

    2016-06-27

    There has been growing interest in utilizing mobile phone applications (apps) to enhance traditional psychotherapy. Previous research has suggested that apps may facilitate patients' completion of cognitive behavioral therapy for insomnia (CBT-I) tasks and potentially increase adherence. This randomized clinical trial pilot study (n = 18) sought to examine the feasibility, acceptability, and potential impact on adherence and sleep outcomes related to CBT-I Coach use. All participants were engaged in CBT-I, with one group receiving the app as a supplement and one non-app group. We found that patients consistently used the app as intended, particularly the sleep diary and reminder functions. They reported that it was highly acceptable to use. Importantly, the app did not compromise or undermine benefits of cognitive behavioral therapy for insomnia and patients in both groups had significantly improved sleep outcomes following treatment. © The Author(s) 2016.

  13. Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial

    Science.gov (United States)

    Safren, Steven A.; O'Cleirigh, Conall M.; Bullis, Jacqueline R.; Otto, Michael W.; Stein, Michael D.; Pollack, Mark H.

    2012-01-01

    Objective: Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment adherence. Injection drug users comprise a substantial portion of individuals with HIV in the United States and globally. The present study tested cognitive behavioral therapy for adherence and depression (CBT-AD) in patients…

  14. Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial

    Science.gov (United States)

    Safren, Steven A.; O'Cleirigh, Conall M.; Bullis, Jacqueline R.; Otto, Michael W.; Stein, Michael D.; Pollack, Mark H.

    2012-01-01

    Objective: Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment adherence. Injection drug users comprise a substantial portion of individuals with HIV in the United States and globally. The present study tested cognitive behavioral therapy for adherence and depression (CBT-AD) in patients…

  15. The Effectiveness of Cognitive-Behavioral Therapy (CBT in Reducing Worry, Anxiety and Panic Attacks Mitral Valve Prolapse Patients

    Directory of Open Access Journals (Sweden)

    AR Jamshidzehi ShahBakhsh

    2016-07-01

    Full Text Available Introduction: The mitral valve prolapse is a heart syndrome that is characterized by considerable physical and psychological consequences for affected patients. This study aimed to assess the efficacy of cognitive-behavioral therapy in reducing worrying, generalized anxiety and panic attacks in patients with mitral valve prolapse. Methods: This study is quasi-experimental research with pretest-posttest and control group. 16 patients with mitral valve prolapse divided into to two groups: experimental (n = 8 and control (n = 8 groups. CBT was used during 10 sessions twice a week with a focus on cognitive restructuring, modification of cognitive distortions and training of behavioral techniques for the experimental group. For participants health  concerns spot and doush (HCQ, Generalized anxiety disorder (GAD- 7 and Albania panic scales as pre-test, post-test. Results: Data were analyzed by covariance analysis. The results showed that worrying, anxiety, and panic attacks significantly reduced in the experimental group. Discussion: Cognitive behavioral therapy is remarkably effective for reducing fear, anxiety and panic patients with mitral valve prolapse. Therefore, it is recommended for the patients with mitral valve prolapse that cognitive behavioral therapy can be used as a complementary therapy.

  16. Cognitive-Behavioural Treatment for Men with Intellectual Disabilities and Sexually Abusive Behaviour: A Pilot Study

    Science.gov (United States)

    Murphy, Glynis; Powell, Simon; Guzman, Ana-Maria; Hays, Sarah-Jane

    2007-01-01

    Background: Cognitive-behaviour therapy (CBT) seems to be becoming the treatment of choice for non-disabled sex offenders. Nevertheless, there have been relatively few evaluations of such treatment for men with intellectual disabilities (ID) and sexually abusive behaviour. Method: A pilot study providing CBT for two groups of men with ID is…

  17. Cognitive behaviour therapy for older adults experiencing insomnia and depression in a community mental health setting: Study protocol for a randomised controlled trial.

    Science.gov (United States)

    Sadler, Paul; McLaren, Suzanne; Klein, Britt; Jenkins, Megan; Harvey, Jack

    2015-11-27

    Cognitive behaviour therapy for insomnia (CBT-I) is a well-established treatment; however, the evidence is largely limited to homogenous samples. Although emerging research has indicated that CBT-I is also effective for comorbid insomnia, CBT-I has not been tested among a complex sample of older adults with comorbid insomnia and depression. Furthermore, no study has explored whether modifying CBT-I to target associated depressive symptoms could potentially enhance sleep and mood outcomes. Therefore, this study aims to report a protocol designed to test whether an advanced form of CBT for insomnia and depression (CBT-I-D) is more effective at reducing insomnia and depressive symptoms compared to a standard CBT-I and psychoeducation control group (PCG) for older adults in a community mental health setting. We aim to recruit 150 older adults with comorbid insomnia who have presented to community mental health services for depression. Eligible participants will be randomly allocated via block/cluster randomisation to one of three group therapy conditions: CBT-I, CBT-I-D, or PCG. Participants who receive CBT-I will only practice strategies designed to improve their sleep, whereas participants who receive CBT-I-D will practice additional strategies designed to also improve their mood. This trial will implement a mixed-methods design involving quantitative outcome measures and qualitative focus groups. The primary outcome measures are insomnia and depression severity, and secondary outcomes are anxiety, hopelessness, beliefs about sleep, comorbid sleep conditions, and health. Outcomes will be assessed at pre-intervention (week 0), post-intervention (week 8), and 3-month follow-up (week 20). This CBT study protocol has been designed to address comorbid insomnia and depression for older adults receiving community mental health services. The proposed trial will determine whether CBT-I is more effective for older adults with comorbid insomnia and depression compared to a PCG

  18. A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors.

    Science.gov (United States)

    Johnson, Jillian A; Rash, Joshua A; Campbell, Tavis S; Savard, Josée; Gehrman, Philip R; Perlis, Michael; Carlson, Linda E; Garland, Sheila N

    2016-06-01

    This review examined the efficacy of cognitive behavior therapy for insomnia (CBT-I) in people diagnosed with cancer. Studies were identified through November 2014 using multiple databases, clinical trial records, and bibliography searches. Inclusion was limited to randomized controlled trials of CBT-I conducted in individuals with a cancer diagnosis who had clinically relevant insomnia. The primary outcome variable was sleep efficiency (SE) as measured by sleep diary. Eight studies including data from 752 cancer survivors met inclusion criteria. CBT-I resulted in a 15.5% improvement in SE relative to control conditions (6.1%) from pre- to post-intervention, with a medium effect size (ES: d = 0.53). Overall, sleep latency was reduced by 22 min with an ES of d = 0.43, compared to a reduction of 8 min in the control conditions. Wake after sleep onset was reduced by 30 min with an ES of d = 0.41, compared to 13 min in the control conditions. Large effect sizes were observed for self-reported insomnia severity (d = 0.77) for those patients who received CBT-I, representing a clinically relevant eight point reduction. Effects were durable up to 6 mo. The quality of the evidence supports a strong recommendation for the use of CBT-I among cancer survivors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. The Comparative Impact of Mindfulness-Based Cancer Recovery (MBCR) and Cognitive Behavior Therapy for Insomnia (CBT-I) on Sleep and Mindfulness in Cancer Patients.

    Science.gov (United States)

    Garland, Sheila N; Rouleau, Codie R; Campbell, Tavis; Samuels, Charles; Carlson, Linda E

    2015-01-01

    Insomnia is an important but often overlooked side effect of cancer. Dysfunctional sleep beliefs have been identified as an important perpetuating factor for insomnia. Mindfulness practice has been demonstrated to improve sleep quality but it is unknown whether these effects relate to changes in dysfunctional sleep beliefs. This study is a secondary analysis of a randomized controlled trial comparing mindfulness-based cancer recovery (MBCR) to cognitive behavior therapy for insomnia (CBT-I) in cancer patients with insomnia. This present analysis compares program impact on mindfulness, dysfunctional sleep beliefs, and insomnia severity clinical cutoffs. Patients (MBCR, n = 32; CBT-I, n = 40) were assessed at baseline, post-program, and 3-month follow-up. Across both groups, patients showed improvements over time in acting with awareness (P = .021) and not judging experiences (P = .023). Changes in dysfunctional sleep beliefs produced by the CBT-I group exceeded those produced by MBCR at post-program and follow-up (P mindfulness associated with an overall reduction in dysfunctional sleep beliefs. There were no significant differences between the MBCR and CBT-I groups in the percentage of patients exceeding insomnia severity clinical cutoffs at post-program or follow-up. This study supports the use of both CBT-I and MBCR to reduce insomnia severity and suggests the development of mindfulness facets as a method of reducing dysfunctional sleep beliefs. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Palavras, Marly Amorim; Hay, Phillipa; Touyz, Stephen; Sainsbury, Amanda; da Luz, Felipe; Swinbourne, Jessica; Estella, Nara Mendes; Claudino, Angélica

    2015-12-18

    Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed. HAPIFED integrates the leading evidence-based psychological therapies, cognitive behavioural therapy-enhanced (CBT-E) and behavioural weight loss treatment (BWLT) for binge eating disorder and obesity respectively. The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of HAPIFED versus CBT-E for people with bulimia nervosa and binge eating disorder who are overweight/obese. A single-blind superiority RCT is proposed. One hundred Brazilian participants aged ≥ 18 years, with a diagnosis of bulimia nervosa or binge eating disorder, BMI > 27 to bulimia nervosa as well as with binge eating disorder. It will have the potential to improve health outcomes for the rapidly increasing number of adults with co-morbid obesity and binge eating disorder or bulimia nervosa. US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 1 June 2015.

  1. Effectiveness of enhanced cognitive behavioral therapy (CBT-E in the treatment of anorexia nervosa: a prospective multidisciplinary study

    Directory of Open Access Journals (Sweden)

    Yngvild S. Danielsen

    2016-10-01

    Full Text Available Abstract Background Anorexia nervosa (AN is a debilitating psychiatric disorder associated with a wide array of negative health complications and psychiatric comorbidity. Existing evidence for AN treatment in adults is weak, and no empirically supported treatment has been reliably established. The primary objective of this study is to gain knowledge about the effectiveness of enhanced cognitive behavioral therapy (CBT-E for anorexia nervosa delivered in a public hospital setting. Baseline predictors of treatment outcome and dropout are studied. Furthermore, there will be collected blood and stool samples for a general biobank to be able to initiate research on possible pathophysiological mechanisms underlying AN. Methods The study will assess the potency of outpatient CBT-E in a sample of patients suffering from AN (age >16 admitted to the Section for Eating Disorders at the Department for Psychosomatic Medicine, Haukeland University Hospital in Bergen, Norway. The study has a longitudinal design with five main assessment time points: before treatment, at 3 months, at the end of treatment, at 20 weeks, and at 12 months follow-up including biobank samples. A control group without an eating disorder will also be recruited. Discussion Treatment research in a public hospital setting is important for gaining knowledge about the transportability of treatments evaluated in research clinics into ordinary clinical practice. Furthermore, biological material from the thoroughly described patient cohort will serve as a basis for further research on the pathophysiological mechanisms in AN. Trial registration ClinicalTrials.gov Identifier: NCT02745067 . Registered 14 April 2016. 

  2. Adolescent and Family-focused Cognitive-behavioural Therapy for Paediatric Bipolar Disorders: A Case Series.

    Science.gov (United States)

    Knutsson, Jens; Bäckström, Beata; Daukantaitė, Daiva; Lecerof, Fredrik

    2017-05-01

    Although pharmacological treatments can help alleviate mood symptoms in youth with paediatric bipolar disorder (PBD), residual symptoms still commonly persist. In many cases, these symptoms seriously affect the social and psychological development of children and adolescents suffering from PBD. Complementary interventions, such as psychosocial and psychoeducational treatments, can help children and their families manage mood regulation and other challenges throughout childhood and adolescence. However, most research on such interventions has focused on children, single-family psychoeducation, and individual cognitive behavioural therapy. The present study, conducted in Sweden, used a case-series design to explore whether child- and family-focused cognitive behavioural therapy (CFF-CBT) for PBD, adapted from children (8-12 years) to adolescents (13-18 years) and applied in a multi-family format, could help reduce symptoms, improve psychosocial functioning, increase parents' knowledge of and skills for coping with the disorder, and improve family expressed emotion for adolescents with PBD. Furthermore, we aimed to assess whether the effects of such CFF-CBT are maintained at a one-year follow-up. Seven adolescents and 11 parents in two multi-family groups received twelve sessions of CFF-CBT. Self-rating questionnaires and clinical observations were used to evaluate clinically significant changes for individual cases. The results suggest that CFF-CBT is feasible to deliver in an outpatient psychiatric setting and may be effective for developing parents' skills and knowledge for coping with PBD, increasing adolescents' psychosocial functioning, and improving family climate. The results are in line with previous findings on CFF-CBT for children with PBD, suggesting that CFF-CBT is a valuable adjunctive treatment for adolescents with PBD. Copyright © 2016 John Wiley & Sons, Ltd. Preliminary evidence indicates that CFF-CBT (RAINBOW) is both acceptable and an important

  3. Costs and cost-effectiveness of family CBT versus individual CBT in clinically anxious children

    NARCIS (Netherlands)

    D.H.M. Bodden; C.D. Dirksen; S.M. Bögels; M.H. Nauta; E. de Haan; J. Ringrose; C. Appelboom; A.G. Brinkman; K.C.M.M.J. Appelboom-Geerts

    2008-01-01

    The objective of this study was to investigate the cost-effectiveness of family cognitive-behavioral therapy (CBT) compared with individual CBT in children with anxiety disorders. Clinically anxious children (aged 8—18 years) referred for treatment were randomly assigned to family or individual CBT

  4. Serotonin transporter [corrected] methylation and response to cognitive behaviour therapy in children with anxiety disorders.

    Science.gov (United States)

    Roberts, S; Lester, K J; Hudson, J L; Rapee, R M; Creswell, C; Cooper, P J; Thirlwall, K J; Coleman, J R I; Breen, G; Wong, C C Y; Eley, T C

    2014-09-16

    Anxiety disorders that are the most commonly occurring psychiatric disorders in childhood, are associated with a range of social and educational impairments and often continue into adulthood. Cognitive behaviour therapy (CBT) is an effective treatment option for the majority of cases, although up to 35-45% of children do not achieve remission. Recent research suggests that some genetic variants may be associated with a more beneficial response to psychological therapy. Epigenetic mechanisms such as DNA methylation work at the interface between genetic and environmental influences. Furthermore, epigenetic alterations at the serotonin transporter (SERT) promoter region have been associated with environmental influences such as stressful life experiences. In this study, we measured DNA methylation upstream of SERT in 116 children with an anxiety disorder, before and after receiving CBT. Change during treatment in percentage DNA methylation was significantly different in treatment responders vs nonresponders. This effect was driven by one CpG site in particular, at which responders increased in methylation, whereas nonresponders showed a decrease in DNA methylation. This is the first study to demonstrate differences in SERT methylation change in association with response to a purely psychological therapy. These findings confirm that biological changes occur alongside changes in symptomatology following a psychological therapy such as CBT.

  5. Pre-treatment child and family characteristics as predictors of outcome in cognitive behavioural therapy for youth anxiety disorders

    DEFF Research Database (Denmark)

    Lundkvist-Houndoumadi, Irene; Hougaard, Esben; Thastum, Mikael

    2014-01-01

    BACKGROUND: Cognitive behavioural therapy (CBT) has been found to be effective for children and adolescents (6-18 years) with anxiety disorders, but the non-response rate is high-a fact that may argue for the importance of studies on pre-treatment characteristics of children and their families...... that predict treatment outcome. AIMS: To provide a systematic review of clinical and demographic pre-treatment child and family predictors of treatment outcome in CBT for anxiety disorders in youth. METHOD: A systematic literature search was conducted based on electronic databases (PsycINFO, Embase and Pub......-treatment child and family predictors of outcome in CBT for youth anxiety disorders have until now resulted in few findings of clinical or theoretical significance....

  6. Satisfaction with Therapist-Delivered vs. Self-Administered Online Cognitive Behavioural Treatments for Depression Symptoms in College Students

    Science.gov (United States)

    Richards, Derek; Timulak, Ladislav

    2013-01-01

    Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n = 37), or eight sessions of computerised CBT self-administered treatment (cCBT; n = 43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online…

  7. Satisfaction with Therapist-Delivered vs. Self-Administered Online Cognitive Behavioural Treatments for Depression Symptoms in College Students

    Science.gov (United States)

    Richards, Derek; Timulak, Ladislav

    2013-01-01

    Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n = 37), or eight sessions of computerised CBT self-administered treatment (cCBT; n = 43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online…

  8. Randomized Controlled Trial of Full and Brief Cognitive-Behaviour Therapy and Wait-List for Paediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Bolton, Derek; Williams, Tim; Perrin, Sean; Atkinson, Linda; Gallop, Catherine; Waite, Polly; Salkovskis, Paul

    2011-01-01

    Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to…

  9. A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis

    DEFF Research Database (Denmark)

    Sørensen, Per; Birket-Smith, M; Wattar, U

    2011-01-01

    Hypochondriasis is common in the clinic and in the community. Cognitive behavioural therapy (CBT) has been found to be effective in previous trials. Psychodynamic psychotherapy is a treatment routinely offered to patients with hypochondriasis in many countries, including Denmark. The aim of this ...

  10. Randomized Controlled Trial of Full and Brief Cognitive-Behaviour Therapy and Wait-List for Paediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Bolton, Derek; Williams, Tim; Perrin, Sean; Atkinson, Linda; Gallop, Catherine; Waite, Polly; Salkovskis, Paul

    2011-01-01

    Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to…

  11. Inpatient cognitive behaviour therapy for adolescents with anorexia nervosa: immediate and longer-term effects

    Directory of Open Access Journals (Sweden)

    Riccardo eDalle Grave

    2014-02-01

    Full Text Available Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based upon enhanced cognitive behaviour therapy (CBT-E. The patients were assessed before and after hospitalization, and six and 12 months later. Results: Twenty-six patients (96% completed the program. In these patients there was a substantial improvement in weight, eating disorder features and general psychopathology that was well maintained at 12-month follow-up. Conclusions: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa.

  12. Low-intensity cognitive-behaviour therapy interventions for obsessive-compulsive disorder compared to waiting list for therapist-led cognitive-behaviour therapy: 3-arm randomised controlled trial of clinical effectiveness.

    Science.gov (United States)

    Lovell, Karina; Bower, Peter; Gellatly, Judith; Byford, Sarah; Bee, Penny; McMillan, Dean; Arundel, Catherine; Gilbody, Simon; Gega, Lina; Hardy, Gillian; Reynolds, Shirley; Barkham, Michael; Mottram, Patricia; Lidbetter, Nicola; Pedley, Rebecca; Molle, Jo; Peckham, Emily; Knopp-Hoffer, Jasmin; Price, Owen; Connell, Janice; Heslin, Margaret; Foley, Christopher; Plummer, Faye; Roberts, Christopher

    2017-06-01

    Obsessive-compulsive disorder (OCD) is prevalent and without adequate treatment usually follows a chronic course. "High-intensity" cognitive-behaviour therapy (CBT) from a specialist therapist is current "best practice." However, access is difficult because of limited numbers of therapists and because of the disabling effects of OCD symptoms. There is a potential role for "low-intensity" interventions as part of a stepped care model. Low-intensity interventions (written or web-based materials with limited therapist support) can be provided remotely, which has the potential to increase access. However, current evidence concerning low-intensity interventions is insufficient. We aimed to determine the clinical effectiveness of 2 forms of low-intensity CBT prior to high-intensity CBT, in adults meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for OCD. This study was approved by the National Research Ethics Service Committee North West-Lancaster (reference number 11/NW/0276). All participants provided informed consent to take part in the trial. We conducted a 3-arm, multicentre randomised controlled trial in primary- and secondary-care United Kingdom mental health services. All patients were on a waiting list for therapist-led CBT (treatment as usual). Four hundred and seventy-three eligible patients were recruited and randomised. Patients had a median age of 33 years, and 60% were female. The majority were experiencing severe OCD. Patients received 1 of 2 low-intensity interventions: computerised CBT (cCBT; web-based CBT materials and limited telephone support) through "OCFighter" or guided self-help (written CBT materials with limited telephone or face-to-face support). Primary comparisons concerned OCD symptoms, measured using the Yale-Brown Obsessive Compulsive Scale-Observer-Rated (Y-BOCS-OR) at 3, 6, and 12 months. Secondary outcomes included health-related quality of life, depression, anxiety, and functioning. At

  13. Low-intensity cognitive-behaviour therapy interventions for obsessive-compulsive disorder compared to waiting list for therapist-led cognitive-behaviour therapy: 3-arm randomised controlled trial of clinical effectiveness.

    Directory of Open Access Journals (Sweden)

    Karina Lovell

    2017-06-01

    Full Text Available Obsessive-compulsive disorder (OCD is prevalent and without adequate treatment usually follows a chronic course. "High-intensity" cognitive-behaviour therapy (CBT from a specialist therapist is current "best practice." However, access is difficult because of limited numbers of therapists and because of the disabling effects of OCD symptoms. There is a potential role for "low-intensity" interventions as part of a stepped care model. Low-intensity interventions (written or web-based materials with limited therapist support can be provided remotely, which has the potential to increase access. However, current evidence concerning low-intensity interventions is insufficient. We aimed to determine the clinical effectiveness of 2 forms of low-intensity CBT prior to high-intensity CBT, in adults meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria for OCD.This study was approved by the National Research Ethics Service Committee North West-Lancaster (reference number 11/NW/0276. All participants provided informed consent to take part in the trial. We conducted a 3-arm, multicentre randomised controlled trial in primary- and secondary-care United Kingdom mental health services. All patients were on a waiting list for therapist-led CBT (treatment as usual. Four hundred and seventy-three eligible patients were recruited and randomised. Patients had a median age of 33 years, and 60% were female. The majority were experiencing severe OCD. Patients received 1 of 2 low-intensity interventions: computerised CBT (cCBT; web-based CBT materials and limited telephone support through "OCFighter" or guided self-help (written CBT materials with limited telephone or face-to-face support. Primary comparisons concerned OCD symptoms, measured using the Yale-Brown Obsessive Compulsive Scale-Observer-Rated (Y-BOCS-OR at 3, 6, and 12 months. Secondary outcomes included health-related quality of life, depression, anxiety, and

  14. Group cognitive behaviour therapy for adults with Asperger syndrome and anxiety or mood disorder: a case series.

    Science.gov (United States)

    Weiss, Jonathan A; Lunsky, Yona

    2010-01-01

    Individuals with Asperger syndrome are at increased risk for mental health problems compared with the general population, especially with regard to mood and anxiety disorders. Generic mental health services are often ill-equipped to offer psychotherapeutic treatments to this population, and specialized supports are difficult to find. This case series used a manualized cognitive behaviour therapy group programme (Mind Over Mood) with three adults diagnosed with Asperger syndrome, who were each unable to access psychotherapy through mainstream mental health services. This review highlights the benefits of a cognitive behaviour therapy (CBT) group approach for adults with Asperger syndrome and suggests some potential modifications to traditional CBT provision.  © 2010 John Wiley & Sons, Ltd.

  15. Would Confucius benefit from psychotherapy? The compatibility of cognitive behaviour therapy and Chinese values.

    Science.gov (United States)

    Hodges, Julie; Oei, Tian P S

    2007-05-01

    The purpose of the present paper is to explore the conceptual compatibility between cognitive behaviour therapy (CBT) and the common values of Chinese Culture. In order to address such a question, the distinctive processes attributed to CBT (e.g., teaching of skills, emphasis on homework, cognitive processes, present/future focus), as summarized in the meta-analysis by Blagys and Hilsenroth [(2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychology Review, 22, 671-706], and the core values of Chinese Culture, determined through an integration of The Hofstede Project, [Hofstede, G.H. (1980). Culture's consequences: International differences in work related values. Beverly Hills: Sage]. The Chinese Value Survey [Chinese Culture Connection (1987). Chinese values and the search for culture-free dimensions of culture. Journal of Cross-Cultural Psychology, 18, 143-164]. The Schwartz Value Survey [Schwartz, S.H. (1994). Cultural dimensions of values: Towards an understanding of national differences. In Kim, U., Trandis, H.C., Katiticibasi, C., Choi, S.C., & Yoon, G. (eds.), Individualism and collectivism: Theory, method and application (pp. 85-119). Thousand Oaks, CA: Sage] were used. A strong degree of compatibility between the two was found and it is argued that rather than developing new indigenized therapies, with some structural changes to the processes of CBT, this therapy can be effective for Chinese clients. It is further proposed that Chinese clients may benefit from challenging their irrational cognitions that are bound up in their strict adherence to social norms. Future recommendations for increasing the compatibility of CBT to Chinese culture are discussed.

  16. Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression.

    Science.gov (United States)

    Richards, David A; Rhodes, Shelley; Ekers, David; McMillan, Dean; Taylor, Rod S; Byford, Sarah; Barrett, Barbara; Finning, Katie; Ganguli, Poushali; Warren, Fiona; Farrand, Paul; Gilbody, Simon; Kuyken, Willem; O'Mahen, Heather; Watkins, Ed; Wright, Kim; Reed, Nigel; Fletcher, Emily; Hollon, Steven D; Moore, Lucy; Backhouse, Amy; Farrow, Claire; Garry, Julie; Kemp, Deborah; Plummer, Faye; Warner, Faith; Woodhouse, Rebecca

    2017-08-01

    Depression is a common, debilitating and costly disorder. The best-evidenced psychological therapy - cognitive-behavioural therapy (CBT) - is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative. To determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months' follow-up, and to investigate the processes of treatments. Randomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation. Three community mental health services in England. Adults aged ≥ 18 years with major depressive disorder (MDD) recruited from primary care and psychological therapy services. BA delivered by NHS junior mental health workers (MHWs); CBT by NHS psychological therapists. Primary: depression severity (as measured via the Patient Health Questionnaire-9; PHQ-9) at 12 months. Secondary: MDD status; number of depression-free days; anxiety (as measured via the Generalised Anxiety Disorder-7); health-related quality of life (as measured via the Short Form questionnaire-36 items) at 6, 12 and 18 months; and PHQ-9 at 6 and 18 months, all collected by assessors blinded to treatment allocation. Non-inferiority margin was 1.9 PHQ-9 points. We undertook intention-to-treat (ITT) and per protocol (PP) analyses. We explored cost-effectiveness by collecting direct treatment and other health- and social-care costs and calculating quality-adjusted life-years (QALYs) using the EuroQol-5 Dimensions, three-level version, at 18 months. We recruited 440 participants (BA, n = 221; CBT, n = 219); 175 (79%) BA and 189 (86%) CBT participants provided ITT data and 135 (61%) BA and 151 (69%) CBT participants provided PP data. At 12 months we found that BA was non-inferior to CBT {ITT: CBT 8.4 PHQ-9 points [standard deviation (SD) 7.5 PHQ-9 points], BA 8

  17. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial.

    Science.gov (United States)

    White, P D; Goldsmith, K A; Johnson, A L; Potts, L; Walwyn, R; DeCesare, J C; Baber, H L; Burgess, M; Clark, L V; Cox, D L; Bavinton, J; Angus, B J; Murphy, G; Murphy, M; O'Dowd, H; Wilks, D; McCrone, P; Chalder, T; Sharpe, M

    2011-03-05

    Trial findings show cognitive behaviour therapy (CBT) and graded exercise therapy (GET) can be effective treatments for chronic fatigue syndrome, but patients' organisations have reported that these treatments can be harmful and favour pacing and specialist health care. We aimed to assess effectiveness and safety of all four treatments. In our parallel-group randomised trial, patients meeting Oxford criteria for chronic fatigue syndrome were recruited from six secondary-care clinics in the UK and randomly allocated by computer-generated sequence to receive specialist medical care (SMC) alone or with adaptive pacing therapy (APT), CBT, or GET. Primary outcomes were fatigue (measured by Chalder fatigue questionnaire score) and physical function (measured by short form-36 subscale score) up to 52 weeks after randomisation, and safety was assessed primarily by recording all serious adverse events, including serious adverse reactions to trial treatments. Primary outcomes were rated by participants, who were necessarily unmasked to treatment assignment; the statistician was masked to treatment assignment for the analysis of primary outcomes. We used longitudinal regression models to compare SMC alone with other treatments, APT with CBT, and APT with GET. The final analysis included all participants for whom we had data for primary outcomes. This trial is registered at http://isrctn.org, number ISRCTN54285094. We recruited 641 eligible patients, of whom 160 were assigned to the APT group, 161 to the CBT group, 160 to the GET group, and 160 to the SMC-alone group. Compared with SMC alone, mean fatigue scores at 52 weeks were 3·4 (95% CI 1·8 to 5·0) points lower for CBT (p = 0·0001) and 3·2 (1·7 to 4·8) points lower for GET (p = 0·0003), but did not differ for APT (0·7 [-0·9 to 2·3] points lower; p = 0·38). Compared with SMC alone, mean physical function scores were 7·1 (2·0 to 12·1) points higher for CBT (p = 0·0068) and 9·4 (4·4 to 14·4) points higher

  18. Early improvement in eating attitudes during cognitive behavioural therapy for eating disorders: the impact of personality disorder cognitions.

    Science.gov (United States)

    Park, Emma C; Waller, Glenn; Gannon, Kenneth

    2014-03-01

    The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.

  19. Are there reliable changes in memory and executive functions after cognitive behavioural therapy in patients with obsessive-compulsive disorder?

    Science.gov (United States)

    Vandborg, Sanne Kjær; Hartmann, Tue Borst; Bennedsen, Birgit Egedal; Pedersen, Anders Degn; Thomsen, Per Hove

    2015-01-01

    Patients with obsessive-compulsive disorder (OCD) have impaired memory and executive functions, but it is unclear whether these functions improve after cognitive behavioural therapy (CBT) of OCD symptoms. The primary aim of this study was to investigate whether memory and executive functions change after CBT in patients with OCD. We assessed 39 patients with OCD before and after CBT with neuropsychological tests of memory and executive functions. To correct for practice effects, 39 healthy controls (HCs) were assessed at two parallel time intervals with the neuropsychological tests. There were no changes in memory and executive functions after CBT in patients with OCD when results were corrected for practice effects. Patients performed worse on a test of visuospatial memory and organisational skills (Rey complex figure test [RCFT]) compared to HCs both before and after CBT (ps = .002-.036). The finding of persistent poor RCFT performances indicates that patients with OCD have impaired visuospatial memory and organisational skills that may be trait-related rather than state-dependent. These impairments may need to be considered in treatment. Our findings underline the importance of correcting for practice effects when investigating changes in cognitive functions.

  20. A Remotely-Delivered CBT and Contingency Management Therapy for Substance Using People with HIV.

    Science.gov (United States)

    Moore, Brent A; Rosen, Marc I; Wang, Yan; Shen, Jie; Ablondi, Karen; Sullivan, Anna; Guerrero, Mario; Siqueiros, Lisa; Daar, Eric S; Liu, Honghu

    2015-06-01

    Substance using HIV patients are at risk for non-adherence, and most prior interventions in this population have had only modest effects on adherence. Contingency management (CM) is a promising intervention. The Centralized Off-site Adherence Enhancement (CARE) program involved 12 telephone-delivered substance and adherence-targeted cognitive behavior therapy sessions coupled with CM for adherence to antiretroviral therapy (ART) and counseling participation. CM involved 6 weeks of escalating reinforcement for taking prescribed doses followed by 6 weeks of tapering variable rate reinforcement, and separate reinforcement for counseling ($806 possible). Participants' adherence was measured by devices which wirelessly provided real-time notification of device-opening. HIV infected patients on ART (N = 10) with recent stimulant or alcohol use completed 10.2 of 12 possible telephone sessions, spent 42.8 min/call, and rated the counseling 6.2 on a 1-7 scale. Medication adherence improved from 81 to 93 % (p = 0.04). CARE appears to be acceptable and engaging.

  1. Using CBT with Anxious Language Learners: The Potential Role of the Learning Advisor

    Directory of Open Access Journals (Sweden)

    Neil Curry

    2014-01-01

    Full Text Available Foreign Language Anxiety (FLA can be a crippling condition for many students, preventing them from taking an active part in the classroom, and also retarding their L2 use in wider communicative situations. Providing learners with the tools to overcome anxiety on an individual basis is an area which needs further investigation. Cognitive Behaviour Therapy (CBT is a widespread counselling practice used to treat anxieties. It shares similarities with some techniques employed in Advising in Language Learning (ALL for helping students with language goals, and it is worthwhile investigating and raising awareness of how it can be used for FLA. The article describes major characteristics of FLA and also CBT, and then describes four functions which CBT and ALL share: goal-setting, guided discovery, Socratic questioning and use of reflection. Preliminary research also demonstrates how some of the practices associated with CBT could be applied by Learning Advisors to help students to overcome FLA.

  2. The efficacy of attendance and semi-attendance group cognitive-behavioral therapy (CBT) on the anxiety disorders of adolescent girls

    Science.gov (United States)

    Karbasi, Afsaneh; Arman, Soroor; Maracy, Mohamad Reza

    2010-01-01

    BACKGROUND: Anxiety disorders are one of the most psychiatric disorders in children and adolescents that can cause long life functional disability. The first line treatment for this disorder is cognitive behavioral therapy that has primary, secondary and tertiary preventive effect, but is expensive and long time. Today there is some effort to find short term, group, semi-attendance and low cost therapies. METHODS: Subjects were 42 girls (12- 17 y) with at least one anxiety disorder according to DSM-IV-TR with their parents who were divided into two groups randomly: group A which participated in 8 sessions and group B which participated in 4 sessions and the contents of sessions 3, 4, 6, and 7 were recorded on a CD for them. The tests used in this study were: SCARED, CATS, CAIS-C, CAIS-P, conducted before (T0), just after (T1) and three months after the treatment (T2). The collected data were analyzed by multivariate analysis of covariance test using SPSS software package, version 15.0. RESULTS: There was no significant difference between efficacy of semi-attendance group CBT and attendance group CBT in T0, T1 and T2 according to 4 tests (p = 0.311). The difference between the scores of these tests between T0 andT1 and T0 and T2 was significant in both groups (p < 0.001) but the difference between T1 and T2 was not significant. (p = 0.771). CONCLUSIONS: The efficacy of semi-attendance group CBT and attendance group CBT is similar and would sustain after 3 months. PMID:21526093

  3. The efficacy of attendance and semi-attendance group cognitive-behavioral therapy (CBT on the anxiety disorders of adolescent girls

    Directory of Open Access Journals (Sweden)

    Afsaneh Karbasi

    2010-01-01

    Full Text Available Background: Anxiety disorders are one of the most psychiatric disorders in children and adolescents that can cause long life functional disability. The first line treatment for this disorder is cognitive behavioral therapy that has primary, secondary and tertiary preventive effect, but is expensive and long time. Today there is some effort to find short term, group, semi-attendance and low cost therapies. Methods: Subjects were 42 girls (12- 17 y with at least one anxiety disorder according to DSM-IV-TR with their parents who were divided into two groups randomly: group A which participated in 8 sessions and group B which participated in 4 sessions and the contents of sessions 3, 4, 6, and 7 were recorded on a CD for them. The tests used in this study were: SCARED, CATS, CAIS-C, CAIS-P, conducted before (T0, just after (T1 and three months after the treatment (T2. The collected data were analyzed by multivariate analysis of covariance test using SPSS software package, version 15.0. Results: There was no significant difference between efficacy of semi-attendance group CBT and attendance group CBT in T0, T1 and T2 according to 4 tests (p = 0.311. The difference between the scores of these tests between T0 andT1 and T0 and T2 was significant in both groups (p < 0.001 but the difference between T1 and T2 was not significant. (p = 0.771. Conclusions: The efficacy of semi-attendance group CBT and attendance group CBT is similar and would sustain after 3 months.

  4. Investigation of consumer satisfaction with cognitive-behaviour therapy and sertraline in the treatment of adolescent depression.

    Science.gov (United States)

    Dudley, Amanda L; Melvin, Glenn A; Williams, Nicola J; Tonge, Bruce J; King, Neville J

    2005-06-01

    A new instrument, the Adolescent Depression Treatment Satisfaction Questionnaire (ADTSQ) was devised to measure the consumer satisfaction of depressed adolescents and their parents. The objectives of the paper were to present the psychometric properties of the ADTSQ and to investigate the relative consumer satisfaction with cognitive-behavioural therapy (CBT), sertraline (SRT) and a combined treatment of CBT and SRT (COMBINED) for the treatment of adolescent depression. In addition, participants were asked to rank their most preferred treatment from the following approaches: medication, individual counselling, group program and family therapy. Thirty-eight adolescents with a unipolar depressive disorder and 37 parents who participated in a randomized clinical trial of CBT versus SRT versus COMBINED completed the ADTSQ following the completion of acute treatment. The ADTSQ was found to have high internal consistency and exploratory factor analysis detected three underlying factors. High levels of consumer satisfaction were reported by both adolescents and parents in all three treatments. Those treated with CBT treatments reported higher levels of skill acquisition than those treated with SRT. Of the four treatment approaches, most parents and adolescents rated individual counselling as their first preference. The ADTSQ is a useful measure of consumer satisfaction for depressed adolescents and their parents. CBT, SRT and COMBINED were shown to have high consumer satisfaction with CBT's higher skills training content reflected in the participants' reports. Individual counselling was perceived as the most favourable choice of treatment for adolescent depression. Although limitations associated with the measurement of consumer satisfaction and of the study are acknowledged, it is recommended that the inclusion of consumer satisfaction measures be considered in clinical trials that examine treatment efficacy.

  5. Treatment acceptability and preferences for managing severe health anxiety: Perceptions of internet-delivered cognitive behaviour therapy among primary care patients.

    Science.gov (United States)

    Soucy, Joelle N; Hadjistavropoulos, Heather D

    2017-12-01

    While cognitive behaviour therapy (CBT) is an established treatment for health anxiety, there are barriers to service access. Internet-delivered cognitive behaviour therapy (ICBT) has demonstrated effectiveness and has the potential to improve access to treatment. Nevertheless, it is unknown how patients perceive ICBT relative to other interventions for health anxiety and what factors predict ICBT acceptability. This study investigated these questions. Primary care patients (N = 116) who reported elevated levels of health anxiety were presented three treatment vignettes that each described a different protocol for health anxiety (i.e., medication, CBT, ICBT). Acceptability and credibility of the treatments were assessed following the presentation of each vignette. Participants then ranked the three treatments and provided a rational for their preferences. The treatments were similarly rated as moderately acceptable. Relative to medication and ICBT, CBT was perceived as the most credible treatment for health anxiety. The highest preference ranks were for CBT and medication. Regression analyses indicated that lower computer anxiety, past medication use, and lower ratings of negative cognitions about difficulty coping with an illness significantly predicted greater ICBT acceptability. Health anxiety was not assessed with a diagnostic interview. Primary care patients were recruited through a Qualtrics panel. Patients did not have direct experience with treatment but learned about treatment options through vignettes. Medication and CBT are preferred over ICBT. If ICBT is to increase treatment access, methods of improving perceptions of this treatment option are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Comparison of the effects of cognitive behavioural therapy and inhalation sedation on child dental anxiety.

    Science.gov (United States)

    Kebriaee, F; Sarraf Shirazi, A; Fani, K; Moharreri, F; Soltanifar, A; Khaksar, Y; Mazhari, F

    2015-04-01

    To compare the effectiveness of inhalation sedation with nitrous oxide/oxygen (N2O/O2) and cognitive behavioural therapy (CBT) in reducing dental anxiety in preschool children. Randomised controlled clinical trial. This study was conducted on 45 preschoolers with moderate to severe dental anxiety (determined by the Children's Fear Survey Schedule Dental Subscale), who required pulp treatment of at least one primary mandibular molar. Baseline anxiety and cooperation levels were determined using Venham Clinical Anxiety and Cooperation Scales (VCAS and VCCS) and Venham Picture Test (VPT) at the first dental visit (dental prophylaxis and fluoride treatment). Before the second dental visit (pulp treatment), the children were randomly assigned to one of three groups--1: control, 2: N(2)O/O(2) and 3: CBT. In group 1, the usual behaviour management techniques were used, in group 2, nitrous oxide/oxygen gas was used and in group 3, unrelated play, Benson's breathing and positive self-talk and modelling were used. Anxiety and cooperation levels were determined at three periods: injection, rubber dam placement and the application of a high-speed handpiece with VCAS and VCCS and VPT. Finally, anxiety and cooperation differences between the two dental visits were compared within the three groups. Chi square, ANOVA and Kruskal-Wallis and Mann-Whitney U tests were used. N(2)O/O(2) and CBT significantly resulted in lower anxiety and higher cooperation in the second visit (at all three periods) compared to the control, although there was no significant difference between these two treatment methods. Both test methods were effective in reducing dental anxiety in preschoolers. Considering the adverse effects and necessity of equipment and trained personnel when using nitrous oxide and oxygen inhalation sedation, cognitive behavioural therapy is preferable because of its better applicability.

  7. Investigating the relationship between competence and patient outcome with CBT.

    Science.gov (United States)

    Branson, Amanda; Shafran, Roz; Myles, Pamela

    2015-05-01

    Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government's Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed.

  8. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression

    DEFF Research Database (Denmark)

    Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig

    2015-01-01

    BACKGROUND: Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients...... of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more...... effective in treating depression and reducing relapse than standard cognitive behavioural therapy. METHOD/DESIGN: This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness...

  9. A CBT Approach to Inpatient Psychiatric Hospitalization

    Science.gov (United States)

    Masters, Kim J.

    2005-01-01

    During a psychiatric hospitalization of 5 to 10 days, cognitive-behavioral therapy (CBT) strategies can be used for the management of inpatients and to support the transition to outpatient treatment. This format was chosen after several years of frustration dealing with crisis inpatient care. The use of CBT is well known, and it seemed that an…

  10. Comparing the acceptability of a positive psychology intervention versus a cognitive behavioural therapy for clinical depression.

    Science.gov (United States)

    Lopez-Gomez, Irene; Chaves, Covadonga; Hervas, Gonzalo; Vazquez, Carmelo

    2017-09-01

    There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients. Key Practitioner Message This study sheds light on the client satisfaction and adherence to a positive intervention. For participants, positive psychology interventions (PPI) may be more satisfactory than CBT as PPI are framed within a positive mental health model and, consequently, may reduce the risk of stigmatization Because acceptability of treatments and preferences may affect the efficacy of treatments, this study provides an excellent opportunity to offer professionals more therapeutic options to tailor treatments to clients' needs and expectations. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings

    Directory of Open Access Journals (Sweden)

    Fröberg Anders

    2011-01-01

    Full Text Available Abstract Background Reviews of randomized controlled trials (RCTs of cognitive behavioural therapy (CBT for anxiety disorders have reported large pre- to post-treatment within-group effect sizes on measures of anxiety when supplied in therapist consultations and in technology-supported settings. However, the stringent experimental control of RCTs results in a lack of external validity, which limits the generalizability of findings to real-world frontline clinical practice. We set out to examine the specification of a protocol for study of the effectiveness of cell phone-supported CBT for in situ management of anxiety disorders. Methods and design Nominal group methods were used for requirements analysis and protocol design. Making a distinction between different forms of technology-supported therapy, examination of therapists' role, and implementing trials in existing organizational and community contexts were found to be the central requirements in the protocol. Discussion The resulting protocol (NCT01205191 at clinicaltrials.gov for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.

  12. Service user satisfaction with cognitive behavioural therapy for psychosis: Associations with therapy outcomes and perceptions of the therapist.

    Science.gov (United States)

    Lawlor, Caroline; Sharma, Bina; Khondoker, Mizanur; Peters, Emmanuelle; Kuipers, Elizabeth; Johns, Louise

    2017-03-01

    Few studies have investigated service user satisfaction with cognitive behavioural therapy for psychosis (CBTp). This study explored its associations with clinical presentation and outcomes, retrospective expectations of progress, perceptions of the therapist, and demographic variables. One hundred and sixty-five service users completed self-report questionnaires pre- and post-CBTp in relation to the constructs of interest. Regression analyses explored associations with (1) overall satisfaction with therapy and (2) perceived progress, skills, and knowledge gained. Ninety-six per cent of service users reported satisfaction with therapy. Higher levels of overall satisfaction with, and perceived benefit from, therapy were associated with positive therapy expectations, positive ratings of therapist's personal qualities, competence and trustworthiness, lower pre-therapy depression, and improvements in quality of life. Symptom improvements were not related to overall satisfaction with therapy; however, with the exception of voices, better clinical outcomes were associated with subjective ratings of having made more progress and gained more CBT skills and knowledge. Demographic factors were not associated with satisfaction or perceived progress. In multiple regression analyses, expectations of progress showed the strongest associations with both satisfaction and perceived benefits. Other remaining significant associations consisted of perceptions of the therapist for satisfaction, and both pre-therapy levels of, and changes in, depression for perceived benefits. Qualitative feedback emphasized the importance of the therapeutic relationship and developing new coping strategies. The findings provide preliminary evidence that high levels of satisfaction with therapy are not contingent on good clinical outcomes and are instead associated with positive therapy expectations and perceptions of the therapist. Therapy expectations represent a neglected area of research and may

  13. Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial.

    Science.gov (United States)

    Imamura, K; Kawakami, N; Furukawa, T A; Matsuyama, Y; Shimazu, A; Umanodan, R; Kawakami, S; Kasai, K

    2015-07-01

    In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers. Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section. The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank χ2 = 7.04, p < 0.01). The hazard ratio for the intervention group was 0.22 (95% confidence interval 0.06-0.75), when estimated by the Cox proportional hazard model. The present study demonstrates that an iCBT program is effective in preventing MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.

  14. Does enhanced cognitive behaviour therapy for eating disorders improve quality of life?

    Science.gov (United States)

    Watson, Hunna J; Allen, Karina; Fursland, Anthea; Byrne, Susan M; Nathan, Paula R

    2012-09-01

    Quality of life (QOL) is the degree of enjoyment and satisfaction experienced in life, and embraces emotional well-being, physical health, economic and living circumstances, and work satisfaction. QOL recovery with eating disorder treatment has received sparse attention, and until now, no study has investigated QOL recovery with enhanced cognitive behaviour therapy (CBT-E). Patients (n = 196) admitted to a specialist eating disorders outpatient programme and receiving CBT-E completed measures of QOL, eating disorder psychopathology, depression, anxiety and self-esteem, before and after treatment. QOL at intake was compared with community norms, and QOL below the norm was predicted from sociodemographic and clinical correlates with logistic regression. Baseline QOL below the norm was associated with depression and anxiety Axis I comorbidity, and severity of depressive symptoms. Predictors of post-treatment QOL were baseline QOL and level of depressive symptoms and self-esteem at post-treatment. CBT-E was associated with gains in QOL over the course of treatment, in addition to eating disorder symptom relief. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

  15. A randomised controlled trial of group cognitive behavioural therapy for perfectionism.

    Science.gov (United States)

    Handley, Alicia K; Egan, Sarah J; Kane, Robert T; Rees, Clare S

    2015-05-01

    Perfectionism is associated with symptoms of anxiety disorders, eating disorders and mood disorders. Treatments targeting perfectionism may reduce the symptoms of these disorders (Egan, Wade, & Shafran, 2011). This study is the first randomised controlled trial to investigate the efficacy of group cognitive behavioural therapy (CBT) for perfectionism. Forty-two participants with elevated perfectionism and a range of anxiety, eating and mood disorders were randomised to group CBT for perfectionism or a waitlist control. The treatment group reported significantly greater pre-post reductions in perfectionism, symptoms of depression, eating disorders, social anxiety, anxiety sensitivity and rumination, as well as significantly greater pre-post increases in self-esteem and quality of life compared to the waitlist control group. The impact of treatment on most of these outcomes was mediated by pre-post change in perfectionism (Concern over Mistakes). Treatment gains were reliable and clinically significant, and were maintained at 6-month follow-up. Findings support group CBT for perfectionism being an efficacious treatment for perfectionism and related psychopathology, as well as increasing self-esteem and quality of life.

  16. Family-focused cognitive behaviour therapy versus psycho-education for chronic fatigue syndrome in 11- to 18-year-olds: a randomized controlled treatment trial.

    Science.gov (United States)

    Chalder, T; Deary, V; Husain, K; Walwyn, R

    2010-08-01

    Only one previous randomized controlled trial (RCT) has examined the efficacy of cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) in children. The aim of this study was to compare family-focused CBT with psycho-education for CFS in adolescents. Sixty-three 11- to 18-year-olds (43 girls, 20 boys) with CFS were randomly assigned to either family-focused CBT or psycho-education delivered over 6 months. School attendance was the main outcome, which was assessed at the end of treatment and at 3, 6 and 12 months follow-up. At the main outcome point (the 6-month follow-up) both groups had improved similarly. However, although those who received family-focused CBT were attending school for longer than those who received psycho-education, at discharge from treatment and at 3 months follow-up, they improved less quickly across the follow-up period. Adolescents with CFS get back to school more quickly after family-focused CBT. This is important as they are at a crucial stage of their development. However, the finding that psycho-education was as effective as family-focused CBT at 6 and 12 months follow-up has important implications for health service delivery.

  17. Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial

    Directory of Open Access Journals (Sweden)

    Karlsson Andreas

    2010-07-01

    Full Text Available Abstract Background Internet administered cognitive behaviour therapy (CBT is a promising new way to deliver psychological treatment, but its effectiveness in regular care settings and in relation to more traditional CBT group treatment has not yet been determined. The primary aim of this study was to compare the effectiveness of Internet-and group administered CBT for panic disorder (with or without agoraphobia in a randomised trial within a regular psychiatric care setting. The second aim of the study was to establish the cost-effectiveness of these interventions. Methods Patients referred for treatment by their physician, or self-referred, were telephone-screened by a psychiatric nurse. Patients fulfilling screening criteria underwent an in-person structured clinical interview carried out by a psychiatrist. A total of 113 consecutive patients were then randomly assigned to 10 weeks of either guided Internet delivered CBT (n = 53 or group CBT (n = 60. After treatment, and at a 6-month follow-up, patients were again assessed by the psychiatrist, blind to treatment condition. Results Immediately after randomization 9 patients dropped out, leaving 104 patients who started treatment. Patients in both treatment conditions showed significant improvement on the main outcome measure, the Panic Disorder Severity Scale (PDSS after treatment. For the Internet treatment the within-group effect size (pre-post on the PDSS was Cohen's d = 1.73, and for the group treatment it was d = 1.63. Between group effect sizes were low and treatment effects were maintained at 6-months follow-up. We found no statistically significant differences between the two treatment conditions using a mixed models approach to account for missing data. Group CBT utilised considerably more therapist time than did Internet CBT. Defining effect as proportion of PDSS responders, the cost-effectiveness analysis concerning therapist time showed that Internet treatment had superior cost

  18. Transdiagnostic versus disorder-specific internet-delivered cognitive behaviour therapy for anxiety and depression in primary care.

    Science.gov (United States)

    Newby, Jill M; Mewton, Louise; Andrews, Gavin

    2017-03-01

    Disorder-specific and transdiagnostic internet cognitive behaviour therapy (iCBT) programs are effective for anxiety and depression, but no studies have compared their effectiveness in primary care. Patient characteristics, adherence and effectiveness of Transdiagnostic iCBT (n=1005) were compared to disorder-specific programs for generalized anxiety disorder (GAD) (n=738) and depression (n=366) in a naturalistic non-randomised comparison study. Patients completed their iCBT program in primary care. The PHQ-9 (depression), GAD-7 (generalized anxiety), K-10 (distress), and the WHODAS-II (disability) were measured at pre- and post-treatment. Patients in the Transdiagnostic program had higher comorbidity rates and baseline distress. All programs were associated with medium to large within-group effect sizes for improving anxiety, depression and distress between pre- and post-treatment (d's=0.64-1.39). Controlling for baseline group differences in severity, we found small effect sizes favoring the Transdiagnostic program over the GAD program in reducing PHQ-9 (d=0.44, 95%CI: 0.34-0.53), K-10 (d=0.21, 95%CI: 0.16-0.35) and WHODAS scores (d=0.20, 95%CI: 0.10-0.29), and small effect sizes favoring the Transdiagnostic program over the Depression program in reducing GAD-7 scores (d=0.48, 95%CI: 0.36-0.60). A smaller proportion of patients completed the Transdiagnostic program (44.9%) compared to the depression (51.6%) and GAD (49.2%) programs, which was attributable to baseline differences in age and symptom severity. Both Transdiagnostic iCBT and disorder-specific iCBT programs are effective in primary care, but there appears to be small effects favoring Transdiagnostic iCBT. Methods to increase adherence are needed to optimize the benefits to patients, and these findings await replication in a RCT. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD.

    Science.gov (United States)

    Rector, Neil A; Richter, Margaret A; Lerman, Bethany; Regev, Rotem

    2015-01-01

    The majority of "responders" to first-line cognitive-behavioural therapy (CBT) and pharmacological treatments for obsessive-compulsive disorder (OCD) are left with residual symptoms that are clinically relevant and disabling. Therefore, there is pressing need for widely accessible efficacious alternative and/or adjunctive treatments for OCD. Accumulating evidence suggests that physical exercise may be one such intervention in the mood and anxiety disorders broadly, although we are aware of only two positive small-scale pilot studies that have tested its clinical benefits in OCD. This pilot study aimed to test the feasibility and preliminary efficacy of adding a structured physical exercise programme to CBT for OCD. A standard CBT group was delivered concurrently with a 12-week customized exercise programme to 11 participants. The exercise regimen was individualized for each participant based on peak heart rate measured using an incremental maximal exercise test. Reports of exercise adherence across the 12-week regimen exceeded 80%. A paired-samples t-test indicated very large treatment effects in Yale-Brown Obsessive-Compulsive Scale scores from pre- to post-treatment in CBT group cohorts led by expert CBT OCD specialists (d = 2.55) and junior CBT clinician non-OCD specialists (d = 2.12). These treatment effects are very large and exceed effects typically observed with individual and group-based CBT for OCD based on leading meta-analytic reviews, as well as previously obtained treatment effects for CBT using the same recruitment protocol without exercise. As such, this pilot work demonstrates the feasibility and significant potential clinical utility of a 12-week aerobic exercise programme delivered in conjunction with CBT for OCD.

  20. Cognitive behavioural therapy (CBT) for carers of patients with Parkinson's disease: a preliminary randomised controlled trial

    National Research Council Canada - National Science Library

    Secker, D L; Brown, R G

    2005-01-01

    .... Providing such long term care can be a source of significant stress, with many carers experiencing sleep difficulty, depression, anxiety, loneliness, and other symptoms of psychological strain...

  1. Characteristics and Components of the TADS CBT Approach

    Science.gov (United States)

    Rohde, Paul; Feeny, Norah C.; Robins, Michele

    2005-01-01

    In this article, we describe the acute phase of a cognitive-behavioral therapy (CBT) developed for and utilized in the Treatment for Adolescents With Depression Study (TADS). The acute phase of TADS CBT consists of 8 skills that were considered essential to any CBT intervention for adolescent depression (e.g., mood monitoring, increasing pleasant…

  2. Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial.

    Science.gov (United States)

    Dahlin, Mats; Andersson, Gerhard; Magnusson, Kristoffer; Johansson, Tomas; Sjögren, Johan; Håkansson, Andreas; Pettersson, Magnus; Kadowaki, Åsa; Cuijpers, Pim; Carlbring, Per

    2016-02-01

    Generalized anxiety disorder (GAD) is a disabling condition which can be treated with cognitive behaviour therapy (CBT). The present study tested the effects of therapist-guided internet-delivered acceptance-based behaviour therapy on symptoms of GAD and quality of life. An audio CD with acceptance and mindfulness exercises and a separate workbook were also included in the treatment. Participants diagnosed with GAD (N = 103) were randomly allocated to immediate therapist-guided internet-delivered acceptance-based behaviour therapy or to a waiting-list control condition. A six month follow-up was also included. Results using hierarchical linear modelling showed moderate to large effects on symptoms of GAD (Cohen's d = 0.70 to 0.98), moderate effects on depressive symptoms (Cohen's d = 0.51 to 0.56), and no effect on quality of life. Follow-up data showed maintained effects. While there was a 20% dropout rate, sensitivity analyses showed that dropouts did not differ in their degree of change during treatment. To conclude, our study suggests that internet-delivered acceptance-based behaviour therapy can be effective in reducing the symptoms of GAD.

  3. Cognitive behaviour therapy in medication-treated adults with ADHD and persistent Symptoms: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Einarsson Emil

    2011-07-01

    Full Text Available Abstract Background Attention deficit hyperactivity disorder (ADHD in adulthood is not fully treated by psychopharmacological treatment alone. The main aim of the current study was to evaluate a newly developed cognitive behaviour therapy (CBT based group programme, the Reasoning and Rehabilitation for ADHD Youths and Adults (R&R2ADHD, using a randomized controlled trial. Methods 54 adults with ADHD already receiving psychopharmacological treatment were randomly allocated to an experimental (CBT/MED treatment condition (n = 27 and a 'treatment as usual' (TAU/MED control condition (n = 27 that did not receive the CBT intervention. The outcome measures were obtained before treatment (baseline, after treatment and at three month follow-up and included ADHD symptoms and impairments rated by independent assessors, self-reported current ADHD symptoms, and comorbid problems. Results The findings suggested medium to large treatment effects for ADHD symptoms, which increased further at three month follow-up. Additionally, comorbid problems also improved at follow-up with large effect sizes. Conclusions The findings give support for the effectiveness of R&R2ADHD in reducing ADHD symptoms and comorbid problems, an improving functions associated with impairment. The implications are that the benefits of R&R2ADHD are multifaceted and that combined psychopharmacological and CBT based treatments may add to and improve pharmacological interventions. Trial registration ACTRN12611000533998 (http://www.ANZCTR.org.au/ACTRN12611000533998.aspx

  4. Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment

    Science.gov (United States)

    Santacana, Martí; Arias, Bárbara; Mitjans, Marina; Bonillo, Albert; Montoro, María; Rosado, Sílvia; Guillamat, Roser; Vallès, Vicenç; Pérez, Víctor; Forero, Carlos G.; Fullana, Miquel A.

    2016-01-01

    Background Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT) for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understanding which genetic and environmental factors are responsible for this differential response to treatment is a key step towards “personalized medicine”. Based on previous research, our objective was to test whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based CBT for panic disorder (PD). Method We used Growth Mixture Modeling to identify latent classes of change (response trajectories) in patients with PD (N = 97) who underwent group manualized exposure-based CBT. We conducted logistic regression to investigate the effect on these trajectories of the BDNF Val66Met polymorphism and two different types of childhood maltreatment, abuse and neglect. Results We identified two response trajectories (“high response” and “low response”), and found that they were not significantly associated with either the genetic (BDNF Val66Met polymorphism) or childhood trauma-related variables of interest, nor with an interaction between these variables. Conclusions We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD. Future studies in this field may benefit from looking at other genotypes or using different (e.g. whole-genome) approaches. PMID:27355213

  5. Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment.

    Directory of Open Access Journals (Sweden)

    Martí Santacana

    Full Text Available Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understanding which genetic and environmental factors are responsible for this differential response to treatment is a key step towards "personalized medicine". Based on previous research, our objective was to test whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based CBT for panic disorder (PD.We used Growth Mixture Modeling to identify latent classes of change (response trajectories in patients with PD (N = 97 who underwent group manualized exposure-based CBT. We conducted logistic regression to investigate the effect on these trajectories of the BDNF Val66Met polymorphism and two different types of childhood maltreatment, abuse and neglect.We identified two response trajectories ("high response" and "low response", and found that they were not significantly associated with either the genetic (BDNF Val66Met polymorphism or childhood trauma-related variables of interest, nor with an interaction between these variables.We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD. Future studies in this field may benefit from looking at other genotypes or using different (e.g. whole-genome approaches.

  6. Effectiveness of cognitive behavioural therapy with people who have autistic spectrum disorders: A systematic review and meta-analysis.

    Science.gov (United States)

    Weston, Lisa; Hodgekins, Joanne; Langdon, Peter E

    2016-11-01

    The aims of this study were to undertake a meta-analytic and systematic appraisal of the literature investigating the effectiveness of cognitive behavioural therapy (CBT) when used with individuals who have autistic spectrum disorders (ASDs) for either a) affective disorders, or b) the symptoms of ASDs. Following a systematic search, 48 studies were included. CBT, used for affective disorders, was associated with a non-significant small to medium effect size, g=0.24, for self-report measures, a significant medium effect size, g=0.66, for informant-report measures, and a significant medium effect size, g=0.73, for clinician-report measures. CBT, used as a treatment for symptoms of ASDs, was associated with a small to medium non-significant effect size, g=0.25, for self-report measures, a significant small to medium effect size, g=0.48, for informant-report measures, a significant medium effect size, g=0.65, for clinician-report measures, and a significant small to medium effect size, g=0.35, for task-based measures. Sensitivity analyses reduced effect size magnitude, with the exception of that based on informant-report measures for the symptoms of ASDs, which increased, g=0.52. Definitive trials are needed to demonstrate that CBT is an empirically validated treatment for use with people who have ASDs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Cognitive-behavioural group therapy versus guided self-help for compulsive buying disorder: a preliminary study.

    Science.gov (United States)

    Müller, A; Arikian, A; de Zwaan, M; Mitchell, J E

    2013-01-01

    Compulsive buying (CB) is defined as extreme preoccupation with buying/shopping and frequent buying that causes substantial negative psychological, social, occupational and financial consequences. There exists preliminary evidence that group cognitive-behavioural therapy (CBT) is effective in the treatment of CB. The present pilot study made a first attempt to compare group CBT for CB with telephone-guided self-help (GSH). Fifty-six patients were allocated randomly to one of the three conditions: (1) group CBT (n = 22); (2) GSH (n = 20); and (3) a waiting list condition (n = 14). The results indicate that face-to-face group CBT is superior not only to the waiting list condition but also to GSH. Patients who received GSH tended to have more success in overcoming CB compared with the waiting list controls. Given the sample size, the results must be considered as preliminary and further research is needed to address the topic whether GSH also could be a helpful intervention in reducing CB. Copyright © 2011 John Wiley & Sons, Ltd.

  8. Becoming Therapeutic Agents: A Grounded Theory of Mothers' Process When Implementing Cognitive Behavioural Therapy at Home with an Anxious Child.

    Science.gov (United States)

    Pishva, Rana

    2016-09-29

    The premise of parent-centred programmes for parents of anxious children is to educate and train caregivers in the sustainable implementation of cognitive behaviour therapy (CBT) in the home. The existing operationalization of parent involvement, however, does not address the systemic, parent or child factors that could influence this process. The qualitative approach of grounded theory was employed to examine patterns of action and interaction involved in the complex process of carrying out CBT with one's child in one's home. A grounded theory goes beyond the description of a process, offering an explanatory theory that brings taken-for-granted meanings and processes to the surface. The theory that emerged from the analysis suggests that CBT implementation by mothers of anxious children is characterized by the evolution of mothers' perception of their child and mothers' perception of their role as well as a shift from reacting with emotion to responding pragmatically to the child. Changes occur as mothers recognize the crisis, make links between the treatment rationale, child's symptoms and their own parenting strategies, integrate tenets of CBT for anxiety and eventually focus on sustaining therapeutic gains through natural life transitions. The theory widens our understanding of mothers' role, therapeutic engagement, process, and decision-making. The theory also generates new hypotheses regarding parent involvement in the treatment of paediatric anxiety disorders and proposes novel research avenues that aim to maximize the benefits of parental involvement in the treatment of paediatric anxiety disorders. Copyright © 2016 John Wiley & Sons, Ltd.

  9. The Effectiveness of Mindfulness-based Cognitive Therapy (MBCT and Cognitive Behavior Therapy (CBT on Decreasing Pain, Depression and Anxiety of Patients with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    M Abdolghadery

    2014-02-01

    Conclusion: The results support the effectiveness of MBCT and CBT in decreasing pain, depression and anxiety. Therefore, taking account of these two therapeutic methods is very important for patients with chronic low back pain.

  10. Exploring the Effect of Case Formulation Driven CBT for Children with Anxiety Disorders

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Reinholdt-Dunne, Marie Louise; Nielsen, Sara K

    2015-01-01

    only as the child's assistants, treatment being primarily directed at the child), or as co-clients (parents received therapy targeting theoretically established maintaining mechanisms; children received half of the sessions, parents the other half). Method: Feasibility of the case-formulation driven...... CBT was established by comparing the completion rate and the percentage of children free of anxiety after treatment, with manualized treatments reported in existing meta-analyses. Children aged 7-12 years and their parents participated (n = 54). Families were assessed at pre- and posttreatment......Background: Little is known about the effect of case-formulation based cognitive behaviour therapy (CBT) for anxious children. Aim: The present study explores the feasibility of case-formulation driven CBT for anxious children. Parents were involved in treatment as either co-facilitators (involved...

  11. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression

    DEFF Research Database (Denmark)

    Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig;

    2015-01-01

    Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome......BACKGROUND: Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients...... of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more...

  12. Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

    Directory of Open Access Journals (Sweden)

    Anna Lucia Spear King

    2011-01-01

    Full Text Available Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive, especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

  13. Intensive Cognitive Therapy for PTSD: A Feasibility Study

    OpenAIRE

    Ehlers, Anke; Clark, David M.; Hackmann, Ann; Grey, Nick; Liness, Sheena; Wild, Jennifer; Manley, John; Waddington, Louise; McManus, Freda

    2010-01-01

    Background: Cognitive Behaviour Therapy (CBT) of anxiety disorders is usually delivered in weekly or biweekly sessions. There is evidence that intensive CBT can be effective in phobias and obsessive compulsive disorder. Studies of intensive CBT for posttraumatic stress disorder (PTSD) are lacking. Method: A feasibility study tested the acceptability and efficacy of an intensive version of Cognitive Therapy for PTSD (CT-PTSD) in 14 patients drawn from consecutive referrals. Patients received u...

  14. "I've Lost My Husband, My House and I Need a New Knee...Why Should I Smile?": Action Research Evaluation of a Group Cognitive Behavioural Therapy Program for Older Adults with Depression

    Science.gov (United States)

    Richardson, Lisa; Reid, Corinne

    2006-01-01

    The current paper details an action research approach to developing and evaluating a group cognitive-behavioural therapy (CBT) program for older adults (65+ years) experiencing depression. This approach allowed the development of a novel program and for each component of the program to be evaluated and modified in an iterative, developmental…

  15. School based cognitive behavioural therapy targeting anxiety in children with autistic spectrum disorder: a quasi-experimental randomised controlled trail incorporating a mixed methods approach.

    Science.gov (United States)

    Clarke, Chris; Hill, Vivian; Charman, Tony

    2016-04-30

    Children with a diagnosis of autism are more likely to experience anxiety than their typically developing peers. Research suggests that Cognitive Behavioural Therapy (CBT) could offer a way to help children with autism manage their anxiety but most evidence is based on clinical trials. This study investigated a school-based CBT programme using a quasi-experimental design incorporating the child and parent versions of the Spence Children's Anxiety Scale (Spence, J Abnorm Psy 106(2):280-297, 1997) and the Coping Scale for Children and Youth (Brodzinsky et al., J Appl Dev Psychol 13:195-214, 1992). Interview data was incorporated to help understand the process of change further. Children in the experimental condition had lower levels of anxiety, maintained at follow-up and changes were found in coping behaviours such as lower behavioural avoidance strategies but increased problem solving strategies at follow-up. Limitations of the research together with future directions are also discussed.

  16. Rational emotive behaviour therapy: distinctive features

    OpenAIRE

    Dryden, Windy

    2008-01-01

    Rational emotive behaviour therapy (REBT) encourages the client to focus on their emotional problems in order to understand, challenge and change the irrational beliefs that underpin these problems. REBT can help clients to strengthen conviction in their alternative rational beliefs by acting in ways that are consistent with them and thus encourage a healthier outlook.\\ud \\ud This accessible and direct guide introduces the reader to REBT while indicating how it is different from other approac...

  17. CHAMP: Cognitive behaviour therapy for health anxiety in medical patients, a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Murphy David

    2011-06-01

    Full Text Available Abstract Background Abnormal health anxiety, also called hypochondriasis, has been successfully treated by cognitive behaviour therapy (CBT in patients recruited from primary care, but only one pilot trial has been carried out among those attending secondary medical clinics where health anxiety is likely to be more common and have a greater impact on services. The CHAMP study extends this work to examine both the clinical and cost effectiveness of CBT in this population. Method/Design The study is a randomized controlled trial with two parallel arms and equal randomization of 466 eligible patients (assuming a 20% drop-out to an active treatment group of 5-10 sessions of cognitive behaviour therapy and to a control group. The aim at baseline, after completion of all assessments but before randomization, was to give a standard simple explanation of the nature of health anxiety for all participants. Subsequently the control group was to receive whatever care might usually be available in the clinics, which is normally a combination of clinical assessment, appropriate tests and reassurance. Those allocated to the active treatment group were planned to receive between 5 and 10 sessions of an adapted form of cognitive behaviour therapy based on the Salkovskis/Warwick model, in which a set of treatment strategies are chosen aimed at helping patients understand the factors that drive and maintain health anxiety. The therapy was planned to be given by graduate research workers, nurses or other health professionals trained for this intervention whom would also have their competence assessed independently during the course of treatment. The primary outcome is reduction in health anxiety symptoms after one year and the main secondary outcome is the cost of care after two years. Discussion This represents the first trial of adapted cognitive behaviour therapy in health anxiety that is large enough to test not only the clinical benefits of treatment but also

  18. A randomized controlled effectiveness trial of cognitive behavior therapy for post-traumatic stress disorder in terrorist-affected people in Thailand

    OpenAIRE

    Bryant, Richard A.; EKASAWIN, SUPARAT; CHAKRABHAND, SOMCHAI; SUWANMITRI, SOAWALUK; DUANGCHUN, ORAWAN; CHANTALUCKWONG, THANANET

    2011-01-01

    Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), there is no evidence of its success with PTSD patients still under direct threat of terrorist attacks. This study reports the first randomized controlled trial of CBT for PTSD terrorist-affected people. Twenty-eight survivors of terrorist attacks in southern Thailand were randomized to 8 sessions of either CBT or treatment as usual (TAU). CBT was modified to accom...

  19. Cognitive-behavioural therapy for obsessive-compulsive disorder co-occurring with psychosis: Systematic review of evidence.

    Science.gov (United States)

    Tundo, Antonio; Necci, Roberta

    2016-12-22

    To review available evidence on the use of cognitive behavioural therapy (CBT) for treating obsessive compulsive disorder co-occurring with psychosis. In this paper we present a detailed and comprehensive review of the current literature focusing on CBT treatment of obsessive compulsive disorder (OCD) co-occurring with schizophrenia or schizoaffective disorder. We identified relevant literature published between 2001 and May 2016 through MEDLINE/PubMed search using as search string ("obsessive compulsive disorders" or "obsessive compulsive symptoms") and ("schizophrenia" or "schizoaffective disorder" or "psychosis") and ("cognitive behavioural therapy"). Other citations of interest were further identified from references reported in the accessed articles. The search was limited to studies written in English and carried out in adult patients. A total of 9 studies, 8 case reports and 1 case series, were found. The reviewed evidence indicates that CBT is: (1) safe, i.e., does not worsen psychotic symptoms; (2) well accepted, with a discontinuation rate quite similar to that reported for patients with OCD without psychosis comorbidity; (3) effective, with a symptom reduction quite similar to that reported for patients with OCD without psychosis and for SRIs treatment of OCD co-occurring with psychosis; and (4) effective in patients with OCD induced by second-generation antipsychotic as well as in patients with OCD not induced by second-generation antipsychotic. Alcohol/substance use disorder comorbidity and OCD onset preceding that of SCH/SA was predictors of poor outcome. These results are derived only by additional studies with adequate sample size. Our results support the use of CBT for OCD in patients with psychosis.

  20. Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: preliminary recommendations for future research.

    Science.gov (United States)

    Grenier, Sébastien; Forget, Hélène; Bouchard, Stéphane; Isere, Sébastien; Belleville, Sylvie; Potvin, Olivier; Rioux, Marie-Ève; Talbot, Mélissa

    2015-07-01

    Cognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers (e.g. fear of illness). Indeed, imaginal exposure may become less effective as the person gets older since normal aging is characterized by the decline in cognitive functions involved in the creation of vivid/detailed mental images. One way to circumvent this difficulty is to expose the older patient to a virtual environment that does not require the ability to imagine the frightening situation. In virtuo exposure has proven to be efficient to treat anxiety in working-age people. In virtuo exposure could be employed to improve the efficacy of CBT with exposure sessions in the treatment of late-life anxiety? The current paper explores this question and suggests new research avenues.

  1. Neural correlation of successful cognitive behaviour therapy for spider phobia: a magnetoencephalography study.

    Science.gov (United States)

    Wright, Barry; Alderson-Day, Ben; Prendergast, Garreth; Kennedy, Juliette; Bennett, Sophie; Docherty, Mary; Whitton, Clare; Manea, Laura; Gouws, Andre; Tomlinson, Heather; Green, Gary

    2013-12-30

    Cognitive behavioural therapy (CBT) can be an effective treatment for spider phobia, but the underlying neural correlates of therapeutic change are yet to be specified. The present study used magnetoencephalography (MEG) to study responses within the first half second, to phobogenic stimuli in a group of individuals with spider phobia prior to treatment (n=12) and then in nine of them following successful CBT (where they could touch and manage live large common house spiders) at least 9 months later. We also compared responses to a group of age-matched healthy control participants (n=11). Participants viewed static photographs of real spiders, other fear-inducing images (e.g. snakes, sharks) and neutral stimuli (e.g. kittens). Beamforming methods were used to localise sources of significant power changes in response to stimuli. Prior to treatment, participants with spider phobia showed a significant maximum response in the right frontal pole when viewing images of real spiders specifically. No significant frontal response was observed for either control participants or participants with spider phobia post-treatment. In addition, participants' subjective ratings of spider stimuli significantly predicted peak responses in right frontal regions. The implications for understanding brain-based effects of cognitive therapies are discussed.

  2. The effects of brief individual cognitive behavioural therapy for depression and homesickness among international students in Malaysia.

    Science.gov (United States)

    Saravanan, Coumaravelou; Alias, Alizi; Mohamad, Mardiana

    2017-10-01

    Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression. The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression. Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores. The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months. Overall, homesickness is considered a normal reaction. Brief

  3. Manual-guided cognitive-behavioural therapy for insomnia delivered by ordinary primary care personnel in general medical practice: a randomized controlled effectiveness trial.

    Science.gov (United States)

    Bothelius, Kristoffer; Kyhle, Kicki; Espie, Colin A; Broman, Jan-Erik

    2013-12-01

    Chronic insomnia is a prevalent problem in primary health care and tends to be more serious than insomnia in the general population. These patients often obtain little benefit from hypnotics, and are frequently open to exploring various options for medical treatment. However, most general practitioners (GPs) are unable to provide such options. Several meta-analyses have shown that cognitive-behavioural therapy (CBT) for insomnia results in solid improvements on sleep parameters, and a few studies have demonstrated promising results for nurse-administered CBT in primary care. The aim of this randomized controlled study was to investigate the clinical effectiveness of manual-guided CBT for insomnia delivered by ordinary primary care personnel in general medical practice with unselected patients. Sixty-six primary care patients with insomnia were randomized to CBT or a waiting-list control group. The CBT group improved significantly more than the control group using the Insomnia Severity Index as the outcome. The effect size was high. Sleep diaries showed a significant, medium-sized treatment effect for sleep onset latency and wake time after sleep onset. However, for all measures there is a marked deterioration at follow-up assessments. Almost half of the treated subjects (47%) reported a clinically relevant treatment effect directly after treatment. It is concluded that this way of delivering treatment may be cost-effective.

  4. Occupational impact of internet-delivered cognitive behaviour therapy for depression and anxiety: reanalysis of data from five Australian randomised controlled trials.

    Science.gov (United States)

    Mackenzie, Anna; Harvey, Samuel; Mewton, Louise; Andrews, Gavin

    2014-10-06

    To determine whether internet-delivered cognitive behaviour therapy (iCBT) for depression and anxiety reduces self-reported absenteeism in employed individuals. We reanalysed data from five randomised controlled trials of iCBT: two for depression (conducted from September 2008 to February 2009 and from June 2009 to January 2010), two for generalised anxiety disorder (conducted from March 2009 to June 2009 and from July 2009 to January 2010) and one for social phobia (conducted from May 2008 to July 2008). Participants across Australia were recruited via a website. The inclusion criteria were: (i) meets criteria for the disorder of interest; (ii) aged 18 years or over; (iii) no previous history of a psychotic disorder or drug or alcohol misuse; (iv) not actively suicidal. The iCBT courses each consisted of six online lessons (to be completed within 11 weeks), homework assignments, automatic emails and resource documents. The number of days absent (self-reported absenteeism) in the previous week. We included 284 participants in our analysis. When data for the three disorders were combined, participants who received iCBT had significant reductions in self-reported absenteeism compared with those in the control groups (who were on a waitlist) (P = 0.03). When data for the three disorders were analysed separately, reductions in self-reported absenteeism for participants who received iCBT were not significantly different to those for participants in the control groups. Using data from five RCTs, we showed that iCBT was associated with reductions in self-reported absenteeism. Future research should focus on replicating these findings in other contexts, such as other disorders and other iCBT courses.

  5. Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders.

    Science.gov (United States)

    Sannibale, Claudia; Teesson, Maree; Creamer, Mark; Sitharthan, Thiagarajan; Bryant, Richard A; Sutherland, Kylie; Taylor, Kirsten; Bostock-Matusko, Delphine; Visser, Alicia; Peek-O'Leary, Marie

    2013-08-01

    Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.

  6. The feasibility and effectiveness of Catch It, an innovative CBT smartphone app

    Science.gov (United States)

    Hagan, Paul; King, Sophie; Bowman, James; Chahal, Jasprit; Gan, Li; McKnight, Rebecca; Waldon, Charlotte; Smith, Matthew; Gilbertson, John; Tai, Sara

    2016-01-01

    Background The widespread use of smartphones makes effective therapies such as cognitive–behavioural therapy (CBT) potentially accessible to large numbers of people. Aims This paper reports the usage data of the first trial of Catch It, a new CBT smartphone app. Method Uptake and usage rates, fidelity of user responses to CBT principles, and impact on reported negative and positive moods were assessed. Results A relatively modest proportion of people chose to download the app. Once used, the app tended to be used more than once, and 84% of the user-generated content was consistent with the basic concepts of CBT. There were statistically significant reductions in negative mood intensity and increases in positive mood intensity. Conclusions Smartphone apps have potential beneficial effects in mental health through the application of basic CBT principles. More research with randomised controlled trial designs should be conducted. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703777

  7. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression

    DEFF Research Database (Denmark)

    Pedersen, Morten Hvenegaard; Watkins, Ed R; Poulsen, Stig;

    2015-01-01

    present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration......BACKGROUND: Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients...... of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more...

  8. Towards the Development of an Integrated CBT Provision within a Large Organisation Offering Services to People with Mental Health Problems and/or Learning Disabilities

    Directory of Open Access Journals (Sweden)

    Metka Shawe-Taylor

    2010-12-01

    Full Text Available Cognitive Behavioural Therapy (CBT has become the main psychological treatment provided by the National Health Service (NHS of the UK. Its position in the NHS has been strengthened by the National Institute for Health and Clinical Excellence (NICE guidance, which recommends CBT as the psychological treatment of choice for a broad range of psychological and mental health problems. The NICE guidelines also recommend that CBT should be delivered by suitably trained and supervised clinicians. All these recommendations have put considerable pressure on NHS mental health providers to increase access to good quality CBT provision.This paper will describe how this challenge is being addressed by one such organisation. It will briefly introduce the organisation and provide information on the initial reviews of its CBT provision. It will then describe the model of CBT clinical governance that has been developed, the CBT training schemes available within the organisation and the model of CBT supervision structure that is being implemented. Difficulties and successes of this project will be discussed and illustrated with relevant data

  9. Group therapy for anxiety disorders using rational emotive behaviour therapy.

    Science.gov (United States)

    Cowan, D; Brunero, S

    1997-12-01

    This paper reports a pilot study designed to investigate Rational Emotive Behaviour Therapy in the group treatment of selected clients suffering from anxiety disorders. A convenience sample of 17 clients who completed the treatment programme was selected for the study. Biographical information was sought and data were collected on subject anxiety and depression. Intervention was targeted at identifying and correcting irrational beliefs via the application of a range of Rational Emotive Behaviour Therapy techniques. Pre- and postintervention data were analysed by two-tailed t-tests for paired samples and found to be significant at P < 0.001. The results suggest that the treatment approach was successful in modifying irrational beliefs and anxiety.

  10. Cognitive behavioural therapy for ADHD in adults

    DEFF Research Database (Denmark)

    Jensen, Christina Mohr; Amdisen, Birgitte Lind; Jørgensen, Karsten Juhl

    2016-01-01

    Systematically review and analyse the efficacy of CBT versus treatment as usual in adults with ADHD. The literature was systematically searched ending the 28 March 2014. Standardised mean differences (SMD) and 95% confidence intervals were calculated. CBT was efficacious in reducing symptoms...... of ADHD (SDM -1.0, 95% CI -1.5 to -0.5) when evaluated by the patients, but not when evaluated by a clinician. Symptoms of depression and anxiety were significantly reduced when self-reported (SMD -1.0, 95% CI -1.6 to -0.5 and -1.0, 95% CI -1.3 to -0.3, respectively) and evaluated by a clinician (SMD -0.......9, 95% CI -1.7 to -0.2 and -0.9, 95% CI -1.6 to -0.1). The clinical global impression scores improved more in the group randomised to CBT (-1.0; 95% CI -1.6 to -0.4). CBT seems efficacious in some domains affecting adult patients with ADHD, but needs further evaluation....

  11. Cognitive-behavioural therapy effects on employment-related outcomes for individuals with mental illness: A systematic review

    Directory of Open Access Journals (Sweden)

    Kim Minjoo

    2014-06-01

    Full Text Available Orientation: To identify the effects of interventions in cognitive-behaviour therapy (CBT on employment-related outcomes world-wide for individuals with mental illness.Research purpose: A search of the relevant literature was conducted through PsychInfo, Medline, Scopus and Google Scholar™, covering the period between 1995 and August 2011. The methodological quality of included studies was assessed using the criteria from Evidence Based Library and Information Practice (EBLIP. Eleven studies met the inclusion criteria.Motivation for the study: Evidence is needed on best practices to support work participation by people with mental illness. Effective cognitive-behavioural intervention might enhance their personal control over participation in employment aside from systemic or policy-oriented interventions.Research approach, design and method: A scoping review was done to map trends in the evidence for CBT as an intervention to support employment participation by people with mental illness. A scoping review is exploratory, the evidence of which lays the basis for subsequent studies. The methodological quality of included studies was assessed using the EBLIP Critical Appraisal Checklist.Main findings: Cognitive-behaviour therapy was an effective intervention approach for better work productivity, longer work hours, higher re-employment rate and enhanced mental health for individuals with mental illness.Practical/managerial implications: Cognitive-behaviour therapy is a promising strategy for industrial and organisational psychologists dealing with people who have a mental illness. It enhances employment and maintains work adjustment. Additional clinical trials in diverse populations and contexts will further establish its efficacy.Contribution/value-add: This scoping review aggregated the preliminary evidence for the efficacy of cognitive-behaviour therapy as a work-participation intervention for people with mental illness.

  12. Internet-delivered cognitive behaviour therapy for depression in people with diabetes: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Robins, Lisa; Newby, Jill; Wilhelm, Kay; Smith, Jessica; Fletcher, Therese; Ma, Trevor; Finch, Adam; Campbell, Lesley; Andrews, Gavin

    2015-01-01

    Depression substantially contributes to the personal burden and healthcare costs of living with diabetes mellitus (DM). Comorbid depression and DM are associated with poorer quality of life, poorer self-management and glycemic control, increased risk for DM complications and higher mortality rates, and higher health service utilization. Depression remains under-recognized and undertreated in people with DM, which may, in part, result from barriers associated with accessing face-to-face treatment. This study will examine the efficacy of an internet-based cognitive behaviour therapy programme for major depressive disorder (iCBT-MDD) in people with DM. A CONSORT 2010 compliant, registered randomised controlled trial of the intervention (iCBT-MDD) versus a treatment as usual control group will be conducted. The study will include 100 adults aged 18 years and over with a diagnosis of type 1 or type 2 DM and self-reported symptoms that satisfy MDD which will enable us to detect a statistically significant difference with a group effect size of 0.6 at a power of 80% and significance level of p=0.05. Participants will be randomised to receive the iCBT-MDD programme immediately, or to wait 10 weeks before accessing the programme. Primary outcomes will be self-reported depression severity, DM-related distress, and glycemic control (glycosylated hemoglobin). Secondary outcomes will be general distress and disability, generalized anxiety, lifestyle behaviours, somatization, eating habits, alcohol use, and acceptability of the iCBT programme to participants, and practicality for clinicians. Data will be analyzed with linear mixed models for each outcome measure. The Human Research Ethics Committee of St Vincent's Hospital Australia have given ethics approval (HREC/13/SVH/291). Results will be disseminated via peer-reviewed publication and social media channels of Australian Diabetes Consumer Representative Bodies. The trial is registered with the Australian and New Zealand

  13. Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

    NARCIS (Netherlands)

    van Straten, A.; Emmelkamp, J.; de Wit, J.; Lancee, J.; Andersson, G.; van Someren, E.J.W.; Cuijpers, P.

    2014-01-01

    Background: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT de

  14. Guided Internet-delivered cognitive behavioural treatment for insomnia : a randomized trial

    NARCIS (Netherlands)

    van Straten, A; Emmelkamp, J; de Wit, J; Lancee, J; Andersson, G; van Someren, E J W; Cuijpers, P

    2014-01-01

    BACKGROUND: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT de

  15. Guided Internet-delivered cognitive behavioural treatment for insomnia : a randomized trial

    NARCIS (Netherlands)

    van Straten, A; Emmelkamp, J; de Wit, J; Lancee, J; Andersson, G; van Someren, E J W; Cuijpers, P

    BACKGROUND: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT

  16. Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

    NARCIS (Netherlands)

    van Straten, A.; Emmelkamp, J.; de Wit, J.; Lancee, J.; Andersson, G.; van Someren, E.J.W.; Cuijpers, P.

    2014-01-01

    Background: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT

  17. Guided Internet-delivered cognitive behavioural treatment for insomnia : a randomized trial

    NARCIS (Netherlands)

    van Straten, A; Emmelkamp, J; de Wit, J; Lancee, J; Andersson, G; van Someren, E J W; Cuijpers, P

    2014-01-01

    BACKGROUND: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT de

  18. Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

    NARCIS (Netherlands)

    van Straten, A.; Emmelkamp, J.; de Wit, J.; Lancee, J.; Andersson, G.; van Someren, E.J.W.; Cuijpers, P.

    2014-01-01

    Background: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT de

  19. A Qualitative Process Evaluation of Classroom-Based Cognitive Behaviour Therapy to Reduce Adolescent Depression

    Directory of Open Access Journals (Sweden)

    John A. Taylor

    2014-06-01

    Full Text Available Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030 randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628. The views of young people (n = 42, teachers (n = 12 and facilitators (n = 16 involved in the Resourceful Adolescent Programme (RAP were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing.

  20. Effectiveness of cognitive-behavioural therapy for post-disaster distress in post-traumatic stress symptoms after Chilean earthquake and tsunami.

    Science.gov (United States)

    Leiva-Bianchi, Marcelo; Cornejo, Felipe; Fresno, Andrés; Rojas, Carolina; Serrano, Camila

    2017-10-05

    This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America. Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements. Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución). A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment. CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010. Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment. The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGAAB: 31.556; p<0.01; 95%CI: 0.21-2.01]; η(2)=0.709). The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Towards standardisation and improved understanding of sleep restriction therapy for insomnia disorder: A systematic examination of CBT-I trial content.

    Science.gov (United States)

    Kyle, Simon D; Aquino, Maria Raisa Jessica; Miller, Christopher B; Henry, Alasdair L; Crawford, Megan R; Espie, Colin A; Spielman, Arthur J

    2015-10-01

    Sleep restriction therapy is a core element of contemporary cognitive-behavioural therapy for insomnia and is also effective as a single-component therapeutic strategy. Since its original description, sleep restriction therapy has been applied in several different ways, potentially limiting understanding of key therapeutic ingredients, mode of action, evidence synthesis, and clinical implementation. We sought to examine the quality of reporting and variability in the application of sleep restriction therapy within the context of insomnia intervention trials. Systematic literature searches revealed 88 trials of cognitive-behavioural therapy/sleep restriction therapy that met pre-defined inclusion/exclusion criteria. All papers were coded in relation to their description of sleep restriction therapy procedures. Findings indicate that a large proportion of papers (39%) do not report any details regarding sleep restriction therapy parameters and, for those papers that do, variability in implementation is present at every level (sleep window generation, minimum time-in-bed, sleep efficiency titration criteria, and positioning of sleep window). Only 7% of papers reported all parameters of sleep restriction treatment. Poor reporting and variability in the application of sleep restriction therapy may hinder progress in relation to evidence synthesis, specification of mechanistic components, and refinement of therapeutic procedures for patient benefit. We set out guidelines for the reporting of sleep restriction therapy as well as a research agenda aimed at advancing understanding of sleep restriction therapy.

  2. Impact of personality status on the outcomes and cost of cognitive–behavioural therapy for health anxiety

    Science.gov (United States)

    Sanatinia, Rahil; Wang, Duolao; Tyrer, Peter; Tyrer, Helen; Crawford, Mike; Cooper, Sylvia; Loebenberg, Gemma; Barrett, Barbara

    2016-01-01

    Background Health anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT). Aims To test the impact of personality status using ICD-11 criteria on the clinical and cost outcomes of treatment with cognitive–behavioural therapy for health anxiety (CBT-HA) and standard care over 2 years. Method Personality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years. Results In total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P = 0.90) and worse social function with CBT-HA compared with standard care (PCBT-HA maintained over 2 years (Pbenefit was shown in those with more severe personality disorder (PCBT-HA except for non-significant greater differences in those with moderate or severe personality disorder. Conclusions The results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term. PMID:27445356

  3. The efficacy and effectiveness of online CBT

    NARCIS (Netherlands)

    J.-J. Ruwaard

    2013-01-01

    In 1997, researches at the University of Amsterdam developed one of the first psychotherapeutic applications of the World Wide Web. The implemented a standardized cognitive behavioural treatment (CBT) of post-traumatic stress symptoms in a website, and used this site to treat clients over the intern

  4. Is immediate adjunctive CBT more beneficial than delayed CBT in treating depression?: A Pilot Study.

    Science.gov (United States)

    Rizvi, Sakina J; Zaretsky, Ari; Schaffer, Ayal; Levitt, Anthony

    2015-03-01

    Cognitive-behavioral therapy (CBT) is an efficacious first-line therapy for patients with major depressive disorder (MDD). Due to the limited accessibility of CBT, long wait lists result in delayed treatment, which may affect treatment outcomes. The goal of this pilot study was to obtain preliminary data from a randomized controlled trial to determine whether delayed CBT reduces the effectiveness of the therapy compared to immediate CBT in patients with MDD receiving pharmacotherapy. Patients were randomized to receive immediate CBT (n=18) or to begin CBT after 6 months (n=20) and received 14 weekly sessions, followed by two additional booster sessions. During the active treatment months, patients in the immediate group demonstrated reductions in scores on the Beck Depression Inventory II (BDI-II) that were similar to those in the delayed CBT group. However, when the analysis was performed using only data from patients in the delayed group who were still in a depressive episode, there was an overall greater decrease in BDI-II scores in the immediate group vs. the delayed group over the active treatment months, but not specifically at the 6-month endpoint. These findings suggest delays in depression treatment, similar to what occurs with real-world wait list times, may not have a significant impact on the effectiveness of CBT in patients who are already receiving treatment as usual. However, such delays may affect the effectiveness of CBT in those patients who remain depressed during the time delay. A larger trial is necessary to confirm these findings. (Journal of Psychiatric Practice 2015;21:107-113).

  5. Adapting CBT for traumatized refugees and ethnic minority patients: examples from culturally adapted CBT (CA-CBT).

    Science.gov (United States)

    Hinton, Devon E; Rivera, Edwin I; Hofmann, Stefan G; Barlow, David H; Otto, Michael W

    2012-04-01

    In this article, we illustrate how cognitive behavioral therapy (CBT) can be adapted for the treatment of PTSD among traumatized refugees and ethnic minority populations, providing examples from our treatment, culturally adapted CBT, or CA-CBT. CA-CBT has a unique approach to exposure (typical exposure is poorly tolerated in these groups), emphasizes the treatment of somatic sensations (a particularly salient part of the presentation of PTSD in these groups), and addresses comorbid anxiety disorders and anger. To accomplish these treatment goals, CA-CBT emphasizes emotion exposure and emotion regulation techniques such as meditation and aims to promote emotional and psychological flexibility. We describe 12 key aspects of adapting CA-CBT that make it a culturally sensitive treatment of traumatized refugee and ethnic minority populations. We discuss three models that guide our treatment and that can be used to design culturally sensitive treatments: (a) the panic attack-PTSD model to illustrate the many processes that generate PTSD in these populations, highlighting the role of arousal and somatic symptoms; (b) the arousal triad to demonstrate how somatic symptoms are produced and the importance of targeting comorbid anxiety conditions and psychopathological processes; and (c) the multisystem network (MSN) model of emotional state to reveal how some of our therapeutic techniques (e.g., body-focused techniques: bodily stretching paired with self-statements) bring about psychological flexibility and improvement.

  6. Young people at risk of psychosis: their subjective experiences of monitoring and cognitive behaviour therapy in the early detection and intervention evaluation 2 trial.

    Science.gov (United States)

    Byrne, Rory E; Morrison, Anthony P

    2014-09-01

    To explore participants' experiences of 'enhanced monitoring' and cognitive behaviour therapy (CBT) within a randomized controlled trial evaluating early detection and prevention of psychosis ('early detection and intervention evaluation [EDIE] 2'). Semi-structured qualitative interviews were conducted with a sample of participants at the end of their involvement with the trial. Ten young people were interviewed; six males and four females, with a mean age of 27.5. Nine participants identified themselves as White British and one Black British. All participants had received 'enhanced monitoring' during the trial, and 8 of 10 also received CBT. Interviews were transcribed verbatim and analysed using thematic analysis to identify central themes within and among participants' accounts. Three super-ordinate thematic areas were identified: 'a chance to talk', monitoring-specific themes, and CBT-specific themes. The central theme ('a chance to talk') was drawn from across all participants' accounts and represents the most consistently valued attribute of participants' experiences of the EDIE 2 trial. Sub-themes of this topic were identified as follows: interpersonal engagement, informality and normalization, and 'opening up'. Sub-themes related to monitoring include the following: clarity and reassurance, 'a therapeutic process', and challenges. CBT experience was most consistently conceptualized as 'rethinking things', and two additional CBT-specific sub-themes were identified: hard work and moving forward. Our findings suggest that for young people at risk of psychosis, a normalizing psychosocially oriented assessment and monitoring process may have benefits for many, while CBT may help to reduce the negative impact of unusual psychological experiences for both the short- and long term. Young people considered at risk of psychosis highly value normalizing, collaborative, and flexible approaches when engaging with research or clinical staff. All of our participants

  7. Economic evaluation of multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: A randomized controlled trial.

    Science.gov (United States)

    Vos-Vromans, Desirée; Evers, Silvia; Huijnen, Ivan; Köke, Albère; Hitters, Minou; Rijnders, Nieke; Pont, Menno; Knottnerus, André; Smeets, Rob

    2017-01-01

    A multi-centre RCT has shown that multidisciplinary rehabilitation treatment (MRT) is more effective in reducing fatigue over the long-term in comparison with cognitive behavioural therapy (CBT) for patients with chronic fatigue syndrome (CFS), but evidence on its cost-effectiveness is lacking. To compare the cost-effectiveness of MRT versus CBT for patients with CFS from a societal perspective. A multi-centre randomized controlled trial comparing MRT with CBT was conducted among 122 patients with CFS diagnosed using the 1994 criteria of the Centers for Disease Control and Prevention and aged between 18 and 60 years. The societal costs (healthcare costs, patient and family costs, and costs for loss of productivity), fatigue severity, quality of life, quality-adjusted life-year (QALY), and cost-effectiveness ratios (ICERs) were measured over a follow-up period of one year. The main outcome of the cost-effectiveness analysis was fatigue measured by the Checklist Individual Strength (CIS). The main outcome of the cost-utility analysis was the QALY based on the EuroQol-5D-3L utilities. Sensitivity analyses were performed, and uncertainty was calculated using the cost-effectiveness acceptability curves and cost-effectiveness planes. The data of 109 patients (57 MRT and 52 CBT) were analyzed. MRT was significantly more effective in reducing fatigue at 52 weeks. The mean difference in QALY between the treatments was not significant (0.09, 95% CI: -0.02 to 0.19). The total societal costs were significantly higher for patients allocated to MRT (a difference of €5,389, 95% CI: 2,488 to 8,091). MRT has a high probability of being the most cost effective, using fatigue as the primary outcome. The ICER is €856 per unit of the CIS fatigue subscale. The results of the cost-utility analysis, using the QALY, indicate that the CBT had a higher likelihood of being more cost-effective. The probability of being more cost-effective is higher for MRT when using fatigue as primary

  8. Computerized cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism.

    Science.gov (United States)

    Grime, Paul R

    2004-08-01

    Emotional distress has major implications for employees and employers. Cognitive behavioural therapy (CBT) is a recommended treatment, but demand outstrips supply. CBT is well suited to computerization. Most employee assistance programmes have not been systematically evaluated and computerized CBT has not previously been studied in the workplace. To evaluate the effect of an 8 week computerized cognitive behavioural therapy programme, 'Beating The Blues', on emotional distress in employees with recent stress-related absenteeism, and to explore the reasons for non-participation. An open, randomized trial in a London NHS occupational health department. Forty-eight public sector employees, with 10 or more cumulative days stress-related absenteeism in the last 6 months, randomized equally to 'Beating The Blues' plus conventional care, or conventional care alone. Main outcome measures were Hospital Anxiety and Depression Scale and Attributional Style Questionnaire scores at end of treatment and 1, 3 and 6 months later; and reasons for non-participation. At end of treatment and 1 month later, adjusted mean depression scores and adjusted mean negative attributional style scores were significantly lower in the intervention group. One month post-treatment, adjusted mean anxiety scores were also significantly lower in the intervention group. The differences were not statistically significant at 3 and 6 months post-treatment. Non-participation was common and related to access problems, preference for other treatments, time commitment, scepticism about the intervention and the employer connection. 'Beating The Blues' may accelerate psychological recovery in employees with recent stress-related absenteeism. Greater flexibility and accessibility might improve uptake.

  9. Cognitive behavioural therapies versus treatment as usual for depression.

    Science.gov (United States)

    Hunot, Vivien; Moore, Theresa Hm; Caldwell, Deborah; Davies, Philippa; Jones, Hannah; Furukawa, Toshi A; Lewis, Glyn; Churchill, Rachel

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all cognitive behavioural therapies compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of different cognitive behavioural therapy models (cognitive therapy, rational emotive behaviour therapy, problem-solving therapy, self-control therapy and the Coping with Depression course) compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of all cognitive behavioural therapies compared with different types of comparator (standard care, no treatment, waiting list, attention placebo) for acute depression.

  10. Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: long-term follow-up of an RCT.

    Science.gov (United States)

    Lloyd, Samantha; Chalder, Trudie; Rimes, Katharine A

    2012-11-01

    The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with

  11. Examining internet-delivered cognitive behaviour therapy for patients with chronic kidney disease on haemodialysis: A feasibility open trial.

    Science.gov (United States)

    Chan, Ramony; Dear, Blake F; Titov, Nick; Chow, Josephine; Suranyi, Michael

    2016-10-01

    Treating depression among patients with chronic kidney disease (CKD) is imperative because of its high prevalence and health-related costs. However, many patients with CKD experience significant barriers to effective face-to-face psychological treatments. Internet-delivered cognitive behaviour therapy (iCBT) may help overcome the treatment barriers. The aim of the present study was to explore the acceptability and preliminary efficacy of iCBT for depression and anxiety among patients with CKD on haemodialysis. A single-group open trial design involving 22 patients on dialysis and an established iCBT treatment for anxiety and depression was employed. The primary outcomes were symptoms of depression, anxiety and general psychological distress. The secondary and tertiary outcomes were disability, quality of life, kidney disease-related loss and kidney disease burden. A generalised estimation equation modelling technique was employed. Clinically significant improvements (avg. % of improvement) were observed in the primary outcomes of depression (34%), anxiety (31%) and general distress (26%), which were maintained or further improved to 3-month follow-up. Improvements were also observed for quality of life (12%) and kidney disease-related loss (30%). However, no improvements in disability and kidney disease burden were found. High levels of acceptability were reported and relatively little clinician time (99.45min; SD=14.61) was needed to provide the treatment. The present results provide encouraging support for the potential of iCBT as an innovative way of increasing access to effective psychological treatment for CKD patients. These results provide much needed support for further research in this area. Australian and New Zealand Clinical Trials Registry: ACTRN12613000103763. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Therapist-guided, Internet-based cognitive-behavioural therapy for body dysmorphic disorder (BDD-NET): a feasibility study.

    Science.gov (United States)

    Enander, Jesper; Ivanov, Volen Z; Andersson, Erik; Mataix-Cols, David; Ljótsson, Brjánn; Rück, Christian

    2014-09-25

    Cognitive-behavioural therapy (CBT) is an effective treatment for body dysmorphic disorder (BDD). However, most sufferers do not have access to this treatment. One way to increase access to CBT is to administer treatment remotely via the Internet. This study piloted a novel therapist-supported, Internet-based CBT program for BDD (BDD-NET). Uncontrolled clinical trial. Patients (N=23) were recruited through self-referral and assessed face to face at a clinic specialising in obsessive-compulsive and related disorders. Suitable patients were offered secure access to BDD-NET. BDD-NET is a 12-week treatment program based on current psychological models of BDD that includes psychoeducation, functional analysis, cognitive restructuring, exposure and response prevention, and relapse prevention modules. A dedicated therapist provides active guidance and feedback throughout the entire process. The clinician-administered Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS). Symptom severity was assessed pretreatment, post-treatment and at the 3-month follow-up. BDD-NET was deemed highly acceptable by patients and led to significant improvements on the BDD-YBOCS (p=BDD-YBOCS). These gains were maintained at the 3-month follow-up. Secondary outcome measures of depression, global functioning and quality of life also showed significant improvements with moderate to large effect sizes. On average, therapists spent 10 min per patient per week providing support. The results suggest that BDD-NET has the potential to greatly increase access to CBT, at least for low-risk individuals with moderately severe BDD symptoms and reasonably good insight. A randomised controlled trial of BDD-NET is warranted. Clinicaltrials.gov registration ID NCT01850433. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Can a Targeted, Group-Based CBT Intervention Reduce Depression and Anxiety and Improve Self-Concept in Primary-Age Children?

    Science.gov (United States)

    O'Callaghan, Paul; Cunningham, Enda

    2015-01-01

    This pilot study examined the impact of a 10 session, group-based, early-intervention cognitive behavioural therapy (CBT) programme (Cool Connections) on anxiety, depression and self-concept in nine 8-11 year old pupils in Northern Ireland. The intervention was facilitated by a teacher, education welfare officer and two classroom assistants, with…

  14. Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: a randomised attention-controlled trial.

    Science.gov (United States)

    Glozier, Nicholas; Christensen, Helen; Naismith, Sharon; Cockayne, Nicole; Donkin, Liesje; Neal, Bruce; Mackinnon, Andrew; Hickie, Ian

    2013-01-01

    Mild to moderate depression is common in those with cardiovascular disease and undertreated. We aimed to evaluate the effectiveness of internet-delivered Cognitive Behaviour Therapy (iCBT) on depressive symptom severity and adherence to medical advice and lifestyle interventions in adults with mild to moderate depression and high cardiovascular disease (CVD) risks. Randomised double-blind, 12 week attention-controlled trial comparing an iCBT programme (E-couch) with an internet-delivered attention control health information package (HealthWatch, n = 282). The primary outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12610000085077). 487/562 (88%) participants completed the endpoint assessment. 383/562 (70%) were currently treated for cardiovascular disease and 314/562 (56%) had at least one other comorbid condition. In ITT analysis of 562 participants iCBT produced a greater decline in the mean PHQ-9 score compared to the attention control of 1.06 (95% CI: 0.23-1.89) points, with differences between the two arms increasing over the intervention period (time by treatment effect interaction p = .012). There were also larger improvements in adherence (2.16 points; 95% CI: 0.33-3.99), reductions in anxiety (0.96 points; 95% CI: 0.19-1.73), and a greater proportion engaging in beneficial physical activity (Odds Ratio 1.91, 95%CI: 1.01-3.61) in the iCBT participants but no effect upon disability, or walking time/day. There were no withdrawals due to study related adverse events. In people with mild to moderate depression and high levels of CVD risk factors, a freely accessible iCBT programme (http://www.ecouch.anu.edu.au) produced a small, but robust, improvement in depressive symptoms, adherence and some health behaviours. Australian and New Zealand Clinical Trials Registry ACTRN12610000085077.

  15. Study protocol of a multicentre randomised controlled trial of self-help cognitive behaviour therapy for working women with menopausal symptoms (MENOS@Work).

    Science.gov (United States)

    Hunter, Myra S; Hardy, Claire; Norton, Sam; Griffiths, Amanda

    2016-10-01

    Hot flushes and night sweats (HFNS) - the main symptoms of the menopause transition - can reduce quality of life and are particularly difficult to manage at work. A cognitive behaviour therapy (CBT) intervention has been developed specifically for HFNS that is theoretically based and shown to reduce significantly the impact of HFNS in several randomised controlled trials (RCTs). Self-help CBT has been found to be as effective as group CBT for these symptoms, but these interventions are not widely available in the workplace. This paper describes the protocol of an RCT aiming to assess the efficacy of CBT for menopausal symptoms implemented in the workplace, with a nested qualitative study to examine acceptability and feasibility. One hundred menopausal working women, aged 45-60 years, experiencing bothersome HFNS for two months will be recruited from several (2-10) large organisations into a multicentre randomised controlled trial. Women will be randomly assigned to either treatment (a self-help CBT intervention lasting 4 weeks) or to a no treatment-wait control condition (NTWC), following a screening interview, consent, and completion of a baseline questionnaire. All participants will complete follow-up questionnaires at 6 weeks and 20 weeks post-randomisation. The primary outcome is the rating of HFNS; secondary measures include HFNS frequency, mood, quality of life, attitudes to menopause, HFNS beliefs and behaviours, work absence and presenteeism, job satisfaction, job stress, job performance, disclosure to managers and turnover intention. Adherence, acceptability and feasibility will be assessed at 20 weeks post-randomisation in questionnaires and qualitative interviews. Upon trial completion, the control group will also be offered the intervention. This is the first randomised controlled trial of a self-management intervention tailored for working women who have troublesome menopausal symptoms. Clin.Gov NCT02623374. Copyright © 2016 Elsevier Ireland Ltd. All

  16. A critique of the representation of human suffering in the cognitive behavioural therapy literature with implications for mental health nursing practice.

    Science.gov (United States)

    Grant, A

    2011-02-01

    This paper is informed by interpretivist understandings and practices, and the author's own conversion to interpretivist writing practice. The aim of the paper is to critique the ways in which suffering people are represented in the mainstream cognitive behavioural therapy (CBT) literature with a view to identifying some implications for mental health nursing practice. It will begin by identifying key assumptions governing the textual portrayal of human experience, and will argue that the language used to describe human suffering is a potential site for struggles over meaning and more adequate representation. However, reductionist portrayals of individuals and their problems have largely gone unchallenged in much of the CBT literature since its early development in the 1970s. This is arguably because of the socialization of new members of the CBT community into established cultural and textual practices. A comparison of reductionist CBT writing with more fleshed out, more fully human possibilities will further clarify that forms of representation are never neutral, given the danger of reductionist representations facilitating reductionist interventions. The paper will end with the following emerging implications for mental health nursing practice: the therapeutic power of self-narratives, narrative research and the recovery movement, and the promising possibilities for autoethnographic research for mental health nurses and for day to day interactions between nurses and service users. © 2010 Blackwell Publishing.

  17. Cognitive Behaviour Therapy for Bulimia Nervosa and Eating Disorders Not Otherwise Specified: Translation from Randomized Controlled Trial to a Clinical Setting.

    Science.gov (United States)

    Knott, Sarah; Woodward, Debbie; Hoefkens, Antonia; Limbert, Caroline

    2015-11-01

    Enhanced Cognitive Behaviour Therapy (CBT-E) (Fairburn, Cooper and Shafran, 2003) was developed as a treatment approach for eating disorders focusing on both core psychopathology and additional maintenance mechanisms. To evaluate treatment outcomes associated with CBT-E in a NHS Eating Disorders Service for adults with bulimia and atypical eating disorders and to make comparisons with a previously published randomized controlled trial (Fairburn et al., 2009) and "real world" evaluation (Byrne, Fursland, Allen and Watson, 2011). Participants were referred to the eating disorder service between 2002 and 2011. They were aged between 18-65 years, registered with a General Practitioner within the catchment area, and had experienced symptoms fulfilling criteria for BN or EDNOS for a minimum of 6 months. CBT-E was commenced by 272 patients, with 135 completing treatment. Overall, treatment was associated with significant improvements in eating disorder and associated psychopathology, for both treatment completers and the intention to treat sample. Findings support dissemination of CBT-E in this context, with significant improvements in eating disorder psychopathology. Improvements to global EDE-Q scores were higher for treatment completers and lower for the intention to treat sample, compared to previous studies (Fairburn et al., 2009; Byrne et al., 2011). Level of attrition was found at 40.8% and non-completion of treatment was associated with higher levels of anxiety. Potential explanations for these findings are discussed.

  18. The second Randomised Evaluation of the Effectiveness, cost-effectiveness and Acceptability of Computerised Therapy (REEACT-2) trial: does the provision of telephone support enhance the effectiveness of computer-delivered cognitive behaviour therapy? A randomised controlled trial.

    Science.gov (United States)

    Brabyn, Sally; Araya, Ricardo; Barkham, Michael; Bower, Peter; Cooper, Cindy; Duarte, Ana; Kessler, David; Knowles, Sarah; Lovell, Karina; Littlewood, Elizabeth; Mattock, Richard; Palmer, Stephen; Pervin, Jodi; Richards, David; Tallon, Debbie; White, David; Walker, Simon; Worthy, Gillian; Gilbody, Simon

    2016-01-01

    BACKGROUND Computerised cognitive behaviour therapy (cCBT) is an efficient form of therapy potentially improving access to psychological care. Indirect evidence suggests that the uptake and effectiveness of cCBT can be increased if facilitated by telephone, but this is not routinely offered in the NHS. OBJECTIVES To compare the clinical effectiveness and cost-effectiveness of telephone-facilitated free-to-use cCBT [e.g. MoodGYM (National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia)] with minimally supported cCBT. DESIGN This study was a multisite, pragmatic, open, two-arm, parallel-group randomised controlled trial with a concurrent economic evaluation. SETTING Participants were recruited from GP practices in Bristol, Manchester, Sheffield, Hull and the north-east of England. PARTICIPANTS Potential participants were eligible to participate in the trial if they were adults with depression scoring ≥ 10 on the Patient Health Questionnaire-9 (PHQ-9). INTERVENTIONS Participants were randomised using a computer-generated random number sequence to receive minimally supported cCBT or telephone-facilitated cCBT. Participants continued with usual general practitioner care. MAIN OUTCOME MEASURES The primary outcome was self-reported symptoms of depression, as assessed by the PHQ-9 at 4 months post randomisation. SECONDARY OUTCOMES Secondary outcomes were depression at 12 months and anxiety, somatoform complaints, health utility (as assessed by the European Quality of Life-5 Dimensions questionnaire) and resource use at 4 and 12 months. RESULTS Clinical effectiveness: 182 participants were randomised to minimally supported cCBT and 187 participants to telephone-facilitated cCBT. There was a difference in the severity of depression at 4 and 12 months, with lower levels in the telephone-facilitated group. The odds of no longer being depressed (defined as a PHQ-9 score of bibliotherapy and telephone-based interventions are

  19. Effectiveness of a cognitive-behavioral therapy (CBT manualized program for clinically anxious children: study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Jansen Mélou

    2012-03-01

    Full Text Available Abstract Background In the Netherlands, the prevalence of anxiety disorders is 20%; and children with anxiety are at increased risk for psychopathology throughout adulthood. Recently, a revised version of a cognitive behavioral therapy manualized program called 'Thinking + Doing = Daring' (TDD was developed for children between 8 and 12 years old with an anxiety disorder. The main aim of this project is to conduct a Randomized Controlled Trial (RCT to evaluate the effectiveness of TDD. Methods/Design The CBT program will be tested with a RCT with 120 clinically anxious children (8-12 years old referred to one of three mental health care agencies. Children will be randomly assigned to the experimental (N = 60, TDD or to the control condition (N = 60, treatment as usual. The primary outcome measure will be the child's anxiety symptoms level. Secondary outcome measures will be externalizing (e.g. aggression and internalizing problems (e.g. depression. Two potential mediators of change will be examined in the current study: therapeutic alliance and parenting. Mother and child in both the experimental and control condition will be surveyed at baseline, post treatment and after 6 and 12 months (follow-up. It is hypothesized that children in the experimental condition will show a stronger decrease in anxiety symptoms compared to children that receive treatment as usual. Moreover, we expect that a strong therapeutic alliance and decreases in parental control and rejection will contribute to treatment success. Discussion Early treatment for anxiety problems has the potential to not only result in anxiety reductions, but also to prevent future problems such as substance abuse and psychopathology throughout adulthood. Our results will be immediately relevant to practice, since we are partnering with 'real world' community agencies. If the CBT program proves more effective than treatment as usual, it could be implemented in community mental health care

  20. Effectiveness of Modular CBT for Child Anxiety in Elementary Schools

    Science.gov (United States)

    Chiu, Angela W.; Langer, David A.; McLeod, Bryce D.; Har, Kim; Drahota, Amy; Galla, Brian M.; Jacobs, Jeffrey; Ifekwunigwe, Muriel; Wood, Jeffrey J.

    2013-01-01

    Most randomized controlled trials of cognitive-behavioral therapy (CBT) for children with anxiety disorders have evaluated treatment efficacy using recruited samples treated in research settings. Clinical trials in school settings are needed to determine if CBT can be effective when delivered in real world settings. This study evaluated a modular…

  1. Improving the Transportability of CBT for Internalizing Disorders in Children

    Science.gov (United States)

    Elkins, R. Meredith; McHugh, R. Kathryn; Santucci, Lauren C.; Barlow, David H.

    2011-01-01

    Research provides strong support for the efficacy and effectiveness of cognitive behavioral therapy (CBT) for the treatment of childhood internalizing disorders. Given evidence for limited dissemination and implementation of CBT outside of academic settings, efforts are underway to improve its transportability so that more children with mental…

  2. Improving the Transportability of CBT for Internalizing Disorders in Children

    Science.gov (United States)

    Elkins, R. Meredith; McHugh, R. Kathryn; Santucci, Lauren C.; Barlow, David H.

    2011-01-01

    Research provides strong support for the efficacy and effectiveness of cognitive behavioral therapy (CBT) for the treatment of childhood internalizing disorders. Given evidence for limited dissemination and implementation of CBT outside of academic settings, efforts are underway to improve its transportability so that more children with mental…

  3. Effectiveness of Modular CBT for Child Anxiety in Elementary Schools

    Science.gov (United States)

    Chiu, Angela W.; Langer, David A.; McLeod, Bryce D.; Har, Kim; Drahota, Amy; Galla, Brian M.; Jacobs, Jeffrey; Ifekwunigwe, Muriel; Wood, Jeffrey J.

    2013-01-01

    Most randomized controlled trials of cognitive-behavioral therapy (CBT) for children with anxiety disorders have evaluated treatment efficacy using recruited samples treated in research settings. Clinical trials in school settings are needed to determine if CBT can be effective when delivered in real world settings. This study evaluated a modular…

  4. Effects of aerobic exercise therapy and cognitive behavioural therapy on functioning and quality of life in amyotrophic lateral sclerosis: protocol of the FACTS-2-ALS trial

    Directory of Open Access Journals (Sweden)

    van de Weerd Margreet GH

    2011-06-01

    Full Text Available Abstract Background Amyotrophic lateral sclerosis (ALS is a fatal progressive neurodegenerative disorder affecting motor neurons in the spinal cord, brainstem and motor cortex, leading to muscle weakness. Muscle weakness may result in the avoidance of physical activity, which exacerbates disuse weakness and cardiovascular deconditioning. The impact of the grave prognosis may result in depressive symptoms and hopelessness. Since there is no cure for ALS, optimal treatment is based on symptom management and preservation of quality of life (QoL, provided in a multidisciplinary setting. Two distinctly different therapeutic interventions may be effective to improve or preserve daily functioning and QoL at the highest achievable level: aerobic exercise therapy (AET to maintain or enhance functional capacity and cognitive behavioural therapy (CBT to improve coping style and cognitions in patients with ALS. However, evidence to support either approach is still insufficient, and the underlying mechanisms of the approaches remain poorly understood. The primary aim of the FACTS-2-ALS trial is to study the effects of AET and CBT, in addition to usual care, compared to usual care alone, on functioning and QoL in patients with ALS. Methods / Design A multicentre, single-blinded, randomized controlled trial with a postponed information model will be conducted. A sample of 120 patients with ALS (1 month post diagnosis will be recruited from 3 university hospitals and 1 rehabilitation centre. Patients will be randomized to one of three groups i.e. (1 AET + usual care, (2 CBT + usual care, (3 Usual care. AET consists of a 16-week aerobic exercise programme, on 3 days a week. CBT consists of individual psychological support of patients in 5 to 10 sessions over a 16-week period. QoL, functioning and secondary outcome measures will be assessed at baseline, immediately post intervention and at 3- and 6-months follow-up. Discussion The FACTS-2-ALS study is the first

  5. A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

    Directory of Open Access Journals (Sweden)

    Kenicer David

    2012-09-01

    Full Text Available Abstract Background NICE recommends computerised cognitive behavioural therapy (cCBT for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.

  6. Principles and Practice of Cognitive Behaviour Therapy in Working with Parents of Young Children with Behavior Disorder.

    Science.gov (United States)

    Pavuluri, Mani; Smith, Marita

    1996-01-01

    Describes a pragmatic approach using cognitive-behavior therapy (CBT) to help correct parents' dysfunctional cognitions and strengthen confidence in parenting. Details three components of CBT: (1) focusing on positive behavior; (2) ignoring negative behavior if not dangerous; and (3) using special time. Notes that positive reinforcement is key to…

  7. Expanding the Cognitive Behavioural Therapy Traditions: An Application of Functional Analytic Psychotherapy Treatment in a Case Study of Depression

    Science.gov (United States)

    McClafferty, Catherine

    2012-01-01

    What can CBT therapists do when interpersonal issues are pertinent to therapeutic change and there is a deficit of CBT literature offering clinicians' guidance on how to address this as part of the therapy process? Do we say "clients are resistant?", "Not ready for change?", or "there is too much secondary gain?" As therapists we may not be…

  8. Cognitive behavioural therapy for anxiety disorders in later life (Protocol)

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Hendriks, G.J.; Keijsers, G.P.J.; Balkom, A.J.L.M. van

    2009-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: 1. To assess the efficacy and feasability of CBT (CT, BT, CBT and third wave CBT interventions) for different anxiety disorders in older adults aged 55 years or over compared with minimal management 2. To asse

  9. The experiences of staff taking on the role of lay therapist in a group-based cognitive behavioural therapy anger management intervention for people with intellectual disabilities.

    Science.gov (United States)

    Stimpson, Aimée; Kroese, Biza Stenfert; MacMahon, Pamela; Rose, Nicola; Townson, Julia; Felce, David; Hood, Kerenza; Jahoda, Andrew; Rose, John; Willner, Paul

    2013-01-01

    To explore the experience of 'lay therapists' of a group-based cognitive behaviour therapy (CBT) anger management intervention. Staff employed in daytime opportunity services for adults with intellectual disabilities took on the role of 'lay therapist' to facilitate CBT groups. They were trained and supervised by clinical psychologists and interviewed 2-6 weeks after the last group session. Their experiences were explored by means of a qualitative approach, interpretative phenomenological analysis (IPA). Several key themes emerged from the interview data such as 'hopes and fears', 'having a framework', 'making it work', 'observing progress', 'ingredients of success', 'the therapist role' and 'taking the group forward'. These themes indicate that participants' experiences had been perceived as positive for themselves, the service users as well as the relevant organization although initially the therapist role had appeared daunting. © 2012 Blackwell Publishing Ltd.

  10. Cognitive-behavioural therapy with post-session D-cycloserine augmentation for paediatric obsessive-compulsive disorder: pilot randomised controlled trial.

    Science.gov (United States)

    Mataix-Cols, David; Turner, Cynthia; Monzani, Benedetta; Isomura, Kayoko; Murphy, Caroline; Krebs, Georgina; Heyman, Isobel

    2014-01-01

    A partial N-methyl-D-aspartate agonist, D-cycloserine, enhances fear extinction when given before or shortly after exposure to feared stimuli in animals. In this pilot double-blind placebo-controlled trial (trial number: ISRCTN70977225), 27 youth with obsessive-compulsive disorder were randomised to either 50 mg D-cycloserine or placebo administered immediately after each of ten cognitive-behavioural therapy (CBT) sessions, primarily consisting of exposure and ritual prevention. Both groups improved significantly and maintained their gains at 1-year follow-up, with no significant advantage of D-cycloserine over placebo at any time point. The effects of CBT may not be augmented or accelerated when D-cycloserine is administered after sessions.

  11. A qualitative study to explore views of patients', carers' and mental health professionals' to inform cultural adaptation of CBT for psychosis (CBTp) in China.

    Science.gov (United States)

    Li, Weihui; Zhang, Li; Luo, Xuerong; Liu, Bangshan; Liu, Zhipeng; Lin, Fang; Liu, Zhiling; Xie, Yuhuan; Hudson, Melissa; Rathod, Shanaya; Kingdon, David; Husain, Nusrat; Liu, Xudong; Ayub, Muhammad; Naeem, Farooq

    2017-04-08

    The evidence for effectiveness of Cognitive Behaviour Therapy (CBT) is robust and the national organizations in the United Kingdom and the United States recommend its use. It is not utilized to its full potential in low and middle-income countries. Adaptation of CBT treatment to the target culture may facilitate its uptake. This study explored views of patients with schizophrenia, their caregivers, and mental health professionals for the purpose of cultural adaptation of CBT. The project was conducted in a teaching hospital in China. Systematic content and question analysis were the techniques we used to analyse the data generated in a series of qualitative interviews (N 45) in China. After identification of emerging themes and categories we compared and contrasted the themes across different interviews recursively. Triangulation of themes and concepts was undertaken to compare further and contrast the data from the different participating groups. This work highlighted the barriers in therapy as well as opportunities for use of CBT in that environment. Patients and their carers in China use a bio-psycho-spiritual-social model of illness. CBT is not commonly used to help those with schizophrenia in China. This study will facilitate the therapists using CBT for people with psychosis in China. These results require to be tested in clinical trials.

  12. Food for thought: a pilot study of the pros and cons of changing eating patterns within cognitive-behavioural therapy for the eating disorders.

    Science.gov (United States)

    Waller, Glenn; Evans, Jane; Pugh, Matthew

    2013-09-01

    Evidence-based cognitive-behavioural therapy (CBT) for the eating disorders has an early focus on behavioural changes around food intake. However, patients' anxiety around such change might account for why they often seem unmotivated in treatment. In order to determine the impact of changing intake, this pilot study of patients with bulimic disorders (N = 19) or anorexia nervosa (N = 9) used a mixed quantitative and qualitative design to retrospectively examine their perspectives of the short- and long-term pros and cons of such change. As expected, change was seen negatively in the short-term (with particularly high numbers reporting anxiety), but there were few reports of long-term negative outcomes. In contrast, there were both short- and long-term benefits of changing eating. The patients described what was helpful in making changes and what they had learned as a result. In both cases, their descriptions mapped closely onto the content and process of evidence-based CBT for the eating disorders. Although there is a need for more extensive research, these findings suggest that patients (and therapists) might benefit from being aware of the contrast between the short- and the long-term pros and cons of changing eating within CBT for the eating disorders.

  13. Processes of Change in CBT of Adolescent Depression: Review and Recommendations

    Science.gov (United States)

    Webb, Christian A.; Auerbach, Randy P.; DeRubeis, Robert J.

    2012-01-01

    A growing body of research supports the efficacy of cognitive-behavioral therapy (CBT) for adolescent depression. The mechanisms through which CBT exerts its beneficial effects on adolescent patients suffering from depression, however, remain unclear. The current article reviews the CBT for adolescent depression process literature. Our review…

  14. Processes of Change in CBT of Adolescent Depression: Review and Recommendations

    Science.gov (United States)

    Webb, Christian A.; Auerbach, Randy P.; DeRubeis, Robert J.

    2012-01-01

    A growing body of research supports the efficacy of cognitive-behavioral therapy (CBT) for adolescent depression. The mechanisms through which CBT exerts its beneficial effects on adolescent patients suffering from depression, however, remain unclear. The current article reviews the CBT for adolescent depression process literature. Our review…

  15. Rumination-focused cognitive behaviour therapy for residual depression: a case series.

    Science.gov (United States)

    Watkins, Ed; Scott, Jan; Wingrove, Janet; Rimes, Katharine; Bathurst, Neil; Steiner, Herbert; Kennell-Webb, Sandra; Moulds, Michelle; Malliaris, Yanni

    2007-09-01

    The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression.

  16. Cognitive behavioural therapy for obesity: one-year follow-up in a clinical setting.

    Science.gov (United States)

    Melchionda, N; Besteghi, L; Di Domizio, S; Pasqui, F; Nuccitelli, C; Migliorini, S; Baraldi, L; Natale, S; Manini, R; Bellini, M; Belsito, C; Forlani, G; Marchesini, G

    2003-09-01

    Cognitive behavioural therapy (CBT) is the most comprehensive means of medically treating obesity, but only few data have so far been published concerning its long-term effectiveness. We here report our experience of 1068 consecutive patients (868 females) treated with CBT at a university-based obesity centre. The patients were enrolled into three different programmes: a 14-week LEARN programme (672 patients), a 16-week MOB programme for the morbidly obese (259 patients), or a 20-week BINGE programme for subjects affected by binge eating (137 patients). Eighty-five percent of the subjects completed the weekly programmes. The percentage of patients attending the scheduled control visits during the 1-year follow-up gradually decreased, being very low in the BINGE group (10%). The percentage weight loss was an average of 6% during the weekly courses, being higher in the MOB programme; by the end of the weekly sessions, it exceeded 10% of initial body weight in 22% of cases and increased to 36% during the follow-up. The cumulative probability of follow-up was higher among the patients undergoing the MOB and LEARN programmes than among the BINGE patients (p obesity. Female gender and a weight loss of > 10% i.b.w. increased compliance to follow-up. The study further demonstrates the difficulty of achieving compliance to chronic management of obesity and the critical role of binge eating disorder in the medium-term treatment of obesity. Strategies are needed to improve adherence to a follow-up protocol.

  17. OBSESSIVE COMPULSIVE NEUROSIS: TREATMENT OF 28 CASES BY BEHAVIOUR THERAPY

    OpenAIRE

    Pradhan, P.V.; Ayyar, K.S.; Munjal, P.D.; Gopalani, J.H.; Mundra, A.V.; Doshi, Jyoti; Bagadia, V.N.

    1984-01-01

    SUMMARY Twenty-eight cases of obsessive compulsive neurosis were treated with a behaviour therapy package and good results were obtained in 15 (53.6%). Relaxation, thought-stopping, implosion, modelling, response prevention, electrical aversion and positive reinforcement wei; the techniques employed. Chronicity, previous treatments, follow-up data, drop-outs and the use of behaviour therapy in our setting are discussed in this paper.

  18. Asperger syndrome and anxiety disorders (PAsSA) treatment trial: a study protocol of a pilot, multicentre, single-blind, randomised crossover trial of group cognitive behavioural therapy

    Science.gov (United States)

    Langdon, Peter E; Murphy, Glynis H; Wilson, Edward; Shepstone, Lee; Fowler, David; Heavens, David; Malovic, Aida; Russell, Alexandra

    2013-01-01

    Introduction A number of studies have established that children, adolescents and adults with Asperger syndrome (AS) and high functioning autism (HFA) have significant problems with anxiety. Cognitive behavioural therapy (CBT) is an effective treatment for anxiety in a variety of clinical populations. There is a growing interest in exploring the effectiveness of CBT for people with AS who have mental health problems, but currently there are no known clinical trials involving adults with AS or HFA. Studies with children who have AS have reported some success. The current study aims to examine whether modified group CBT for clinically significant anxiety in an AS population is likely to be efficacious. Methods and analysis This study is a randomised, single-blind crossover trial. At least 36 individuals will be recruited and randomised into a treatment arm or a waiting-list control arm. During treatment, individuals will receive 3 sessions of individual CBT, followed by 21 sessions of group CBT. Primary outcome measures focus on anxiety. Secondary outcome measures focus on everyday social and psychiatric functioning, additional measures of anxiety and fear, depression, health-related quality of life and treatment cost. Assessments will be administered at pregroup and postgroup and at follow-up by researchers who are blinded to group allocation. The trial aims to find out whether or not psychological treatments for anxiety can be adapted and used to successfully treat the anxiety experienced by people with AS. Furthermore, we aim to determine whether this intervention represents good value for money. Ethics and dissemination The trial received a favourable ethical opinion from a National Health Service (NHS) Research Ethics Committee. All participants provided written informed consent. Findings will be shared with all trial participants, and the general public, as well as the scientific community. Trial Registration ISRCTN 30265294 (DOI: 10.1186/ISRCTN30265294), UKCRN

  19. Efficacy of exposure versus cognitive therapy in anxiety disorders: systematic review and meta-analysis

    OpenAIRE

    Ougrin Dennis

    2011-01-01

    Abstract Background There is growing evidence of the effectiveness of Cognitive Behavioural Therapy (CBT) for a wide range of psychological disorders. There is a continued controversy about whether challenging maladaptive thoughts rather than use of behavioural interventions alone is associated with the greatest efficacy. However little is known about the relative efficacy of various components of CBT. This review aims to compare the relative efficacy of Cognitive Therapy (CT) versus Exposure...

  20. Teacher Stress and Pupil Behaviour Explored through a Rational-Emotive Behaviour Therapy Framework

    Science.gov (United States)

    Robertson, Caroline; Dunsmuir, Sandra

    2013-01-01

    Using the psychological framework of rational-emotive behaviour therapy, the principal aim of this study was to establish whether irrational beliefs, self-efficacy or pupil behaviour predicted teacher reports of stress. A secondary aim was to establish whether these variables, in addition to teachers' verbal feedback to pupils in class, predicted…

  1. Teacher Stress and Pupil Behaviour Explored through a Rational-Emotive Behaviour Therapy Framework

    Science.gov (United States)

    Robertson, Caroline; Dunsmuir, Sandra

    2013-01-01

    Using the psychological framework of rational-emotive behaviour therapy, the principal aim of this study was to establish whether irrational beliefs, self-efficacy or pupil behaviour predicted teacher reports of stress. A secondary aim was to establish whether these variables, in addition to teachers' verbal feedback to pupils in class, predicted…

  2. The Screen-ICD trial. Screening for anxiety and cognitive therapy intervention for patients with implanted cardioverter defibrillator (ICD)

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Herning, Margrethe; Svendsen, Jesper Hastrup

    2016-01-01

    by Structured Clinical Interview for DSM Disorders (SCID). (3) Investigator-initiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive–behavioural therapy (CBT) performed by a cardiac nurse with CBT training, plus usual care or usual care alone...

  3. The Screen-ICD trial. Screening for anxiety and cognitive therapy intervention for patients with implanted cardioverter defibrillator (ICD)

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Herning, Margrethe; Svendsen, Jesper Hastrup;

    2016-01-01

    by Structured Clinical Interview for DSM Disorders (SCID). (3) Investigator-initiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive–behavioural therapy (CBT) performed by a cardiac nurse with CBT training, plus usual care or usual care alone...

  4. Effect of aerobic exercise training and cognitive behavioural therapy on reduction of chronic fatigue in patients with facioscapulohumeral dystrophy: protocol of the FACTS-2-FSHD trial

    Directory of Open Access Journals (Sweden)

    van Engelen Baziel GM

    2010-06-01

    Full Text Available Abstract Background In facioscapulohumeral dystrophy (FSHD muscle function is impaired and declines over time. Currently there is no effective treatment available to slow down this decline. We have previously reported that loss of muscle strength contributes to chronic fatigue through a decreased level of physical activity, while fatigue and physical inactivity both determine loss of societal participation. To decrease chronic fatigue, two distinctly different therapeutic approaches can be proposed: aerobic exercise training (AET to improve physical capacity and cognitive behavioural therapy (CBT to stimulate an active life-style yet avoiding excessive physical strain. The primary aim of the FACTS-2-FSHD (acronym for Fitness And Cognitive behavioural TherapieS/for Fatigue and ACTivitieS in FSHD trial is to study the effect of AET and CBT on the reduction of chronic fatigue as assessed with the Checklist Individual Strength subscale fatigue (CIS-fatigue in patients with FSHD. Additionally, possible working mechanisms and the effects on various secondary outcome measures at all levels of the International Classification of Functioning, Disability and Health (ICF are evaluated. Methods/Design A multi-centre, assessor-blinded, randomized controlled trial is conducted. A sample of 75 FSHD patients with severe chronic fatigue (CIS-fatigue ≥ 35 will be recruited and randomized to one of three groups: (1 AET + usual care, (2 CBT + usual care or (3 usual care alone, which consists of no therapy at all or occasional (conventional physical therapy. After an intervention period of 16 weeks and a follow-up of 3 months, the third (control group will as yet be randomized to either AET or CBT (approximately 7 months after inclusion. Outcomes will be assessed at baseline, immediately post intervention and at 3 and 6 months follow up. Discussion The FACTS-2-FSHD study is the first theory-based randomized clinical trial which evaluates the effect and the

  5. Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot trial.

    Science.gov (United States)

    Freeman, Daniel; Waite, Felicity; Startup, Helen; Myers, Elissa; Lister, Rachel; McInerney, Josephine; Harvey, Allison G; Geddes, John; Zaiwalla, Zenobia; Luengo-Fernandez, Ramon; Foster, Russell; Clifton, Lei; Yu, Ly-Mee

    2015-11-01

    Sleep disturbance occurs in most patients with delusions or hallucinations and should be treated as a clinical problem in its own right. However, cognitive behavioural therapy (CBT)-the best evidence-based treatment for insomnia-has not been tested in this patient population. We aimed to pilot procedures for a randomised trial testing CBT for sleep problems in patients with current psychotic experiences, and to provide a preliminary assessment of potential benefit. We did this prospective, assessor-blind, randomised controlled pilot trial (Better Sleep Trial [BEST]) at two mental health centres in the UK. Patients (aged 18-65 years) with persistent distressing delusions or hallucinations in the context of insomnia and a schizophrenia spectrum diagnosis were randomly assigned (1:1), via a web-based randomisation system with minimisation to balance for sex, insomnia severity, and psychotic experiences, to receive either eight sessions of CBT plus standard care (medication and contact with the local clinical team) or standard care alone. Research assessors were masked to group allocation. Assessment of outcome was done at weeks 0, 12 (post-treatment), and 24 (follow-up). The primary efficacy outcomes were insomnia assessed by the Insomnia Severity Index (ISI) and delusions and hallucinations assessed by the Psychotic Symptoms Rating Scale (PSYRATS) at week 12. We did analysis by intention to treat, with an aim to provide confidence interval estimation of treatment effects. This study is registered with ISRCTN, number 33695128. Between Dec 14, 2012, and May 22, 2013, and Nov 7, 2013, and Aug 26, 2014, we randomly assigned 50 patients to receive CBT plus standard care (n=24) or standard care alone (n=26). The last assessments were completed on Feb 10, 2015. 48 (96%) patients provided follow-up data. 23 (96%) patients offered CBT took up the intervention. Compared with standard care, CBT led to reductions in insomnia in the large effect size range at week 12 (adjusted

  6. A naturalistic study of the acceptability and effectiveness of internet-delivered cognitive behavioural therapy for psychiatric disorders in older australians.

    Directory of Open Access Journals (Sweden)

    Louise Mewton

    Full Text Available OBJECTIVES: The current study investigates the acceptability, effectiveness and uptake of internet-delivered cognitive behavioural therapy (iCBT amongst older individuals (>60 years seeking psychiatric treatment in general practice. METHODS: The sample consisted of 2413 (mean age 39.5; range 18-83 years patients prescribed iCBT through This Way Up clinic by their primary care clinician. The intervention consisted of six fully automated, unassisted online lessons specific to four disorders major depression, generalised anxiety disorder, panic disorder or social phobia. Patients were categorised into five age groups (18-29 years, 30-39 years, 40-49 years, 50-59 years, 60 years and above. 225 (9.3% patients were aged over 60 years. Analyses were conducted across the four disorders to ensure sufficient sample sizes in the 60 years and older age group. Age differences in adherence to the six lesson courses were assessed to demonstrate acceptability. Age-based reductions in psychological distress (Kessler Psychological Distress Scale; K10 and disability (the World Health Organisation Disability Assessment Schedule; WHODAS-II were compared to demonstrate effectiveness. To evaluate the uptake of iCBT, the age distribution of those commencing iCBT was compared with the prevalence of these disorders in the 2007 Australian National Survey of Mental Health and Well-Being. RESULTS: Older adults were more likely to complete all six lessons when compared with their younger counterparts. Marginal model analyses indicated that there were significant reductions in the K10 and WHODAS-II from baseline to post-intervention, regardless of age (p<0.001. The measurement occasion by age interactions were not significant, indicating that individuals showed similar reductions in the K10 and WHODAS-II regardless of age. In general, the age distribution of individuals commencing the iCBT courses matched the age distribution of the four diagnoses in the Australian general

  7. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression: study protocol for a randomised controlled superiority trial.

    Science.gov (United States)

    Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig; Rosenberg, Nicole K; Gondan, Matthias; Grafton, Ben; Austin, Stephen F; Howard, Henriette; Moeller, Stine B

    2015-08-11

    Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more effective in treating depression and reducing relapse than standard cognitive behavioural therapy. This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness of group-based cognitive behavioural therapy for treatment of depression. One hundred twenty-eight patients with depression will be recruited from and given treatment in an outpatient service at a psychiatric hospital in Denmark. Our primary outcome will be severity of depressive symptoms (Hamilton Rating Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome measure and assessment of relapse. The clinical outcome of this trial may guide clinicians to decide on the merits of including rumination-focused cognitive behavioural therapy in the treatment of depression in

  8. Adding mindfulness to CBT programs for binge eating: a mixed-methods evaluation.

    Science.gov (United States)

    Woolhouse, Hannah; Knowles, Ann; Crafti, Naomi

    2012-01-01

    The current study investigated the effectiveness of a combined mindfulness-CBT group therapy program for women with binge eating problems. Questionnaires were completed by group participants pre-program (n = 30), post-program (n = 30) and 3 month follow-up (n = 28). Significant reductions between pre- and post-program scores were found on standardised measures assessing binge eating, dieting, and body image dissatisfaction, with all reductions maintained at follow-up. Qualitative interviews with 16 women following completion of the program revealed the value of mindfulness in improving eating behaviour through increased self-awareness. This exploratory study supports the value of adding mindfulness to the more commonly utilised CBT-based programs for binge eating.

  9. A feasibility open trial of guided Internet-delivered cognitive behavioural therapy for anxiety and depression amongst Arab Australians

    Directory of Open Access Journals (Sweden)

    Rony Kayrouz

    2015-03-01

    Full Text Available The present study examined the preliminary efficacy and acceptability of a culturally modified therapist-guided cognitive behaviour therapy (CBT treatment for Arab Australians, aged 18 years and over with symptoms of depression and anxiety. To facilitate ease of use, the treatment was delivered via the Internet (Internet CBT; iCBT. Eleven participants with at least mild symptoms of depression (Patient Health Questionnaire 9-item (PHQ-9 total scores  > 4  or anxiety (Generalised Anxiety Disorder 7-item (GAD-7 total scores > 4  accessed the online Arab Wellbeing Course, which consisted of five online lessons delivered over 8 weeks. Measures of depression, anxiety, distress and disability were gathered at pre-treatment, post-treatment and 3-month follow-up. Data were analysed using mixed-linear model analyses. Ninety-one percent (10/11 of participants completed the five lessons over 8 weeks, with 10/11 providing post-treatment and 3-month follow-up data. Participants improved significantly across all outcome measures, with large within-group effect sizes based on estimated marginal means (Cohen's d at post-treatment (d = 1.08 to 1.74 and 3-month follow-up (d = 1.53 to 2.00. The therapist spent an average of 90.72 min (SD = 28.98 in contact, in total, with participants during the trial. Participants rated the Arab Wellbeing Course as acceptable. Caution is needed in interpreting the results of the current study given the small sample size employed, raising questions about the impact of levels of acculturation and the absence of a control group. However, the results are encouraging and indicate that, with minor modifications, western psychological interventions have the potential to be of benefit to English speaking Arab immigrants.

  10. Genome-wide association study of response to cognitive–behavioural therapy in children with anxiety disorders

    Science.gov (United States)

    Coleman, Jonathan R. I.; Lester, Kathryn J.; Keers, Robert; Roberts, Susanna; Curtis, Charles; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Dalgleish, Tim; Hartman, Catharina A.; Heiervang, Einar R.; Hötzel, Katrin; Hudson, Jennifer L.; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J.; Marin, Carla E.; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike H.; Rapee, Ronald M.; Schneider, Silvia; Schneider, Sophie C.; Silverman, Wendy K.; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Breen, Gerome; Eley, Thalia C.

    2016-01-01

    Background Anxiety disorders are common, and cognitive–behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. Aims To perform the first genome-wide association study (GWAS) of psychological treatment response in children with anxiety disorders (n = 980). Method Presence and severity of anxiety was assessed using semi-structured interview at baseline, on completion of treatment (post-treatment), and 3 to 12 months after treatment completion (follow-up). DNA was genotyped using the Illumina Human Core Exome-12v1.0 array. Linear mixed models were used to test associations between genetic variants and response (change in symptom severity) immediately post-treatment and at 6-month follow-up. Results No variants passed a genome-wide significance threshold (P = 5 × 10−8) in either analysis. Four variants met criteria for suggestive significance (P<5 × 10−6) in association with response post-treatment, and three variants in the 6-month follow-up analysis. Conclusions This is the first genome-wide therapygenetic study. It suggests no common variants of very high effect underlie response to CBT. Future investigations should maximise power to detect single-variant and polygenic effects by using larger, more homogeneous cohorts. PMID:26989097

  11. Genome-wide association study of response to cognitive-behavioural therapy in children with anxiety disorders.

    Science.gov (United States)

    Coleman, Jonathan R I; Lester, Kathryn J; Keers, Robert; Roberts, Susanna; Curtis, Charles; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Dalgleish, Tim; Hartman, Catharina A; Heiervang, Einar R; Hötzel, Katrin; Hudson, Jennifer L; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J; Marin, Carla E; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Breen, Gerome; Eley, Thalia C

    2016-09-01

    Anxiety disorders are common, and cognitive-behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. To perform the first genome-wide association study (GWAS) of psychological treatment response in children with anxiety disorders (n = 980). Presence and severity of anxiety was assessed using semi-structured interview at baseline, on completion of treatment (post-treatment), and 3 to 12 months after treatment completion (follow-up). DNA was genotyped using the Illumina Human Core Exome-12v1.0 array. Linear mixed models were used to test associations between genetic variants and response (change in symptom severity) immediately post-treatment and at 6-month follow-up. No variants passed a genome-wide significance threshold (P = 5 × 10(-8)) in either analysis. Four variants met criteria for suggestive significance (P<5 × 10(-6)) in association with response post-treatment, and three variants in the 6-month follow-up analysis. This is the first genome-wide therapygenetic study. It suggests no common variants of very high effect underlie response to CBT. Future investigations should maximise power to detect single-variant and polygenic effects by using larger, more homogeneous cohorts. © The Royal College of Psychiatrists 2016.

  12. Cognitive behaviour therapy for psychosomatic disorders

    African Journals Online (AJOL)

    Repro

    ... behavioural model. (Modified from 5-Factor Model of Padesky & Mooney.7 .... sound therapeutic relationship .6 ... by the term collaborativ e .... short-term benefit is, however, like- ... child is ill, have a major impact in .... been cared for by his mother before dying, when Mr Q was 8 years old. ... the memories which are uncov-.

  13. Sign and Symptom and Ability to Control Violent Behaviour with Music Therapy and Rational Emotive Cognitive Behaviour Therapy

    Directory of Open Access Journals (Sweden)

    Heri Setiawan

    2015-10-01

    Full Text Available Introduction: Prevalence of violence is highly occur in mental disorders clients at psychiatric hospitals. The impact is injure to others. This research aims to examine the effectiveness of music therapy and RECBT to sign and symptom and ability to control violent behaviour. Methods: Quasi-experimental research design with a sample of 64 respondents. Result: The study found a decrease symptoms of violent behaviour, ability to control violent behavior include relaxation, change negative thingking, irational belief, and negative behavior have increased significantly than the clients that did not receiving therapy. Discussion: Music therapy and RECBT is recommended as a therapeutic nursing at the client’s violent behaviour. Key Word: violent, sign and simptom, ability, music therapy, RECBT

  14. Effectiveness of Cognitive Behavioral Therapy for Depression in Patients Receiving Disability Benefits: A Systematic Review and Individual Patient Data Meta-Analysis

    NARCIS (Netherlands)

    S. Ebrahim (Shanil); L. Montoya (Luis); W. Truong (Wanda); S. Hsu (Sandy); M. Kamal el Din (Mostafa); A. Carrasco-Labra (Alonso); J.W. Busse (Jason); S.D. Walter (Stephen); D. Heels-Ansdell (Diane); R. Couban (Rachel); I. Patelis-Siotis (Irene); M. Bellman (Marg); L.E. de Graaf (Esther); D.J.A. Dozois (David); P.J. Bieling (Peter); G.H. Guyatt (Gordon)

    2012-01-01

    textabstractObjectives: To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits. Data Sources: All rele

  15. Cognitive-Behavioural Therapies for Young People in Outpatient Treatment for NonOpioid Drug Use

    DEFF Research Database (Denmark)

    Filges, Trine; Jørgensen, Anne-Marie Klint

    2016-01-01

    Objectives: This review evaluates the evidence on the effects of cognitive–behavioral therapy (CBT) on drug use reduction for young people in treatment for nonopioid drug use. Method: We followed Campbell Collaboration guidelines to conduct a systematic review of randomized and nonrandomized tria...

  16. Neurorehabilitation and cognitive-behaviour therapy of anxiety disorders after brain injury: An overview and a case illustration of obsessive-compulsive disorder.

    Science.gov (United States)

    Williams, W H; Evans, J J; Fleminger, S

    2003-01-01

    Survivors of acquired and traumatic brain injuries may often experience anxiety states. Psychological reactions to neurological trauma may be caused by a complex interaction of a host of factors. We explore how anxiety states may be understood in terms of a biopsychosocial formulation of such factors. We also review the current evidence for the presence of specific anxiety disorders after brain injury. We then describe how cognitive-behaviour therapy (CBT), a treatment of choice for many anxiety disorders, may be integrated with cognitive rehabilitation (CR), for the management of anxiety disorders in brain injury. We illustrate how CBT and CR may be delivered with a case of a survivor of traumatic brain injury (TBI) who had developed obsessive compulsive disorder and health anxiety. We show how CBT plus CR allows a biopsychosocial formulation to be developed of the survivor's concerns for guiding a goal-based intervention. The survivor made significant gains from intervention in terms of goals achieved and changes on clinical measures. We argue that large-scale research is needed for developing an evidence base for managing emotional disorders in brain injury.

  17. Group cognitive behavioural therapy for stroke survivors with depression and their carers.

    Science.gov (United States)

    K Ward, Susan; Turner, Alyna; A Hambridge, John; A Halpin, Sean; E Valentine, Megan; L Sweetapple, Anne; H White, Jennifer; Hackett, Maree L

    2016-10-01

    Depression in stroke survivors is common, leads to poorer outcomes and often not treated. A group cognitive behavioural therapy (CBT) program (Brainstorm) for stroke survivors with depression, and their carers has been running as part of usual care since 2007. To evaluate the implementation and acceptability of Brainstorm, a closed group intervention consisting of up to 10 sessions of education, activity planning, problem solving and thought challenging. Participating stroke survivors and their carers complete assessment measures at baseline, post-treatment and 1-month and 6-months follow-up. A mixed models for repeated measures data was conducted with depression and anxiety scores for stroke survivors (Beck Depression Inventory-II; Hospital Anxiety and Depression Scale) and the assessment of depression, anxiety and carer burden for carers. Acceptability was assessed by session attendance and written and open participant feedback upon completion of the program. Forty-eight community dwelling stroke survivors and 34 carers attended Brainstorm, with a median attendance of 88% of sessions. Follow-up assessments were completed by 77% (post-treatment), 46% (1-month) and 38% (6-month) of stroke survivors. Stroke survivors' depression scores decreased from baseline to post-treatment (pBrainstorm group intervention for depression in stroke survivors appears to have been effectively implemented and is acceptable to stroke survivors and carers.

  18. Symptom fluctuations, self-esteem, and cohesion during group cognitive behaviour therapy for early psychosis.

    Science.gov (United States)

    Lecomte, Tania; Leclerc, Claude; Wykes, Til

    2017-07-14

    Group cohesion has been linked to positive changes in self-esteem and in symptoms during group psychotherapy in people with psychosis. These changes may be linked to changes in symptoms as fluctuations in self-esteem have been linked to symptom fluctuations. We aimed to determine the relationship between these three factors - group cohesion, self-esteem, and symptoms - during group cognitive behaviour therapy for psychosis (GCBTp). We hypothesized that group cohesion would precede changes in symptoms and self-esteem and that improvements in self-esteem would precede improvements in symptoms. This is an uncontrolled longitudinal study recruiting from a convenience sample within two early psychosis clinics. Sixty-six individuals from first episode of psychosis treatment programmes participated in this study and received 24 sessions of a validated GCBTp protocol. Participants answered a brief questionnaire at the end of each session, measuring their group cohesion, self-esteem, and perception of their symptoms as worse, same, or better than usual. Orthogonal polynomial contrasts for time effects were estimated with a mixed model for repeated measures with a random cluster effect and revealed a quartic trend regarding changes in symptoms over the 24 sessions. Self-esteem, symptoms, and group cohesion were strongly linked during a given session. Also, self-esteem changes predicted changes in symptoms up to two sessions later, and symptoms changes predicted self-esteem changes at the next session. Group cohesion preceded improvements in both self-esteem and symptoms; self-esteem also predicted improvements in group cohesion. These results suggest that self-esteem and symptoms influence each other during therapy, with improvements in one leading to improvements in the other. Group cohesion also appears to be an essential prerequisite to positive changes in self-esteem and symptoms during GCBTp. This study emphasizes the interrelation between self-esteem improvements and

  19. Therapist-guided, Internet-based cognitive–behavioural therapy for body dysmorphic disorder (BDD-NET): a feasibility study

    Science.gov (United States)

    Enander, Jesper; Ivanov, Volen Z; Andersson, Erik; Mataix-Cols, David; Ljótsson, Brjánn; Rück, Christian

    2014-01-01

    Objectives Cognitive–behavioural therapy (CBT) is an effective treatment for body dysmorphic disorder (BDD). However, most sufferers do not have access to this treatment. One way to increase access to CBT is to administer treatment remotely via the Internet. This study piloted a novel therapist-supported, Internet-based CBT program for BDD (BDD-NET). Design Uncontrolled clinical trial. Participants Patients (N=23) were recruited through self-referral and assessed face to face at a clinic specialising in obsessive–compulsive and related disorders. Suitable patients were offered secure access to BDD-NET. Intervention BDD-NET is a 12-week treatment program based on current psychological models of BDD that includes psychoeducation, functional analysis, cognitive restructuring, exposure and response prevention, and relapse prevention modules. A dedicated therapist provides active guidance and feedback throughout the entire process. Main outcome measure The clinician-administered Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS). Symptom severity was assessed pretreatment, post-treatment and at the 3-month follow-up. Results BDD-NET was deemed highly acceptable by patients and led to significant improvements on the BDD-YBOCS (p=<0.001) with a large within-group effect size (Cohen's d=2.01, 95% CI 1.05 to 2.97). At post-treatment, 82% of the patients were classified as responders (defined as≥30% improvement on the BDD-YBOCS). These gains were maintained at the 3-month follow-up. Secondary outcome measures of depression, global functioning and quality of life also showed significant improvements with moderate to large effect sizes. On average, therapists spent 10 min per patient per week providing support. Conclusions The results suggest that BDD-NET has the potential to greatly increase access to CBT, at least for low-risk individuals with moderately severe BDD symptoms and reasonably good insight. A randomised controlled trial of BDD-NET is warranted

  20. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2013-10-01

    Training’; ‘ Cognitive - Behavioral Therapy ’; ‘Behavioral Task Assignment’; ‘Chain Analysis’. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF... cognitive behavioral therapy (CBT) interventions have been shown to be effective in alleviating symptoms of Post-Traumatic Stress Disorder (PTSD) and...target groups: VA clinicians, community practitioners, and cognitive behavioral therapy experts. The surveys collected both qualitative and quantitative

  1. Working with resistance in rational emotive behaviour therapy

    OpenAIRE

    Dryden, Windy; Neenan, Michael

    2011-01-01

    Productive therapeutic change is facilitated when the therapist and client have a good therapeutic relationship, share views on salient therapeutic matters, agree on goals to enhance client well-being, and understand what they each have to do to achieve the goals of therapy. In this book Windy Dryden and Michael Neenan address the difficulties that both client and therapist bring to rational emotive behaviour therapy (REBT) when either party is resistant to change.\\ud \\ud Divided into two par...

  2. One-year follow-up results of a randomized controlled clinical trial on internet-based cognitive behavioral therapy for subthreshold depres- sion in people over 50 years old.

    NARCIS (Netherlands)

    Spek, V.; Cuijpers, P.; Nyklicek, I.; Smits, N.; Riper, H.; Pop, V.

    2008-01-01

    Background Internet-based cognitive behaviour therapy (CBT) is a promising new approach for the treatment of depressive symptoms. The current study had two aims: (1) to determine whether, after 1 year, an internet-based CBT intervention was more effective than a waiting-list control group; and (2) t

  3. CBT for children with depressive symptoms: a meta-analysis.

    Science.gov (United States)

    Arnberg, Alexandra; Ost, Lars-Göran

    2014-01-01

    Pediatric depression entails a higher risk for psychiatric disorders, somatic complaints, suicide, and functional impairment later in life. Cognitive behavior therapy (CBT) is recommended for the treatment of depression in children, yet research is based primarily on adolescents. The present meta-analysis investigated the efficacy of CBT in children aged 8-12 years with regard to depressive symptoms. We included randomized controlled trials of CBT with participants who had an average age of  ≤ 12 years and were diagnosed with either depression or reported elevated depressive symptoms. The search resulted in 10 randomized controlled trials with 267 participants in intervention and 256 in comparison groups. The mean age of participants was 10.5 years. The weighted between-group effect size for CBT was moderate, Cohen's d = 0.66. CBT outperformed both attention placebo and wait-list, although there was a significant heterogeneity among studies with regard to effect sizes. The weighted within-group effect size for CBT was large, d = 1.02. Earlier publication year, older participants, and more treatment sessions were associated with a larger effect size. In conclusion, the efficacy of CBT in the treatment of pediatric depression symptoms was supported. Differences in efficacy, methodological shortcomings, and lack of follow-up data limit the present study and indicate areas in need of improvement.

  4. Addressing Anger Using Sensorimotor Psychotherapy and Cognitive Behaviour Therapy

    Science.gov (United States)

    Flynn, Sarah M.

    2010-01-01

    A young woman initiated counselling services at a community agency to address her explosive anger that was a remnant of childhood physical and emotional abuse. Sensorimotor psychotherapy was used to help this client learn how to monitor and regulate her sensorimotor processes. In conjunction with this approach, Cognitive behavioural therapy was…

  5. Behavioural activation therapy for adolescents 'at risk' for psychosis?

    Science.gov (United States)

    Welsh, Patrick; Kitchen, Charlotte E W; Ekers, David; Webster, Lisa; Tiffin, Paul A

    2016-04-01

    The following hypothesis explores the possibility of using behavioural activation therapy for adolescents with an at-risk mental state for psychosis. Support is drawn from psychosis-related survey and pilot data as well as a robust evidence base for adult depression. However, we acknowledge that extensive feasibility work is required before exploring this hypothesis further.

  6. Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial.

    Science.gov (United States)

    Creswell, Cathy; Violato, Mara; Fairbanks, Hannah; White, Elizabeth; Parkinson, Monika; Abitabile, Gemma; Leidi, Alessandro; Cooper, Peter J

    2017-07-01

    Half of all lifetime anxiety disorders emerge before age 12 years; however, access to evidence-based psychological therapies for affected children is poor. We aimed to compare the clinical outcomes and cost-effectiveness of two brief psychological treatments for children with anxiety referred to routine child mental health settings. We hypothesised that brief guided parent-delivered cognitive behavioural therapy (CBT) would be associated with better clinical outcomes than solution-focused brief therapy and would be cost-effective. We did this randomised controlled trial at four National Health Service primary child and mental health services in Oxfordshire, UK. Children aged 5-12 years referred for anxiety difficulties were randomly allocated (1:1), via a secure online minimisation tool, to receive brief guided parent-delivered CBT or solution-focused brief therapy, with minimisation for age, sex, anxiety severity, and level of parental anxiety. The allocation sequence was not accessible to the researcher enrolling participants or to study assessors. Research staff who obtained outcome measurements were masked to group allocation and clinical staff who delivered the intervention did not measure outcomes. The primary outcome was recovery, on the basis of Clinical Global Impressions of Improvement (CGI-I). Parents recorded patient-level resource use. Quality-adjusted life-years (QALYs) for use in cost-utility analysis were derived from the Child Health Utility 9D. Assessments were done at baseline (before randomisation), after treatment (primary endpoint), and 6 months after treatment completion. We did analysis by intention to treat. This trial is registered with the ISCRTN registry, number ISRCTN07627865. Between March 23, 2012, and March 31, 2014, we randomly assigned 136 patients to receive brief guided parent-delivered CBT (n=68) or solution-focused brief therapy (n=68). At the primary endpoint assessment (June, 2012, to September, 2014), 40 (59%) children in

  7. Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation.

    Science.gov (United States)

    Hinton, Devon E; Hofmann, Stefan G; Rivera, Edwin; Otto, Michael W; Pollack, Mark H

    2011-04-01

    We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen's d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.

  8. Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: a randomised attention-controlled trial.

    Directory of Open Access Journals (Sweden)

    Nicholas Glozier

    Full Text Available BACKGROUND AND AIM: Mild to moderate depression is common in those with cardiovascular disease and undertreated. We aimed to evaluate the effectiveness of internet-delivered Cognitive Behaviour Therapy (iCBT on depressive symptom severity and adherence to medical advice and lifestyle interventions in adults with mild to moderate depression and high cardiovascular disease (CVD risks. METHODS: Randomised double-blind, 12 week attention-controlled trial comparing an iCBT programme (E-couch with an internet-delivered attention control health information package (HealthWatch, n = 282. The primary outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9 (trial registration: ACTRN12610000085077. RESULTS: 487/562 (88% participants completed the endpoint assessment. 383/562 (70% were currently treated for cardiovascular disease and 314/562 (56% had at least one other comorbid condition. In ITT analysis of 562 participants iCBT produced a greater decline in the mean PHQ-9 score compared to the attention control of 1.06 (95% CI: 0.23-1.89 points, with differences between the two arms increasing over the intervention period (time by treatment effect interaction p = .012. There were also larger improvements in adherence (2.16 points; 95% CI: 0.33-3.99, reductions in anxiety (0.96 points; 95% CI: 0.19-1.73, and a greater proportion engaging in beneficial physical activity (Odds Ratio 1.91, 95%CI: 1.01-3.61 in the iCBT participants but no effect upon disability, or walking time/day. There were no withdrawals due to study related adverse events. CONCLUSIONS: In people with mild to moderate depression and high levels of CVD risk factors, a freely accessible iCBT programme (http://www.ecouch.anu.edu.au produced a small, but robust, improvement in depressive symptoms, adherence and some health behaviours. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12610000085077.

  9. A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN)†

    OpenAIRE

    Stefanopoulou, Evgenia; Yousaf, Omar; Grunfeld, Elizabeth A; Hunter, Myra S

    2015-01-01

    Abstract Objective Hot flushes and night sweats (HFNS) are experienced by up to 80% of prostate cancer patients undergoing androgen deprivation therapy (ADT). This study evaluates the effects of a guided self‐help cognitive behavioural therapy (CBT) intervention on HFNS problem‐rating (primary outcome), HFNS frequency, mood and health‐related quality of life (secondary outcomes) in patients undergoing ADT. Methods Patients reporting treatment‐induced HFNS were randomly assigned to CBT (n = 33...

  10. Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Louise Farrer

    Full Text Available BACKGROUND: Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. AIM: To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. METHOD: 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. RESULTS: Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. CONCLUSIONS: A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. TRIAL REGISTRATION: Controlled-Trials.comISRCTN93903959.

  11. The Impact of CBT and ACT Models Using Psychology Trainee Therapists: A Preliminary Controlled Effectiveness Trial

    Science.gov (United States)

    Lappalainen, Raimo; Lehtonen, Tuula; Skarp, Eerika; Taubert, Eija; Ojanen, Markku; Hayes, Steven C.

    2007-01-01

    The present study compares the impact of individualized treatment provided by trainee therapists based on a traditional cognitive behavior therapy (CBT) and acceptance and commitment therapy (ACT) model. Fourteen therapists were given initial training in CBT and ACT. Outpatients (N = 28) were randomized to either approach, with each therapist…

  12. Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: a pilot study.

    Science.gov (United States)

    Pigeon, Wilfred R; Moynihan, Jan; Matteson-Rusby, Sara; Jungquist, Carla R; Xia, Yinglin; Tu, Xin; Perlis, Michael L

    2012-11-01

    Chronic pain is difficult to treat and often precedes or exacerbates sleep disturbances such as insomnia. Insomnia, in turn, can amplify the pain experience. Both conditions are associated with inflammatory processes, which may be involved in the bi-directional relationship between pain and sleep. Cognitive behavioral therapy (CBT) for pain and CBT for insomnia are evidence based interventions for, respectively, chronic pain and insomnia. The study objectives were to determine the feasibility of combining CBT for pain and for insomnia and to assess the effects of the combined intervention and the stand alone interventions on pain, sleep, and mood outcomes compared to a control condition. Twenty-one adults with co-occurring chronic pain and chronic insomnia were randomized to either CBT for pain, CBT for insomnia, combined CBT for pain and insomnia, or a wait-list control condition. The combined CBT intervention was feasible to deliver and produced significant improvements in sleep, disability from pain, depression and fatigue compared to the control condition. Overall, the combined intervention appeared to have a strong advantage over CBT for pain on most outcomes, modest advantage over both CBT for insomnia in reducing insomnia severity in chronic pain patients. CBT for pain and CBT for insomnia may be combined with good results for patients with co-occurring chronic pain and insomnia. Published by Elsevier Ltd.

  13. Working Memory Training and CBT Reduces Anxiety Symptoms and Attentional Biases to Threat: A Preliminary Study.

    Science.gov (United States)

    Hadwin, Julie A; Richards, Helen J

    2016-01-01

    Research indicates that cognitive processes linked to the detection of threat stimuli are associated with poor attentional control, placing children and adolescents at increased risk for the development of anxious affect. The current study aimed to provide preliminary data to assess whether an intervention designed to improve attentional control (via working memory; WM) would lead to better performance in tests of WM and would be associated with positive changes in symptoms of trait and test anxiety, increased inhibitory control and reduced attention to threat. Forty adolescents aged 11-14 years who reported elevated anxiety and low attentional control were randomly allocated to a WM training or an active cognitive behavioural therapy (CBT) control group. Post intervention, WM training was associated with greater improvements (versus. CBT) in trained WM tasks. Both groups, however, reported fewer anxiety symptoms, demonstrated increased inhibitory control and a reduction in attentional biases to threat post intervention and these results were maintained at follow up. The study provides indicative evidence which suggests that WM training has similar benefits to a more traditional CBT intervention on reduced anxiety and attentional biases for threat. Future research should aim to replicate the findings in a large sample size and explore the broader impact of training on day-to-day functioning. In addition, further research is needed to identify which participants benefit most from different interventions (using baseline characteristics) on treatment compliance and outcome.

  14. Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies.

    Science.gov (United States)

    Ayers, Susan; McKenzie-McHarg, Kirstie; Eagle, Andrew

    2007-09-01

    Background. Approximately 1-2% of women suffer from postnatal post-traumatic stress disorder (PTSD) with wide ranging consequences for these women and their families 1. Appropriate treatment of women who have difficult or traumatic births is not yet established. Evidence in other populations shows that cognitive behavior therapy (CBT) is effective for PTSD and it is therefore the recommended treatment 2. However, a recent review of treatments for postnatal distress concluded that descriptions of postnatal counseling are largely generalized and non-specific, which makes them difficult to assess or replicate 3. Aims and method. The current paper therefore aims to describe the use of CBT interventions to treat postnatal distress, and to illustrate common themes or issues that occur in postnatal PTSD. This paper reports two case studies of women with postnatal PTSD and their treatment using CBT. Conclusions. In these cases, CBT was an effective treatment for postnatal PTSD. A number of implications are explored for the management of pregnancy and labor.

  15. A Comparison of Learning Outcomes in Cognitive Behavioural Therapy and Existential Therapy

    DEFF Research Database (Denmark)

    Sørensen, Anders Dræby

    the lived experience of the learning outcomes of these approaches. The study also clarifies the differences between existential psychotherapy as an art of learning directed at existential learning of authenticity and cognitive- behavioural therapy as a learning-based medical treatment technology directed...... of the outcome of psychotherapy through qualitative research. The precise aim is to draw attention to the special characteristics of this outcome in terms of learning outcome. This regards both existential therapy and cognitive behavioural therapy and to clarify the possible differences and similarities between...

  16. Inpatient Cognitive Behavior Therapy for Severe Eating Disorders

    Directory of Open Access Journals (Sweden)

    Riccardo Dalle Grave

    2010-12-01

    Full Text Available Enhanced cognitive behaviour therapy (CBT-E for eating disorders has been developed and evaluated only in outpatient setting. Aim of the paper is to describe a novel model of inpatient treatment, termed inpatient CBT-E, indicated for patients with an eating disorder of clinical severity not manageable in an outpatient setting or that failed outpatient treatment. Inpatient CBT-E is derived by the outpatients CBT-E with some adaptations to rend the treatments suitable for an inpatient setting. The principal adaptations include: 1 multidisciplinary and non-eclectic team composed of physicians, psychologists, dieticians and nurses all trained in CBT; 2 assisted eating; 3 group sessions; and a CBT family module for patients younger than 18 years. The treatment lasts 20 weeks (13 for inpatients followed by seven weeks of residential day treatment and, as CBT-E, is divided in four stages and can be administered in a focused form (CBT-F or in a broad form (CBT-B. A randomized control trial is evaluating the effectiveness of the treatment.

  17. The Use of Group Therapy as a Means of Facilitating Cognitive-Behavioural Instruction for Adolescents with Disruptive Behaviour

    Science.gov (United States)

    Larmar, Stephen

    2006-01-01

    This article reports on the findings of an action research enquiry examining the efficacy of group therapy as a means of facilitating cognitive-behavioural instruction for students who exhibit disruptive behaviours. A curriculum comprising the key tenets of cognitive-behaviour modification was developed and taught over a 9-week period to a group…

  18. Therapist guided internet based cognitive behavioural therapy for body dysmorphic disorder: single blind randomised controlled trial

    Science.gov (United States)

    Andersson, Erik; Mataix-Cols, David; Lichtenstein, Linn; Alström, Katarina; Andersson, Gerhard; Ljótsson, Brjánn; Rück, Christian

    2016-01-01

    Objectives To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. Design A 12 week single blind parallel group randomised controlled trial. Setting Academic medical centre. Participants 94 self referred adult outpatients with a diagnosis of body dysmorphic disorder and a modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score of ≥20. Concurrent psychotropic drug treatment was permitted if the dose had been stable for at least two months before enrolment and remained unchanged during the trial. Interventions Participants received either BDD-NET (n=47) or supportive therapy (n=47) delivered via the internet for 12 weeks. Main outcome measures The primary outcome was the BDD-YBOCS score after treatment and follow-up (three and six months from baseline) as evaluated by a masked assessor. Responder status was defined as a ≥30% reduction in symptoms on the scale. Secondary outcomes were measures of depression (MADRS-S), global functioning (GAF), clinical global improvement (CGI-I), and quality of life (EQ5D). The six month follow-up time and all outcomes other than BDD-YBOCS and MADRS-S at 3 months were not pre-specified in the registration at clinicaltrials.gov because of an administrative error but were included in the original trial protocol approved by the regional ethics committee before the start of the trial. Results BDD-NET was superior to supportive therapy and was associated with significant improvements in severity of symptoms of body dysmorphic disorder (BDD-YBOCS group difference −7.1 points, 95% confidence interval −9.8 to −4.4), depression (MADRS-S group difference −4.5 points, −7.5 to −1.4), and other secondary measures. At follow-up, 56% of those receiving BDD-NET were classed as responders, compared with 13% receiving supportive therapy. The number needed to treat was 2.34 (1.71 to 4.35). Self

  19. A Randomized Trial of Cognitive Behaviour Therapy and Cognitive Therapy for Children with Posttraumatic Stress Disorder following Single-Incident Trauma

    Science.gov (United States)

    Nixon, Reginald David Vandervord; Sterk, Jisca; Pearce, Amanda

    2012-01-01

    The present study compared the efficacy of trauma-focused cognitive behavior therapy (CBT) with trauma-focused cognitive therapy (without exposure; CT) for children and youth with posttraumatic stress disorder (PTSD). Children and youth who had experienced single-incident trauma (N = 33; 7-17 years old) were randomly assigned to receive 9 weeks of…

  20. A Randomized Trial of Cognitive Behaviour Therapy and Cognitive Therapy for Children with Posttraumatic Stress Disorder following Single-Incident Trauma

    Science.gov (United States)

    Nixon, Reginald David Vandervord; Sterk, Jisca; Pearce, Amanda

    2012-01-01

    The present study compared the efficacy of trauma-focused cognitive behavior therapy (CBT) with trauma-focused cognitive therapy (without exposure; CT) for children and youth with posttraumatic stress disorder (PTSD). Children and youth who had experienced single-incident trauma (N = 33; 7-17 years old) were randomly assigned to receive 9 weeks of…

  1. Music therapy and Alzheimer's disease: Cognitive, psychological, and behavioural effects.

    Science.gov (United States)

    Gómez Gallego, M; Gómez García, J

    2017-06-01

    Music therapy is one of the types of active ageing programmes which are offered to elderly people. The usefulness of this programme in the field of dementia is beginning to be recognised by the scientific community, since studies have reported physical, cognitive, and psychological benefits. Further studies detailing the changes resulting from the use of music therapy with Alzheimer patients are needed. Determine the clinical improvement profile of Alzheimer patients who have undergone music therapy. Forty-two patients with mild to moderate Alzheimer disease underwent music therapy for 6 weeks. The changes in results on the Mini-mental State Examination, Neuropsychiatric Inventory, Hospital Anxiety and Depression Scale and Barthel Index scores were studied. We also analysed whether or not these changes were influenced by the degree of dementia severity. Significant improvement was observed in memory, orientation, depression and anxiety (HAD scale) in both mild and moderate cases; in anxiety (NPI scale) in mild cases; and in delirium, hallucinations, agitation, irritability, and language disorders in the group with moderate Alzheimer disease. The effect on cognitive measures was appreciable after only 4 music therapy sessions. In the sample studied, music therapy improved some cognitive, psychological, and behavioural alterations in patients with Alzheimer disease. Combining music therapy with dance therapy to improve motor and functional impairment would be an interesting line of research. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Learning from mistakes in rational emotive behaviour therapy

    OpenAIRE

    2011-01-01

    Mistakes are often an inevitable part of training; Learning from Mistakes in Rational Emotive Behaviour Therapy encourages the trainee to pinpoint potential errors at the earliest possible stage in training, helping them to make fast progress towards becoming competent REBT practitioners. Windy Dryden and Michael Neenan have compiled 111 of the most common errors, explaining what has gone wrong and how to put it right, and have divided them into eight accessible parts: general mis...

  3. Learning from mistakes in rational emotive behaviour therapy

    OpenAIRE

    Dryden, Windy; Neenan, Michael

    2011-01-01

    Mistakes are often an inevitable part of training; Learning from Mistakes in Rational Emotive Behaviour Therapy encourages the trainee to pinpoint potential errors at the earliest possible stage in training, helping them to make fast progress towards becoming competent REBT practitioners.\\ud \\ud Windy Dryden and Michael Neenan have compiled 111 of the most common errors, explaining what has gone wrong and how to put it right, and have divided them into eight accessible parts:\\ud \\ud general m...

  4. Review series: chronic cough: behaviour modification therapies for chronic cough.

    Science.gov (United States)

    Vertigan, A E; Theodoros, D G; Gibson, P G; Winkworth, A L

    2007-01-01

    Chronic cough (CC) can be refractory to medical treatment and newer strategies are required for these patients. Behaviour modification therapies are a potential approach for management of cough that does not respond to medical management. Behaviour modification therapy for CC involves an individually tailored programme teaching individuals to increase control over cough symptoms and includes education, specific strategies to suppress the cough, vocal hygiene training and psychoeducational counselling. Several case series have described speech pathology treatment for CC and a recent randomized control trial has demonstrated a significant improvement in symptoms. Possible mechanisms for this improvement include reduced cough reflex sensitivity, increased voluntary control of the cough and reduced stimulation of cough receptors. Respiratory retraining used by physiotherapists may also have potential for use in CC. The validity of psychological therapeutic approaches to CC rests on concepts of CC as a disorder with a psychogenic component, and the ability of cognitive therapies to modify the cough pathway. This work outlines current literature into behavioural management of CC and suggests new directions for practice and research in adults with this condition.

  5. Analysis list: cbt [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available cbt Larvae + dm3 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/target/cbt.1.tsv ht...tp://dbarchive.biosciencedbc.jp/kyushu-u/dm3/target/cbt.5.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/target/cbt....10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/colo/cbt.Larvae.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/colo/Larvae.gml ...

  6. [Castration of dogs from the standpoint of behaviour therapy].

    Science.gov (United States)

    Kuhne, F

    2012-04-24

    The castration of dogs is an amputation covered by Section 6 (1) of the Animal Protection Law in Germany. Apart from the general indications given by veterinary medicine, castration of an animal is a potential method of animal behaviour therapy. However, the highly variable, individual effects of castration on behaviour require detailed diagnosis by the veterinarian. Castration appears to exert its strongest influence on sexually dimorphic behaviour patterns in male dogs, e.g. status- related aggression, urine marking, mounting, house-soiling problems, and roaming. An indication to castrate a bitch is maternal aggression. When evaluating the effects of castration, one should always consider individual circumstances, such as learning experience (for example in the case of "experienced copulators"), age, and pack behaviour (if there is more than one dog in the household). Additional benefits of castration include a reduction in the dog's general activity level, decreased preparatory arousal and a decline in the dog's ability to focus its attention fully on the target of attack. As a result, it is much easier for the owner to disrupt and manage or control the dog's agonistic intentions. However, castration is not the ultimate remedy in dog-handling. Any decision in this respect should be based on a precise behaviour- related indication. Otherwise, such surgery may well violate the Animal Protection Law.

  7. Psychodynamic therapies versus other psychological therapies for depression.

    Science.gov (United States)

    Churchill, Rachel; Moore, Theresa Hm; Davies, Philippa; Caldwell, Deborah; Jones, Hannah; Lewis, Glyn; Hunot, Vivien

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all psychodynamic therapy approaches compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different psychodynamic therapy approaches (drive/structural, relational and integrative analytic models) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all psychodynamic therapy approaches compared with different psychological therapy approaches (behavioural, humanistic, integrative, cognitive-behavioural, 'third-wave' CBT) for acute depression.

  8. The People with Asperger syndrome and anxiety disorders (PAsSA) trial: a pilot multicentre, single-blind randomised trial of group cognitive-behavioural therapy.

    Science.gov (United States)

    Langdon, Peter E; Murphy, Glynis H; Shepstone, Lee; Wilson, Edward C F; Fowler, David; Heavens, David; Malovic, Aida; Russell, Alexandra; Rose, Alice; Mullineaux, Louise

    2016-03-01

    There is a growing interest in using cognitive-behavioural therapy (CBT) with people who have Asperger syndrome and comorbid mental health problems. To examine whether modified group CBT for clinically significant anxiety in an Asperger syndrome population is feasible and likely to be efficacious. Using a randomised assessor-blind trial, 52 individuals with Asperger syndrome were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially randomised to treatment were followed up for 24 weeks. The conversion rate for this trial was high (1.6:1), while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared with those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety. Trials of psychological therapies with this population are feasible. Larger definitive trials are now needed. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

  9. The People with Asperger syndrome and anxiety disorders (PAsSA) trial: a pilot multicentre, single-blind randomised trial of group cognitive–behavioural therapy

    Science.gov (United States)

    Murphy, Glynis H.; Shepstone, Lee; Wilson, Edward C.F.; Fowler, David; Heavens, David; Malovic, Aida; Russell, Alexandra; Rose, Alice; Mullineaux, Louise

    2016-01-01

    Background There is a growing interest in using cognitive–behavioural therapy (CBT) with people who have Asperger syndrome and comorbid mental health problems. Aims To examine whether modified group CBT for clinically significant anxiety in an Asperger syndrome population is feasible and likely to be efficacious. Method Using a randomised assessor-blind trial, 52 individuals with Asperger syndrome were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially randomised to treatment were followed up for 24 weeks. Results The conversion rate for this trial was high (1.6:1), while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared with those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety. Conclusions Trials of psychological therapies with this population are feasible. Larger definitive trials are now needed. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence. PMID:27703772

  10. Effect of combined cognitive-behavioural therapy and endurance training on cortisol and salivary alpha-amylase in panic disorder.

    Science.gov (United States)

    Plag, Jens; Gaudlitz, Katharina; Schumacher, Sarah; Dimeo, Fernando; Bobbert, Thomas; Kirschbaum, Clemens; Ströhle, Andreas

    2014-11-01

    Current data point to an alteration of both the hypothalamo-pituitary-adrenal (HPA)-system and the peripheral transmission of catecholamines in anxiety disorders. There is also some evidence for the effect of several components of cognitive-behavioural interventions such as coping and control and for an effect of exercise training on the neuroendocrine stress response in healthy subjects as well as patients suffering from distinct (mental) disorders. This double-blind, controlled study investigated the effect of cognitive-behavioural therapy (CBT) in combination with either high-level endurance training or low-level exercise on salivary cortisol (sC) and on levels of salivary alpha-amylase (sAA) in patients suffering from panic disorder (PD) with and without agoraphobia. In comparison to the low-level exercise condition, there were significantly lower sC-levels in the experimental group performing high-level endurance training at a 7-month follow-up. In contrast, there were no group differences in sAA levels during the study period. In this trial, we found evidence for a decelerated effect of endurance-training on HPA-system's functioning in PD. Further studies addressing the alteration of sAA levels in this population might investigate physical exercise different in intensity and duration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Protocol for a feasibility study of a self-help cognitive behavioural therapy resource for the reduction of dental anxiety in young people.

    Science.gov (United States)

    Marshman, Zoe; Morgan, Annie; Porritt, Jenny; Gupta, Ekta; Baker, Sarah; Creswell, Cathy; Newton, Tim; Stevens, Katherine; Williams, Christopher; Prasad, Suneeta; Kirby, Jennifer; Rodd, Helen

    2016-01-01

    Childhood dental anxiety is very common, with 10-20 % of children and young people reporting high levels of dental anxiety. It is distressing and has a negative impact on the quality of life of young people and their parents as well as being associated with poor oral health. Affected individuals may develop a lifelong reliance on general anaesthetic or sedation for necessary dental treatment thus requiring the support of specialist dental services. Children and young people with dental anxiety therefore require additional clinical time and can be costly to treat in the long term. The reduction of dental anxiety through the use of effective psychological techniques is, therefore, of high importance. However, there is a lack of high-quality research investigating the impact of cognitive behavioural therapy (CBT) approaches when applied to young people's dental anxiety. The first part of the study will develop a profile of dentally anxious young people using a prospective questionnaire sent to a consecutive sample of 100 young people referred to the Paediatric Dentistry Department, Charles Clifford Dental Hospital, in Sheffield. The second part will involve interviewing a purposive sample of 15-20 dental team members on their perceptions of a CBT self-help resource for dental anxiety, their opinions on whether they might use such a resource with patients, and their willingness to recruit participants to a future randomised controlled trial (RCT) to evaluate the resource. The third part of the study will investigate the most appropriate outcome measures to include in a trial, the acceptability of the resource, and retention and completion rates of treatment with a sample of 60 dentally anxious young people using the CBT resource. This study will provide information on the profile of dentally anxious young people who could potentially be helped by a guided self-help CBT resource. It will gain the perceptions of dental care team members of guided self-help CBT for

  12. The effects of using cognitive behavioural therapy to improve sleep for patients with delusions and hallucinations (the BEST study): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Freeman, Daniel; Startup, Helen; Myers, Elissa; Harvey, Allison; Geddes, John; Yu, Ly-Mee; Zaiwalla, Zenobia; Luengo-Fernandez, Ramon; Foster, Russell; Lister, Rachel

    2013-07-11

    Patients with psychosis frequently report difficulties getting or staying asleep (insomnia). Dissatisfaction with sleep is high. Insomnia should be treated in this group, but typically it is not even assessed. Importantly, recent evidence indicates that insomnia triggers and exacerbates delusions and hallucinations. The clinical implication is that if the insomnia is treated then the psychotic symptoms will significantly lessen. In a case series with 15 patients with persecutory delusions resistant to previous treatment this is exactly what we found: cognitive behavioural therapy for insomnia (CBT-I) led to large reductions in both the insomnia and delusions. The clear next step is a pilot randomized controlled test. The clinical aim is to test whether CBT-I can reduce both insomnia and psychotic symptoms. The trial will inform decisions for a definitive large-scale evaluation. We will carry out a randomized controlled trial (the Better Sleep Trial, or the BEST study) with 60 patients with distressing delusions or hallucinations in the context of a schizophrenia spectrum diagnosis. Half of the participants will be randomized to receive CBT-I, in addition to their standard treatment, for up to eight sessions over 12 weeks. The other half will continue with treatment as usual. Blind assessments will take place at 0 weeks, 12 weeks (post-treatment) and 24 weeks (follow-up). The primary outcome hypotheses are that CBT-I added to treatment as usual will improve sleep, delusions and hallucinations compared with only treatment as usual. All main analyses will be carried out at the end of the last follow-up assessments and will be based on the intention-to-treat principle. The trial is funded by the NHS National Institute for Health Research (NIHR) Research for Patient Benefit Programme. Data collection will be complete by the end of 2014. This will be the first controlled test of CBT-I for patients with delusions and hallucinations. It will provide significant evidence

  13. The effectiveness of community day-long CBT-I workshops for participants with insomnia symptoms: a randomised controlled trial.

    Science.gov (United States)

    Swift, Naomi; Stewart, Robert; Andiappan, Manoharan; Smith, Anna; Espie, Colin A; Brown, June S L

    2012-06-01

    Insomnia is a very common and disabling symptom. Whilst evidence for the efficacy of cognitive behavioural therapy for people diagnosed with insomnia (CBT-I) is strong, few people seek help and not many services offer CBT-I. Less intensive adaptations of CBT-I have been shown to be valuable, and given the size of the problem and low rates of help-seeking, an accessible intervention with a large capacity is needed. Day-long CBT-I psycho-educational workshops (each for up to 30 people), to which members of the public with insomnia symptoms could self-refer, have been developed. This randomised controlled trial aimed to evaluate the effectiveness of these workshops. Baseline measures were taken from 151 participants, who were then randomised to experimental or waiting-list control groups. Scores of the experimental group and the control group were compared 3 months after baseline. Random effects models found a significant interaction between time and group, indicating differences between the control and experimental groups on the Insomnia Severity Index (ISI). Post hoc analyses indicated that ISI scores decreased significantly in the experimental group, but not in the control group. Promising results were also found on corroborative sleep diary measures. Access to the workshops was good, with 50% of participants having never previously sought help for sleep difficulties from their GP. CBT-I workshops proved to be both accessible and effective in reducing insomnia symptoms in the medium term. They may represent a feasible brief intervention with the potential to address unmet treatment needs of adults complaining of insomnia symptoms.

  14. Computer-Assisted CBT for Child Anxiety: The Coping Cat CD-ROM

    Science.gov (United States)

    Khanna, Muniya S.; Kendall, Philip C.

    2008-01-01

    Empirical data support the efficacy of cognitive-behavioral therapy (CBT) for child anxiety, but there is need and merit in the development and evaluation of cost-effective and transportable CBT approaches. Relatedly, a widely endorsed goal is the dissemination of evidence-based treatments from research clinics to community settings.…

  15. Engagement in Trauma-Specific CBT for Youth Post-9/11

    Science.gov (United States)

    Rodriguez, James; Hoagwood, Kimberly Eaton; Gopalan, Geetha; Olin, Serene; McKay, Mary M.; Marcus, Sue M.; Radigan, Marleen; Chung, Michelle; Legerski, Joanna

    2013-01-01

    Treatment participation was examined among youth enrolled in an evaluation of cognitive behavioral therapy (CBT) for trauma following the 9/11 World Trade Center disaster. Staff at nine agencies serving a predominantly low-income, ethnically diverse population were trained to deliver CBT and structured engagement strategies. A total of 445 youth…

  16. An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario

    Science.gov (United States)

    Manassis, Katharina; Ickowicz, Abel; Picard, Erin; Antle, Beverley; McNeill, Ted; Chahauver, Anu; Mendlowitz, Sandra; Monga, Suneeta; Adler-Nevo, Gili

    2009-01-01

    Objective: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by…

  17. EMDR versus CBT for children with self-esteem and behavioral problems: a randomized controlled trial

    NARCIS (Netherlands)

    F. Wanders; M. Serra; A. de Jongh

    2008-01-01

    This study compared eye movement desensitization and reprocessing (EMDR) with cognitive-behavioral therapy (CBT). Twenty-six children (average age 10.4 years) with behavioral problems were randomly assigned to receive either 4 sessions of EMDR or CBT prior to usual treatment provided in outpatient a

  18. Rational Emotive Behaviour Therapy in a Nutshell 2nd Edition

    OpenAIRE

    Neenan, Michael; Dryden, Windy

    2011-01-01

    Rational Emotive Behaviour Therapy in a Nutshell provides a concise overview of a popular therapeutic approach, starting with the ABCDE Model of Emotional Disturbance and Change.\\ud \\ud Written by leading REBT specialists, Michael Neenan and Windy Dryden, the book goes on to explain the core of the therapeutic process:\\ud \\ud - Assessment\\ud \\ud - Disputing\\ud \\ud - Homework\\ud \\ud - Working through\\ud \\ud - Promoting self-change.\\ud \\ud As an introduction to the basics of the approach, this ...

  19. CBT4BN versus CBTF2F: Comparison of Online versus Face-To-FaceTreatment for Bulimia Nervosa

    Science.gov (United States)

    Bulik, Cynthia M.; Marcus, Marsha D.; Zerwas, Stephanie; Levine, Michele D.; Hofmeier, Sara; Trace, Sara E.; Hamer, Robert M.; Zimmer, Benjamin; Moessner, Markus; Kordy, Hans

    2012-01-01

    Cognitive-behavioral therapy (CBT) is currently the “gold standard” for treatment of bulimia nervosa (BN), and is effective for approximately 40–60% of individuals receiving treatment; however, the majority of individuals in need of care do not have access to CBT. New strategies for service delivery of CBT and for maximizing maintenance of treatment benefits are critical for improving our ability to treat BN. This clinical trial is comparing an Internet-based version of CBT (CBT4BN) in which group intervention is conducted via therapeutic chat group with traditional group CBT (CBTF2F) for BN conducted via face-to-face therapy group. The purpose of the trial is to determine whether manualized CBT delivered via the Internet is not inferior to the gold standard of manualized group CBT. In this two-site randomized controlled trial, powered for non-inferiority analyses, 180 individuals with BN are being randomized to either CBT4BN or CBTF2F. We hypothesize that CBT4BN will not be inferior to CBTF2F and that participants will value the convenience of an online intervention. If not inferior, CBT4BN may be a cost-effective approach to service delivery for individuals requiring treatment for BN. PMID:22659072

  20. CASCADE: Introducing AI into CBT.

    Science.gov (United States)

    Hendley, R. J.; Jurascheck, N.

    1992-01-01

    Discusses changes in training requirements of commerce and industry in the United Kingdom and describes a project, CASCADE, that was developed to investigate and implement the introduction of artificial intelligence (AI) techniques into computer-based training (CBT). An overview of pilot projects in higher education settings is provided. (eight…

  1. Reducing therapist contact in cognitive behaviour therapy for panic disorder and agoraphobia in primary care: global measures of outcome in a randomised controlled trial.

    Science.gov (United States)

    Sharp, D M; Power, K G; Swanson, V

    2000-01-01

    BACKGROUND: Panic disorder, with and without agoraphobia, is a prevalent condition presenting in general practice. Psychological treatments are effective but are limited by restricted availability. Interest has grown in methods by which the efficiency and thus availability of psychological treatments can be improved, with particular emphasis on reduced therapist contact formats. AIM: To evaluate the relative efficacy in a primary care setting of a cognitive behaviour therapy (CBT) delivered at three levels of therapist contact: standard contact, minimum contact, and bibliotherapy. METHOD: A total of 104 patients were randomly allocated to receive standard therapist contact, minimum therapist contact or bibliotherapy, with 91 patients completing treatment. All patients received an identical treatment manual and were seen by the same psychologist therapist. Outcome was reported in terms of brief global ratings of severity of illness, change in symptoms, and levels of social disruption. These brief measures were chosen to be suitable for use in general practice and were used at treatment entry and endpoint. RESULTS: The standard therapist contact group had the strongest and most comprehensive treatment response, showing significant differences from the bibliotherapy group on all, and the minimum therapist contact group on some, endpoint measures. Some reduction in efficacy was therefore found for the reduced therapist contact groups. CONCLUSION: The standard therapist contact group showed the greatest treatment efficacy in the present study. As it was of notably shorter duration than many other current formulations of CBT, it represents a useful and efficient treatment for panic disorder and agoraphobia in primary care. PMID:11224967

  2. Interpersonal, cognitive analytic and other integrative therapies versus other psychological therapies for depression.

    Science.gov (United States)

    Hunot, Vivien; Moore, Theresa Hm; Caldwell, Deborah; Davies, Philippa; Jones, Hannah; Lewis, Glyn; Churchill, Rachel

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all integrative therapies compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different integrative therapy models (IPT, CAT, psychodynamic-interpersonal therapy, CBASP, counselling) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all integrative therapies compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, cognitive-behavioural, third wave CBT) for acute depression.

  3. Effectiveness of cognitive behavioural therapy augmentation in major depression treatment (ECAM study): study protocol for a randomised clinical trial

    Science.gov (United States)

    Nakagawa, Atsuo; Sado, Mitsuhiro; Mitsuda, Dai; Fujisawa, Daisuke; Kikuchi, Toshiaki; Abe, Takayuki; Sato, Yuji; Iwashita, Satoru; Mimura, Masaru; Ono, Yutaka

    2014-01-01

    Introduction Major depression is a serious mental disorder that causes substantial distress and impairment in individuals and places an enormous burden on society. Although antidepressant treatment is the most common therapy provided in routine practice, there is little evidence to guide second-line therapy for patients who have failed to respond to antidepressants. The aim of this paper is to describe the study protocol for a randomised controlled trial that measures the clinical effectiveness of cognitive behavioural therapy (CBT) as an augmentation strategy to treat patients with non-psychotic major depression identified as suboptimal responders to usual depression care. Methods and analysis The current study is a 16-week assessor-blinded randomised, parallel-groups superiority trial with 12-month follow-up at an outpatient clinic as part of usual depression care. Patients aged 20–65 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Major Depressive Disorder who have experienced at least one failed trial of antidepressants as part of usual depression care, will be randomly assigned to receive CBT plus treatment as usual, or treatment as usual alone. The primary outcome is the change in clinician-rated 17-item GRID-Hamilton Depression Rating Scale (GRID-HAMD) score at 16 weeks, and secondary outcomes include severity and change in scores of subjective depression symptoms, proportion of responders and remitters, safety and quality of life. The primary population will be the intention-to-treat patients. Ethics and dissemination All protocols and the informed consent form comply with the Ethics Guideline for Clinical Research (Japanese Ministry of Health, Labour and Welfare). Ethics review committees at the Keio University School of Medicine and the Sakuragaoka Memorial Hospital approved the study protocol. The results of the study will be disseminated at several research conferences and as published articles in peer

  4. CBT for Adolescents With Anxiety: Mature Yet Still Developing.

    Science.gov (United States)

    Kendall, Philip C; Peterman, Jeremy S

    2015-06-01

    Anxiety disorders are common in adolescents (ages 12 to 18) and contribute to a range of impairments. There has been speculation that adolescents with anxiety are at risk for being treatment nonresponders. In this review, the authors examine the efficacy of cognitive-behavioral therapy (CBT) for adolescents with anxiety. Outcomes from mixed child and adolescent samples and from adolescent-only samples indicate that approximately two-thirds of youths respond favorably to CBT. CBT produces moderate to large effects and shows superiority over control/comparison conditions. The literature does not support differential outcomes by age: adolescents do not consistently manifest poorer outcomes relative to children. Although extinction paradigms find prolonged fear extinction in adolescent samples, basic research does not fully align with the processes and goals of real-life exposure. Furthermore, CBT is flexible and allows for tailored application in adolescents, and it may be delivered in alternative formats (i.e., brief, computer/Internet, school-based, and transdiagnostic CBT).

  5. Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial.

    Science.gov (United States)

    Goodyer, Ian M; Reynolds, Shirley; Barrett, Barbara; Byford, Sarah; Dubicka, Bernadka; Hill, Jonathan; Holland, Fiona; Kelvin, Raphael; Midgley, Nick; Roberts, Chris; Senior, Rob; Target, Mary; Widmer, Barry; Wilkinson, Paul; Fonagy, Peter

    2017-02-01

    Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short-term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self-reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and

  6. Effectiveness of a cognitive-behavioral therapy (CBT) manualized program for clinically anxious children: study protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Jansen, M.; Doorn, M.E.M. van; Lichtwarck-Aschoff, A.; Kuijpers, R.C.W.M.; Theunissen, H.L.A.; Korte, M.; Rossum, J.M. van; Wauben, A.; Granic, I.

    2012-01-01

    Background: In the Netherlands, the prevalence of anxiety disorders is 20%; and children with anxiety are at increased risk for psychopathology throughout adulthood. Recently, a revised version of a cognitive behavioral therapy manualized program called 'Thinking + Doing = Daring' (TDD) was

  7. Understanding process in group cognitive behaviour therapy for psychosis.

    Science.gov (United States)

    Lecomte, Tania; Leclerc, Claude; Wykes, Til; Nicole, Luc; Abdel Baki, Amal

    2015-06-01

    Group cognitive behaviour therapy for psychosis (GCBTp) has shown to be effective in diminishing symptoms, as well as in improving other psychosocial dimensions such as self-esteem. But little is known regarding the processes that generate these therapeutic improvements and might be harnessed to further improve its effectiveness. The current study aimed at investigating these processes, particularly those linked to interpersonal relationships. The participants were all assessed at baseline, were given 24 sessions of GCBTp over the course of 3 months and were assessed again at post-treatment as well as 6 months later (9 months from baseline). Sixty-six individuals with early psychosis took part in a study of GCBTp where therapist alliance and group cohesion were assessed at three time points during the therapy, and punctual (each session) self-perceptions on symptoms and optimism were collected. Improvements in symptoms (BPRS), self-esteem (SERS-SF) and in self-perceived therapeutic improvements (CHOICE) were linked to specific aspects of the alliance, group cohesion, as well as optimism. The variables retained were not always overall scores, suggesting the importance of the variables at key moments during the therapy. The results clearly demonstrate the importance of the alliance and group cohesion, together significantly explaining improvements measured at post-therapy or follow-up. This study has attempted to focus mostly on relational aspects, as well as on self-perceptions, in the context of a GCBTp for individuals with early psychosis. This study also showed that these therapeutic relationships are especially useful when they are more stable and at specific moments during the therapy, namely when more difficult psychological work is done. © 2014 The British Psychological Society.

  8. The GoodNight study--online CBT for insomnia for the indicated prevention of depression: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Gosling, John A; Glozier, Nick; Griffiths, Kathleen; Ritterband, Lee; Thorndike, Frances; Mackinnon, Andrew; Hehir, Kanupriya Kalia; Bennett, Anthony; Bennett, Kylie; Christensen, Helen

    2014-02-13

    Cognitive Behaviour Therapy for Insomnia (CBT-I) delivered through the Internet is effective as a treatment in reducing insomnia in individuals seeking help for insomnia. CBT-I also lowers levels of depression in this group. However, it is not known if targeting insomnia using CBT-I will lower depressive symptoms, and thus reduce the risk of major depressive episode onset, in those specifically at risk for depression. Therefore, this study aims to examine whether Internet delivery of fully automated self-help CBT-I designed to reduce insomnia will prevent depression. A sample of 1,600 community-dwelling adults (aged 18-64), who screen positive for both subclinical levels of depressive symptoms and insomnia, will be recruited via various media and randomised to either a 9-week online insomnia treatment programme, Sleep Healthy Using The internet (SHUTi), or an online attention-matched control group (HealthWatch). The primary outcome variable will be depression symptom levels at the 6-month post-intervention on the Patient Heath Questionnaire-9 (PHQ-9). A secondary outcome will be onset of major depressive episodes assessed at the 6-month post-intervention using 'current' and 'time from intervention' criteria from the Mini International Neuropsychiatric Interview. This trial is the first randomised controlled trial of an Internet-based insomnia intervention as an indicated preventative programme for depression. If effective, online provision of a depression prevention programme will facilitate dissemination. Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12611000121965.

  9. Working Memory Training and CBT Reduce Anxiety Symptoms and Attentional Biases to Threat: A Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Julie A. Hadwin

    2016-02-01

    Full Text Available Research indicates that cognitive processes linked to the detection of threat stimuli are associated with poor attentional control, placing children and adolescents at increased risk for the development of anxious affect. The current study aimed to provide preliminary data to assess whether an intervention designed to improve attentional control (via working memory; WM would lead to better performance in tests of WM and would be associated with positive changes in symptoms of trait and test anxiety, increased inhibitory control and reduced attention to threat. Forty adolescents aged 11-14 years who reported elevated anxiety and low attentional control were randomly allocated to a WM training or an active cognitive behavioural therapy (CBT control group. Post intervention, WM training was associated with greater improvements (versus. CBT in trained WM tasks. Both groups however reported fewer anxiety symptoms, demonstrated increased inhibitory control and a reduction in attentional biases to threat post intervention and these results were maintained at follow up. The study provides indicative evidence which suggests that WM training has similar benefits to a more traditional CBT intervention on reduced anxiety and attentional biases for threat. Future research should aim to replicate the findings in a large sample size and explore the broader impact of training on day to day functioning. In addition, further research is needed to identify which participants benefit most from different interventions (using baseline characteristics on treatment compliance and outcome.

  10. Guided parent-delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3- to 5-year follow-up.

    Science.gov (United States)

    Brown, Alexandra; Creswell, Cathy; Barker, Chris; Butler, Stephen; Cooper, Peter; Hobbs, Catherine; Thirlwall, Kerstin

    2017-06-01

    Brief guided parent-delivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non-intensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3-5 years post-treatment. A long-term follow-up (LTFU) cohort study. Families who (1) completed at least 50% of allocated treatment sessions of guided parent-delivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty-seven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39-61 months). At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM-IV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow-up period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range. Children who recovered from anxiety disorders following brief guided parent-delivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first-line, low-intensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment. Treatment gains from brief guided parent-delivered cognitive behaviour therapy for children with anxiety are maintained for most children 3-5 years later. The

  11. Using mobile technology to deliver a cognitive behaviour therapy-informed intervention in early psychosis (Actissist): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bucci, Sandra; Barrowclough, Christine; Ainsworth, John; Morris, Rohan; Berry, Katherine; Machin, Matthew; Emsley, Richard; Lewis, Shon; Edge, Dawn; Buchan, Iain; Haddock, Gillian

    2015-09-10

    Cognitive behaviour therapy (CBT) is recommended for the treatment of psychosis; however, only a small proportion of service users have access to this intervention. Smartphone technology using software applications (apps) could increase access to psychological approaches for psychosis. This paper reports the protocol development for a clinical trial of smartphone-based CBT. We present a study protocol that describes a single-blind randomised controlled trial comparing a cognitive behaviour therapy-informed software application (Actissist) plus Treatment As Usual (TAU) with a symptom monitoring software application (ClinTouch) plus TAU in early psychosis. The study consists of a 12-week intervention period. We aim to recruit and randomly assign 36 participants registered with early intervention services (EIS) across the North West of England, UK in a 2:1 ratio to each arm of the trial. Our primary objective is to determine whether in people with early psychosis the Actissist app is feasible to deliver and acceptable to use. Secondary aims are to determine whether Actissist impacts on predictors of first episode psychosis (FEP) relapse and enhances user empowerment, functioning and quality of life. Assessments will take place at baseline, 12 weeks (post-treatment) and 22-weeks (10 weeks post-treatment) by assessors blind to treatment condition. The trial will report on the feasibility and acceptability of Actissist and compare outcomes between the randomised arms. The study also incorporates semi-structured interviews about the experience of participating in the Actissist trial that will be qualitatively analysed to inform future developments of the Actissist protocol and app. To our knowledge, this is the first controlled trial to test the feasibility, acceptability, uptake, attrition and potential efficacy of a CBT-informed smartphone app for early psychosis. Mobile applications designed to deliver a psychologically-informed intervention offer new possibilities to

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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:…

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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:…

  16. Results from 10 Years of a CBT Pain Self-Management Outpatient Program for Complex Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Kathryn A. Boschen

    2016-01-01

    Full Text Available Background. Traditional unimodal interventions may be insufficient for treating complex pain, as they do not address cognitive and behavioural contributors to pain. Cognitive Behavioural Therapy (CBT and physical exercise (PE are empirically supported treatments that can reduce pain and improve quality of life. Objectives. To examine the outcomes of a pain self-management outpatient program based on CBT and PE at a rehabilitation hospital in Toronto, Ontario. Methods. The pain management group (PMG consisted of 20 sessions over 10 weeks. The intervention consisted of four components: education, cognitive behavioural skills, exercise, and self-management strategies. Outcome measures included the sensory, affective, and intensity of pain experience, depression, anxiety, pain disability, active and passive coping style, and general health functioning. Results. From 2002 to 2011, 36 PMGs were run. In total, 311 patients entered the program and 214 completed it. Paired t-tests showed significant pre- to posttreatment improvements in all outcomes measured. Patient outcomes did not differ according to the number or type of diagnoses. Both before and after treatment, women reported more active coping than men. Discussion. The PMGs improved pain self-management for patients with complex pain. Future research should use a randomized controlled design to better understand the outcomes of PMGs.

  17. An evaluation of a CBT group for women with low self-esteem.

    Science.gov (United States)

    Morton, Liza; Roach, Louise; Reid, Helen; Stewart, Scott Hallam

    2012-03-01

    Self-esteem is an important factor in the development and maintenance of good psychological health. Low self-esteem can be a consequence of mental health disorders (such as depression, anxiety and panic) or it can be a vulnerability factor for the development of such problems. The current study reports pilot findings from a Cognitive Behavioural Therapy (CBT) group intervention for 37 adult women with low self-esteem, based on Fennell's Overcoming Low Self-Esteem Self-Help Course. Findings suggest that the group is (statistically and clinically) effective at increasing levels of self-esteem and at reducing levels of depression and anxiety. Together, results suggest that the group provides an efficient and therapeutically beneficial service. However, since these findings are limited by the lack of control or follow-up data, they warrant further investigation.

  18. Cognitive Behavioral Therapy and Motivational Enhancement Therapy.

    Science.gov (United States)

    Wu, Sarah S; Schoenfelder, Erin; Hsiao, Ray Chih-Jui

    2016-10-01

    Although cognitive behavioral therapy (CBT) is widely recognized as the preferred treatment of psychiatric disorders, less is known about the application of CBT to substance use disorders, particularly in adolescence. This article discusses how CBT conceptualizes substance use and how it is implemented as a treatment of adolescent substance abuse. The article draws on several manuals for CBT that implement it as a standalone treatment or in combination with motivational enhancement therapies. Also reviewed are several studies that examined the efficacy of CBT. Finally, the implications are discussed. Numerous starting resources are provided to help a clinician implement CBT.

  19. Efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in Reducing Bullying Behaviour among In-School Adolescents in Ilorin, Nigeria

    Science.gov (United States)

    Alabi, Yahaya Lasiele; Lami, Mustapha Mulikat

    2015-01-01

    Bullying behaviour refers to repeated negative behaviour displayed by one or more person (s) with the intention of hurting the feeling, personality and power of the victim. The objective of this study therefore was to find out the efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in reducing bullying behaviour among in-school…

  20. Cognitive-behaviour therapy for patients with Abridged Somatization Disorder (SSI 4,6 in primary care: a randomized, controlled study

    Directory of Open Access Journals (Sweden)

    Andrés Eva

    2008-06-01

    Full Text Available Abstract Background Somatoform disorders are characterized by the presence of multiple somatic symptoms without an organic cause that completely explains their symptoms. These patients generate a high cost in health services. We aim to evaluate the effectiveness and feasibility of a cognitive-behaviour therapy (CBT programme, administered in group and individual formats in primary care for patients who are diagnosed with abridged somatization disorder. Method/design Design: Multicentre, randomized, controlled trial involving 3 groups, one of which is the control group consisting of standardized recommended treatment for somatization disorder in primary care (Smith's norms and the 2 others, the intervention groups, consisting of cognitive-behavioural therapy (10 sessions administered in individual format (intervention group 1 or in group format (intervention group 2. Setting: 29 primary care health centres in the province of Zaragoza and 3 primary care health centres in the province of Mallorca, Spain. Sample: N = 204 patients, (68 in each of the three groups, aged 18–65 years, able to understand and read Spanish, who fulfil Escobar's criteria of Abridgged Somatization Disorder (SSI 4,6, stable with pharmacotherapy over the previous month, and who will remain stable for the next 3 months in the doctor's opinion, having signed informed consent. Intervention: Control group: Standardized recommended treatment for somatization disorder in primary care (Smith's norms. Intervention group: 10 weekly sessions of CBT, following a protocol designed by Prof. Escobar's group at UMDNJ, USA. There are 2 different treatment conditions: individual and group format. Measurements: Survey on the use of health services, number and severity of somatic symptoms, anxiety, depression, quality of life and clinical global impression. The interviewers will not know which group the patient belongs to (blind. The assessments will be carried out at baseline, post

  1. The CBT Advisor: An Expert System Program for Making Decisions about CBT.

    Science.gov (United States)

    Kearsley, Greg

    1985-01-01

    Discusses structure, credibility, and use of the Computer Based Training (CBT) Advisor, an expert system designed to help managers make judgements about course selection, system selection, cost/benefits, development effort, and probable success of CBT projects. (MBR)

  2. Effects of added involvement from concerned significant others in internet-delivered CBT treatments for problem gambling: study protocol for a randomised controlled trial

    Science.gov (United States)

    Nilsson, Anders; Andersson, Gerhard; Hellner Gumpert, Clara

    2016-01-01

    Introduction Problem gambling is a public health concern affecting ∼2.3% of the Swedish population. Problem gambling also severely affects concerned significant others (CSOs). Several studies have investigated the effect of individual treatments based on cognitive–behavioural therapy (CBT), but less is known of the effect of involving CSOs in treatment. This study aims to compare an intervention based on behavioural couples therapy (BCT), involving a CSO, with an individual CBT treatment to determine their relative efficacy. BCT has shown promising results in working with substance abuse, but this is the first time it is used as an intervention for problem gambling. Both interventions will be internet-delivered, and participants will receive written support and telephone support. Methods and analysis A sample of 120 couples will be randomised to either the BCT condition, involving the gambler and the CSO, or the CBT condition, involving the gambler alone. Measures will be conducted weekly and at 3, 6 and 12 months follow-up. The primary outcome measure is gambling behaviour, as measured by Timeline Followback for Gambling. This article describes the outline of the research methods, interventions and outcome measures used to evaluate gambling behaviour, mechanisms of change and relationship satisfaction. This study will be the first study on BCT for problem gambling. Ethics and dissemination This study has been given ethical approval from the regional ethics board of Stockholm, Sweden. It will add to the body of knowledge as to how to treat problem gambling and how to involve CSOs in treatment. The findings of this study will be published in peer-reviewed journals and published at international and national conferences. Trial registration number NCT02543372; Pre-results. PMID:27670519

  3. Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial

    NARCIS (Netherlands)

    Nijdam, M.J.; Gersons, B.P.R.; Reitsma, J.B.; de Jongh, A.; Ollf, M.

    2012-01-01

    Background Trauma-focused cognitive-behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) are efficacious treatments for post-traumatic stress disorder (PTSD), but few studies have directly compared them using well-powered designs and few have investigated respon

  4. Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial.

    Science.gov (United States)

    Wiles, Nicola; Thomas, Laura; Abel, Anna; Barnes, Maria; Carroll, Fran; Ridgway, Nicola; Sherlock, Sofie; Turner, Nicholas; Button, Katherine; Odondi, Lang'o; Metcalfe, Chris; Owen-Smith, Amanda; Campbell, John; Garland, Anne; Hollinghurst, Sandra; Jerrom, Bill; Kessler, David; Kuyken, Willem; Morrison, Jill; Turner, Katrina; Williams, Chris; Peters, Tim; Lewis, Glyn

    2014-05-01

    Only one-third of patients with depression respond fully to treatment with antidepressant medication. However, there is little robust evidence to guide the management of those whose symptoms are 'treatment resistant'. The CoBalT trial examined the clinical effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy) for primary care patients with treatment-resistant depression (TRD) compared with usual care alone. Pragmatic, multicentre individually randomised controlled trial with follow-up at 3, 6, 9 and 12 months. A subset took part in a qualitative study investigating views and experiences of CBT, reasons for completing/not completing therapy, and usual care for TRD. General practices in Bristol, Exeter and Glasgow, and surrounding areas. Patients aged 18-75 years who had TRD [on antidepressants for ≥ 6 weeks, had adhered to medication, Beck Depression Inventory, 2nd version (BDI-II) score of ≥ 14 and fulfilled the International Classification of Diseases and Related Health Problems, Tenth edition criteria for depression]. Individuals were excluded who (1) had bipolar disorder/psychosis or major alcohol/substance abuse problems; (2) were unable to complete the questionnaires; or (3) were pregnant, as were those currently receiving CBT/other psychotherapy/secondary care for depression, or who had received CBT in the past 3 years. Participants were randomised, using a computer-generated code, to usual care or CBT (12-18 sessions) in addition to usual care. The primary outcome was 'response', defined as ≥ 50% reduction in depressive symptoms (BDI-II score) at 6 months compared with baseline. Secondary outcomes included BDI-II score as a continuous variable, remission of symptoms (BDI-II score of anxiety and antidepressant use at 6 and 12 months. Data on health and social care use, personal costs, and time off work were collected at 6 and 12 months. Costs from these three perspectives were

  5. Cognitive-Behaviour Formulation for Three Men with Learning Disabilities Who Experience Psychosis: How Do We Make It Make Sense?

    Science.gov (United States)

    Kirkland, Jamie

    2005-01-01

    Cognitive-behaviour therapy (CBT) is increasingly being used with people with learning disabilities. One of the challenges in working this way is effectively sharing and understanding the formulation of the client's problem. One could argue that only with a shared understanding can there be collaboration between the therapist and the client. By…

  6. Emotion awareness and cognitive behavioural therapy in young people with autism spectrum disorder.

    Science.gov (United States)

    Roberts-Collins, Cara; Mahoney-Davies, Gerwyn; Russell, Ailsa; Booth, Anne; Loades, Maria

    2017-07-01

    Young people with autism spectrum disorder experience high levels of emotional problems, including anxiety and depression. Adapted cognitive behavioural therapy is recommended for such difficulties. However, no evidence suggests whether emotion awareness is important in treatment outcome for young people on the autism spectrum. This study aimed to investigate the potential differences in emotion awareness between (1) young people on the autism spectrum and typically developing youth and (2) young people on the autism spectrum with and without experience of cognitive behavioural therapy. Three groups (aged 11-20 years) participated: (1) typically developing young people ( n = 56); (2) young people on the autism spectrum with no experience of cognitive behavioural therapy ( n = 23); and (3) young people on the autism spectrum who had attended cognitive behavioural therapy ( n = 33). All participants completed the Emotion Awareness Questionnaire-30 item version. Young people on the autism spectrum differed significantly from typically developing young people on the emotional awareness measure. Young people on the autism spectrum who had attended cognitive behavioural therapy scored significantly lower on the Differentiating Emotions subscale, and significantly higher on the Attending to Others' Emotions subscale, compared to young people on the autism spectrum who had not attended cognitive behavioural therapy. This study highlights the importance of psycho-educational components of cognitive behavioural therapy when adapting for young people on the autism spectrum.

  7. Parent Involvement in CBT Treatment of Adolescent Depression: Experiences in the Treatment for Adolescents with Depression Study (TADS)

    Science.gov (United States)

    Wells, Karen C.; Albano, Anne Marie

    2005-01-01

    The Treatment for Adolescents With Depression Study (TADS) evaluated the short- and long-term effectiveness of cognitive behavior therapy (CBT) alone, fluoxetine alone, and their combination, relative to pill placebo, and the 12-week treatment effects were recently published (TADS Team, 2004). Results showed that treatment that combined CBT with…

  8. An exploration of attachment strategies among young people who engage in harmful sexual behaviour

    OpenAIRE

    Zaniewski, Bartosz

    2016-01-01

    Background: It is estimated that adolescent offenders account for 65% of contact child sexual abuse. A range of explanatory theories and models of intervention have been proposed. These are mainly based on cognitive theories with Cognitive Behavioural Therapy (CBT) and psycho-education remaining as the dominant models of treatment intervention. This research explored the issue of harmful sexual behaviour from the psychosocial perspective, drawing on attachment theory and social constructionis...

  9. Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis.

    Science.gov (United States)

    Pearl, Shaun B; Norton, Peter J

    2017-03-01

    Research evaluating transdiagnostic CBT (tCBT) demonstrates its efficacy. Some evidence suggests equivalence between tCBT and diagnosis-specific CBT (dxCBT), however more investigations are necessary to clarify any difference in efficacy. This meta-analysis was conducted to compare tCBT and dxCBT, and to investigate the differential impact of comorbidity on effect sizes. Pre and post scores from primary anxiety measures in 83 treatment conditions, taken from studies primarily targeting anxiety disorders, were summarised and compared. Meta-regression analyses were then used to test the effects of comorbidity. DxCBT and tCBT meta-effects were found to be large, where g=0.951, 95% CI: 0.874-1.027, and g=1.059, 95% CI: 0.876-1.242, respectively. While statistically different (p=0.008), overlap of confidence intervals indicated a lack of clinical significance. Furthermore, no relationship between comorbidity rate and tCBT outcome was observed. These results were discussed in the context of previous findings in the transdiagnostic CBT literature. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Specificity of the Codependent Behaviour and Some Models in the Therapy of Codependency

    Directory of Open Access Journals (Sweden)

    Desislava Ivanova

    2012-05-01

    Full Text Available This paper presents the specificity of the codependent behaviour, some models of therapeutical effect, their scientific validity and practicaleffectiveness. The focus is on the possibilities of motivational interviewing - one comparatively new therapy in the area of dependent behaviours with specific techniques, which are directed towards the act and the mobilization of the inner values and goals of the codependents, their resources for stimulating changes in behaviour and forming more effective coping strategies.

  11. A randomised controlled trial of recovery focused CBT for individuals with early bipolar disorder

    Directory of Open Access Journals (Sweden)

    Jones Steven

    2012-11-01

    Full Text Available Abstract Background There is increasing evidence for the effectiveness of structured psychological therapies for bipolar disorder. To date however there have been no psychological interventions specifically designed for individuals with early bipolar disorder. The primary objective of this trial is to establish the acceptability and feasibility of a new CBT based intervention (Recovery focused CBT; RfCBT designed in collaboration with individuals with early bipolar disorder intended to improve clinical and personal recovery outcomes. Methods and design This article describes a single blind randomised controlled trial to assess the feasibility and acceptability of RfCBT compared with treatment as usual. Participants will be recruited from across the North West of England from specialist mental health services and through primary care and self referral. The primary outcome of the study is the feasibility and acceptability of RfCBT as indicated by recruitment to target and retention to follow-up as well as absence of untoward incidents associated with RfCBT. We also intend to estimate the effect size of the impact of the intervention on recovery and mood outcomes and explore potential process measures (self appraisal, stigma, hope and self esteem. Discussion This is the first trial of recovery informed CBT for early bipolar disorder and will therefore be of interest to researchers in this area as well as indicating the wider potential for evaluating approaches to the recovery informed treatment of recent onset severe mental illness in general. Trial registration number ISRCTN43062149

  12. Changes in illness perceptions mediated the effect of cognitive behavioural therapy in severe functional somatic syndromes

    DEFF Research Database (Denmark)

    Christensen, Sara Sletten; Frostholm, Lisbeth; Ørnbøl, Eva

    2014-01-01

    . Methods We analysed additional data from a randomised controlled trial comparing completers of cognitive behavioural group therapy (46 patients) to an enhanced usual care group (66 patients). Proposed mediators (illness perceptions) and primary (physical health) and secondary (somatic symptoms and illness......Objective Although there is substantial evidence that cognitive behavioural therapy alleviates symptoms in functional somatic syndromes, the mechanisms of change are less investigated. This study examined whether changes in illness perceptions mediated the effect of cognitive behavioural therapy...... worry) outcomes were assessed by means of questionnaires at referral, baseline, end of treatment, and 10 and 16 months after randomisation. Multiple mediation analysis determined whether (1) changes in specific illness perceptions during treatment mediated the effect of cognitive behavioural therapy...

  13. Cost-effectiveness analysis of cognitive behaviour therapy for treatment of minor or mild-major depression in elderly patients with type 2 diabetes: study protocol for the economic evaluation alongside the MIND-DIA randomized controlled trial (MIND-DIA CEA

    Directory of Open Access Journals (Sweden)

    Müller Matthias J

    2009-07-01

    Full Text Available Abstract Background Depression and elevated depression symptoms are more prevalent in patients with type 2 diabetes than in those without diabetes and are associated with adverse health outcomes and increased total healthcare utilization. This suggests that more effective depression treatment might not only improve health outcome, but also reduce costs. However, there is a lack of evidence on (cost- effectiveness of treatment options for minor and mild-major depression in patients with type 2 diabetes. In this paper we describe the design and methods of the economic evaluation, which will be conducted alongside the MIND-DIA trial (Cognitive behaviour therapy in elderly type 2 diabetes patients with minor or mild-major depression. The objective of the economic evaluation (MIND-DIA CEA is to examine incremental cost-effectiveness of a diabetes specific cognitive behaviour group therapy (CBT as compared to intensified treatment as usual (TAU and to a guided self-help group intervention (SH. Methods/Design Patients will be followed for 15 months. During this period data on health sector costs, patient costs and societal productivity/time costs will be collected in addition to clinical data. Person-years free of moderate/severe major depression, quality adjusted life years (QALYs, and cumulative costs will be estimated for each arm of the trial (CBT, TAU and SH. To determine cost-effectiveness of the CBT, differences in costs and effects between the CBT group and TAU/SH group will be calculated. Discussion CBT is a potentially effective treatment option to improve quality of life and to avoid the onset of a moderate/severe major depression in elderly patients with type 2 diabetes and minor or mild-major depression. This hypothesis will be evaluated in the MIND-DIA trial. Based on these results the associated economic evaluation will provide additional evidence on the cost-effectiveness of CBT in this target population. Methodological strengths and

  14. Jay Haley's Invited address to the World Congress on Behaviour Therapy, Washington DC, 1983

    OpenAIRE

    Carr, Alan

    1984-01-01

    "Changes to a more sensible therapy" was the title of the paper Jay Haley presented to the 1983 World Congress on Behaviour Therapy. Haley began by pointing out that the idea of training mental health professionals to talk to patients, to change the patients' behaviour is relatively new. While the notion of healing by talking has been known to religious groups since early in our history, only recently has the phenomenon been subject to secular scrutiny.

  15. Treating enuresis in a patient with ADHD: application of a novel behavioural modification therapy

    OpenAIRE

    2014-01-01

    We report the case of a 6-year-old patient diagnosed with attention-deficit hyperactivity disorder (ADHD) and comorbid enuresis disorder, who was treated with methylphenidate for the past 3 months and a novel behavioural modification therapy by using an application called ‘Enuresis Trainer’. This therapeutic application is basically an interactive ‘Bedwetting Calendar’, based on traditional cognitive behavioural modification therapies and positive reinforcement systems. Enuresis is defined as...

  16. Implementing multifactorial psychotherapy research in online virtual environments (IMPROVE-2: study protocol for a phase III trial of the MOST randomized component selection method for internet cognitive-behavioural therapy for depression

    Directory of Open Access Journals (Sweden)

    Edward Watkins

    2016-10-01

    Full Text Available Abstract Background Depression is a global health challenge. Although there are effective psychological and pharmaceutical interventions, our best treatments achieve remission rates less than 1/3 and limited sustained recovery. Underpinning this efficacy gap is limited understanding of how complex psychological interventions for depression work. Recent reviews have argued that the active ingredients of therapy need to be identified so that therapy can be made briefer, more potent, and to improve scalability. This in turn requires the use of rigorous study designs that test the presence or absence of individual therapeutic elements, rather than standard comparative randomised controlled trials. One such approach is the Multiphase Optimization Strategy, which uses efficient experimentation such as factorial designs to identify active factors in complex interventions. This approach has been successfully applied to behavioural health but not yet to mental health interventions. Methods/Design A Phase III randomised, single-blind balanced fractional factorial trial, based in England and conducted on the internet, randomized at the level of the patient, will investigate the active ingredients of internet cognitive-behavioural therapy (CBT for depression. Adults with depression (operationalized as PHQ-9 score ≥ 10, recruited directly from the internet and from an UK National Health Service Improving Access to Psychological Therapies service, will be randomized across seven experimental factors, each reflecting the presence versus absence of specific treatment components (activity scheduling, functional analysis, thought challenging, relaxation, concreteness training, absorption, self-compassion training using a 32-condition balanced fractional factorial design (2IV 7-2. The primary outcome is symptoms of depression (PHQ-9 at 12 weeks. Secondary outcomes include symptoms of anxiety and process measures related to hypothesized mechanisms

  17. Treatment of residual insomnia after CBT for PTSD: case studies.

    Science.gov (United States)

    DeViva, Jason C; Zayfert, Claudia; Pigeon, Wilfred R; Mellman, Thomas A

    2005-04-01

    Insomnia is one of the most common symptoms of posttraumatic stress disorder (PTSD). Evidence suggests that insomnia may persist for many PTSD patients after other symptoms have responded to cognitive-behavioral therapy (CBT). The present article reports the effects of administering a five-session cognitive-behavioral insomnia treatment to 5 patients who responded to CBT for PTSD yet continued to report insomnia. Insomnia treatment was associated with improvements on subjective sleep measures (Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Beliefs and Attitudes about Sleep Scale) and self-monitored sleep efficiency and related measures in 4 of 5 cases. Results highlight issues specific to treating insomnia in trauma populations and future directions for examining treatment of insomnia associated with PTSD.

  18. Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed

    NARCIS (Netherlands)

    Blonk, R.W.B.; Brenninkmeijer, V.; Lagerveld, S.E.; Houtman, I.L.D.

    2006-01-01

    We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions

  19. The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder

    Science.gov (United States)

    Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Nixon, Reginald D. V.

    2005-01-01

    This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure,…

  20. The Effects of Transdiagnostic Group CBT for Anxiety on Insomnia Symptoms.

    Science.gov (United States)

    McGowan, Sarah Kate; Espejo, Emmanuel P; Balliett, Noelle; Werdowatz, Emily A

    2016-01-01

    Insomnia is a common feature among individuals with anxiety disorders. Studies of cognitive behavioral therapy (CBT) for anxiety report moderate effects on concomitant insomnia symptoms, but further research is still needed especially toward understanding how CBT for anxiety renders beneficial effects on insomnia. The current study examined changes in insomnia symptoms reported by 51 Veterans who participated in a group-based transdiagnostic CBT for anxiety intervention. In addition, insomnia symptoms were examined in relation to symptoms of general distress (GD), anhedonic depression (AD), and anxious arousal (AA) pre- to post-treatment. Results revealed a small, though statistically significant (p CBT for anxiety can be largely attributed to changes in AA.

  1. A randomized controlled effectiveness trial of cognitive behavior therapy for post-traumatic stress disorder in terrorist-affected people in Thailand.

    Science.gov (United States)

    Bryant, Richard A; Ekasawin, Suparat; Chakrabhand, Somchai; Suwanmitri, Soawaluk; Duangchun, Orawan; Chantaluckwong, Thananet

    2011-10-01

    Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), there is no evidence of its success with PTSD patients still under direct threat of terrorist attacks. This study reports the first randomized controlled trial of CBT for PTSD terrorist-affected people. Twenty-eight survivors of terrorist attacks in southern Thailand were randomized to 8 sessions of either CBT or treatment as usual (TAU). CBT was modified to accommodate the realistic threats facing patients. There were independent assessments conducted before, immediately after, and 3 months following treatment. Main outcome measures included symptoms of PTSD (PTSD Symptom Scale Interview), depression (Beck Depression Inventory) and complicated grief (Inventory of Complicated Grief). CBT resulted in significantly greater reduction in symptoms, including PTSD, depression, and complicated grief, at follow-up than TAU. Relative to TAU, CBT had stronger effect sizes at follow-up for PTSD, depression, and complicated grief. More patients in the CBT condition (75%) achieved high end-state functioning than participants in the TAU (33%). This preliminary evidence suggests that PTSD, depression, and complicated grief can be effectively treated despite ongoing threats of terrorism. Further, it demonstrates that non-specialist mental health workers in a non-western setting can be efficiently trained in using CBT, and this training can translate into successful treatment gains in trauma-affected individuals.

  2. A randomized controlled effectiveness trial of cognitive behavior therapy for post-traumatic stress disorder in terrorist-affected people in Thailand

    Science.gov (United States)

    BRYANT, RICHARD A.; EKASAWIN, SUPARAT; CHAKRABHAND, SOMCHAI; SUWANMITRI, SOAWALUK; DUANGCHUN, ORAWAN; CHANTALUCKWONG, THANANET

    2011-01-01

    Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), there is no evidence of its success with PTSD patients still under direct threat of terrorist attacks. This study reports the first randomized controlled trial of CBT for PTSD terrorist-affected people. Twenty-eight survivors of terrorist attacks in southern Thailand were randomized to 8 sessions of either CBT or treatment as usual (TAU). CBT was modified to accommodate the realistic threats facing patients. There were independent assessments conducted before, immediately after, and 3 months following treatment. Main outcome measures included symptoms of PTSD (PTSD Symptom Scale Interview), depression (Beck Depression Inventory) and complicated grief (Inventory of Complicated Grief). CBT resulted in significantly greater reduction in symptoms, including PTSD, depression, and complicated grief, at follow-up than TAU. Relative to TAU, CBT had stronger effect sizes at follow-up for PTSD, depression, and complicated grief. More patients in the CBT condition (75%) achieved high end-state functioning than participants in the TAU (33%). This preliminary evidence suggests that PTSD, depression, and complicated grief can be effectively treated despite ongoing threats of terrorism. Further, it demonstrates that non-specialist mental health workers in a non-western setting can be efficiently trained in using CBT, and this training can translate into successful treatment gains in trauma-affected individuals. PMID:21991280

  3. The Effect of an Attachment-Based Behaviour Therapy for Children with Visual and Severe Intellectual Disabilities

    Science.gov (United States)

    Sterkenburg, P. S.; Janssen, C. G. C.; Schuengel, C.

    2008-01-01

    Background: A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method: Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded…

  4. Comparison of brief dynamic and cognitive-behavioural therapies in avoidant personality disorder

    NARCIS (Netherlands)

    Emmelkamp, Paul M. G.; Benner, Ank; Kuipers, Antoinette; Feiertag, Guus A.; Koster, Harrie C.; van Apeldoorn, Franske J.

    2006-01-01

    Background There is a paucity of controlled trials examining the effectiveness of individual psychotherapy in personality disorders, especially in patients with cluster C disorders. Aims To compare the effectiveness of brief dynamic therapy and cognitive-behavioural therapy as out-patient treatment

  5. Effectiveness of Cognitive-Behavioral Therapy Modified for Inpatients with Depression

    Science.gov (United States)

    Page, Andrew C.; Hooke, Geoff R.

    2012-01-01

    The effectiveness among inpatients with depression of a modified cognitive behavior therapy (CBT) program was examined. A group of 300 inpatient admissions with a primary diagnosis of depression attending a private psychiatric clinic were assessed at the beginning and end of a two-week CBT program. The effectiveness of the treatment was demonstrated by improvements on the Beck depression inventory (BDI), the health of the nation outcome scales, locus of control of behaviour scale, and the global assessment of function. The changes on the BDI for patients with depression were benchmarked against estimates generated from published studies. The degree of change in a two-week period for inpatients with depression was similar to that observed in efficacy studies of CBT that typically run over a more extended time. Implications for integrating CBT with inpatient services are discussed. PMID:23738192

  6. Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression

    Directory of Open Access Journals (Sweden)

    Cape John

    2010-06-01

    Full Text Available Abstract Background Psychological therapies provided in primary care are usually briefer than in secondary care. There has been no recent comprehensive review comparing their effectiveness for common mental health problems. We aimed to compare the effectiveness of different types of brief psychological therapy administered within primary care across and between anxiety, depressive and mixed disorders. Methods Meta-analysis and meta-regression of randomized controlled trials of brief psychological therapies of adult patients with anxiety, depression or mixed common mental health problems treated in primary care compared to primary care treatment as usual. Results Thirty-four studies, involving 3962 patients, were included. Most were of brief cognitive behaviour therapy (CBT; n = 13, counselling (n = 8 or problem solving therapy (PST; n = 12. There was differential effectiveness between studies of CBT, with studies of CBT for anxiety disorders having a pooled effect size [d -1.06, 95% confidence interval (CI -1.31 to -0.80] greater than that of studies of CBT for depression (d -0.33, 95% CI -0.60 to -0.06 or studies of CBT for mixed anxiety and depression (d -0.26, 95% CI -0.44 to -0.08. Counselling for depression and mixed anxiety and depression (d -0.32, 95% CI -0.52 to -0.11 and problem solving therapy (PST for depression and mixed anxiety and depression (d -0.21, 95% CI -0.37 to -0.05 were also effective. Controlling for diagnosis, meta-regression found no difference between CBT, counselling and PST. Conclusions Brief CBT, counselling and PST are all effective treatments in primary care, but effect sizes are low compared to longer length treatments. The exception is brief CBT for anxiety, which has comparable effect sizes.

  7. Application of Cognitive Behavioral Therapies for Comorbid Insomnia and Depression.

    Science.gov (United States)

    Haynes, Patricia

    2015-03-01

    This article provides an overview of cognitive behavioral therapy (CBT) for insomnia and depression. Included is a discussion of how CBT for insomnia affects depression symptoms and how CBT for depression affects insomnia symptoms. The extant literature is reviewed on ways that depression/insomnia comorbidity moderates CBT response. The article concludes with an introduction to cognitive behavioral social rhythm therapy, a group therapy that integrates tenets of CBT for both disorders.

  8. A critical evaluation of the evidence supporting the practice of behavioural vision therapy.

    Science.gov (United States)

    Barrett, Brendan T

    2009-01-01

    In 2000, the UK's College of Optometrists commissioned a report to critically evaluate the theory and practice of behavioural optometry. The report which followed Jennings (2000; Behavioural optometry--a critical review. Optom. Pract. 1: 67) concluded that there was a lack of controlled clinical trials to support behavioural management strategies. The purpose of this report was to evaluate the evidence in support of behavioural approaches as it stands in 2008. The available evidence was reviewed under 10 headings, selected because they represent patient groups/conditions that behavioural optometrists are treating, or because they represent approaches to treatment that have been advocated in the behavioural literature. The headings selected were: (1) vision therapy for accommodation/vergence disorders; (2) the underachieving child; (3) prisms for near binocular disorders and for producing postural change; (4) near point stress and low-plus prescriptions; (5) use of low-plus lenses at near to slow the progression of myopia; (6) therapy to reduce myopia; (7) behavioural approaches to the treatment of strabismus and amblyopia; (8) training central and peripheral awareness and syntonics; (9) sports vision therapy; (10) neurological disorders and neuro-rehabilitation after trauma/stroke. There is a continued paucity of controlled trials in the literature to support behavioural optometry approaches. Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated.

  9. A clinical trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Altaye, Mekibib; Stevens, Jack; Teeters, Angelique R; Van Ginkel, Judith B

    2013-09-01

    Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3months postpartum were randomized into IH-CBT and ongoing home visitation (n=47) or standard home visitation (SHV; n=46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs. Copyright © 2013. Published by Elsevier Ltd.

  10. Dealing with Emotional Problems Using Rational-Emotive Cognitive Behaviour Therapy: A Client's Guide

    OpenAIRE

    Dryden, Windy

    2012-01-01

    Dealing with Emotional Problems offers clear, practical advice on how to deal with some of the most common emotional difficulties.\\ud \\ud Rational-Emotive Cognitive Behaviour Therapy (RECBT) is a technique that encourages a direct focus on emotional problems, helping you to understand the thoughts, beliefs and behaviours that cause you to maintain these problems. This understanding will enable you to overcome problems and lead a happier and more fulfilling life.\\ud \\ud The book begins by outl...

  11. The effect of parental involvement in CBT of anxious children: Preliminary results from a RCT study

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise;

    2011-01-01

    Esbjørn, B. H., Breinholst, S., Reinholdt-Dunne, M. L., & Leth, I. (2011). The effect of parental involvement in CBT of anxious children: Preliminary results from a RCT study. Poster accepted for the Association for Behavioral and Cognitive Therapies, Toronto, Canada.......Esbjørn, B. H., Breinholst, S., Reinholdt-Dunne, M. L., & Leth, I. (2011). The effect of parental involvement in CBT of anxious children: Preliminary results from a RCT study. Poster accepted for the Association for Behavioral and Cognitive Therapies, Toronto, Canada....

  12. Randomized controlled study of CBT in bronchial asthma

    Directory of Open Access Journals (Sweden)

    Grover Naveen

    2007-01-01

    Full Text Available The aim of the present study was to find out efficacy of cognitive behavior therapy, as an adjunct to standard pharmacotherapy, in bronchial asthma. In a random-ized two-group design with pre-and post assessments, forty asthma patients were randomly allotted to two groups: self management group and cognitive behavior therapy group. Both groups were exposed to 6-8 weeks of intervention, asthma self management program and cognitive behavior therapy. Assessment measures used were-Semi structured interview schedule, Asthma Symptom Checklist, Asthma di-ary, Asthma Bother Profile, Hospital Anxiety & Depression Scale, AQLQ and Peak Expiratory Flow Rate. Within group comparison showed significant improvement in both groups at the post assessment. Between group comparisons showed that CBT group reported significantly greater change than that of SM group. Cognitive behavior therapy helps in improving the managment of asthma.

  13. The efficacy of individual treatment of subjective tinnitus with cognitive behavioural therapy.

    Science.gov (United States)

    Canals, Pascual; Pérez Del Valle, Belén; Lopez, Francisco; Marco, Amparo

    2016-01-01

    It has been a long time since subjective tinnitus cases were described for the first time but they still lack a treatment with proven effectiveness. The main goal of this study was to evaluate the effectiveness of cognitive behavioural therapy in these patients. Between 2012 and 2013, 310 patients that suffered from subjective tinnitus were studied. Of these, 267 were included in treatment based on cognitive behavioural therapy. The monitoring period lasted 18 months for most cases, while it lasted 21 months for 11 patients. Considering patients that interrupted their treatment as failures, the percentage of recovery was 95.7%. Cognitive behavioural therapy should always be included in the treatment of people suffering from tinnitus. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  14. Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders

    NARCIS (Netherlands)

    Lester, K.J.; Roberts, S.; Keers, R.; Coleman, J.R.I.; Breen, G.; Wong, C.C.Y.; Xu, X.; Arendt, K.; Blatter-Meunier, J.; Bögels, S.M.; Cooper, P.; Creswell, C.; Heiervang, E.R.; Herren, C.; Hogendoorn, S.M.; Hudson, J.L.; Krause, K.; Lyneham, H.J.; McKinnon, A.; Morris, T.; Nauta, M.H.; Rapee, R.M.; Rey, Y.; Schneider, S.; Schneider, S.C.; Silverman, W.K.; Smith, P.; Thastum, M.; Thirlwall, K.; Waite, P.; Wergeland, G.J.; Eley, T.C.

    2015-01-01

    Background We previously reported an association between 5HTTLPR genotype and outcome following cognitive-behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results,

  15. Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders

    NARCIS (Netherlands)

    Lester, Kathryn J; Roberts, Susanna; Keers, Robert; Coleman, Jonathan R I; Breen, Gerome; Wong, Chloe C Y; Xu, Xiaohui; Arendt, Kristian; Blatter-Meunier, Judith; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Heiervang, Einar R; Herren, Chantal; Hogendoorn, Sanne M; Hudson, Jennifer L; Krause, Karen; Lyneham, Heidi J; McKinnon, Anna; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Rey, Yasmin; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Smith, Patrick; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Eley, Thalia C

    2016-01-01

    BackgroundWe previously reported an association between 5HTTLPR genotype and outcome following cognitive-behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results,

  16. Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders

    NARCIS (Netherlands)

    Lester, Kathryn J; Roberts, Susanna; Keers, Robert; Coleman, Jonathan R I; Breen, Gerome; Wong, Chloe C Y; Xu, Xiaohui; Arendt, Kristian; Blatter-Meunier, Judith; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Heiervang, Einar R; Herren, Chantal; Hogendoorn, Sanne M; Hudson, Jennifer L; Krause, Karen; Lyneham, Heidi J; McKinnon, Anna; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Rey, Yasmin; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Smith, Patrick; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Eley, Thalia C

    2016-01-01

    BackgroundWe previously reported an association between 5HTTLPR genotype and outcome following cognitive-behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, wi

  17. Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders

    NARCIS (Netherlands)

    Lester, K.J.; Roberts, S.; Keers, R.; Coleman, J.R.I.; Breen, G.; Wong, C.C.Y.; Xu, X.; Arendt, K.; Blatter-Meunier, J.; Bögels, S.M.; Cooper, P.; Creswell, C.; Heiervang, E.R.; Herren, C.; Hogendoorn, S.M.; Hudson, J.L.; Krause, K.; Lyneham, H.J.; McKinnon, A.; Morris, T.; Nauta, M.H.; Rapee, R.M.; Rey, Y.; Schneider, S.; Schneider, S.C.; Silverman, W.K.; Smith, P.; Thastum, M.; Thirlwall, K.; Waite, P.; Wergeland, G.J.; Eley, T.C.

    2015-01-01

    Background We previously reported an association between 5HTTLPR genotype and outcome following cognitive-behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, w

  18. Mindfulness-Based Cognitive Behaviour Therapy with Emotionally Disturbed Adolescents Affected by HIV/AIDS

    Science.gov (United States)

    Sinha, Uday K.; Kumar, Deepak

    2010-01-01

    Mindfulness-based approaches have been shown to be useful in a variety of physical and mental health conditions including chronic pain, cancer, psoriasis, eating disorders, anxiety and depression. Mindfulness based CBT finds its origins in Eastern Buddhist meditation which began many centuries ago. Recent studies on CBT with mindfulness have shown…

  19. Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial

    OpenAIRE

    Mann, Eleanor; Smith, Melanie J; Hellier, Jennifer; Balabanovic, Janet A; Hamed, Hisham; Grunfeld, Elizabeth A; Hunter, Myra S.

    2012-01-01

    Summary Background Hot flushes and night sweats (HFNS) affect 65–85% of women after breast cancer treatment; they are distressing, causing sleep problems and decreased quality of life. Hormone replacement therapy is often either undesirable or contraindicated. Safe, effective non-hormonal treatments are needed. We investigated whether cognitive behavioural therapy (CBT) can help breast cancer survivors to effectively manage HFNS. Methods In this randomised controlled trial, we recruited women...

  20. Internet-delivered cognitive-behavioural therapy v. conventional guided self-help for bulimia nervosa: long-term evaluation of a randomised controlled trial.

    Science.gov (United States)

    Wagner, Gudrun; Penelo, Eva; Wanner, Christian; Gwinner, Paulina; Trofaier, Marie-Louise; Imgart, Hartmut; Waldherr, Karin; Wöber-Bingöl, Ciçek; Karwautz, Andreas F K

    2013-02-01

    Cognitive-behavioural therapy (CBT)-based guided self-help is recommended as a first step in the treatment of bulimia nervosa. To evaluate in a randomised controlled trial (Clinicaltrials.gov registration number: NCT00461071) the long-term effectiveness of internet-based guided self-help (INT-GSH) compared with conventional guided bibliotherapy (BIB-GSH) in females with bulimia nervosa. A total of 155 participants were randomly assigned to INT-GSH or BIB-GSH for 7 months. Outcomes were assessed at baseline, month 4, month 7 and month 18. The greatest improvement was reported after 4 months with a continued reduction in eating disorder symptomatology reported at month 7 and 18. After 18 months, 14.6% (n = 7/48) of the participants in the INT-GSH group and 25% (n = 7/28) in the BIB-GSH group were abstinent from binge eating and compensatory measures, 43.8% (n = 21/48) and 39.2% (n = 11/28) respectively were in remission. No differences regarding outcome between the two groups were found. Internet-based guided self-help for bulimia nervosa was not superior compared with bibliotherapy, the gold standard of self-help. Improvements remain stable in the long term.

  1. Cognitive behaviour therapy and inflammation: A systematic review of its relationship and the potential implications for the treatment of depression.

    Science.gov (United States)

    Lopresti, Adrian L

    2017-06-01

    There is growing evidence confirming increased inflammation in a subset of adults with depression. The impact of this relationship has mostly been considered in biologically based interventions; however, it also has potential implications for psychological therapies. Cognitive behaviour therapy is the most commonly used psychological intervention for the treatment of depression with theories around its efficacy primarily based on psychological mechanisms. However, cognitive behaviour therapy may have an effect on, and its efficacy influenced by, physiological processes associated with depression. Accordingly, the purpose of this systematic review was to examine the relationship between cognitive behaviour therapy and inflammation. Studies examining the anti-inflammatory effects of cognitive behaviour therapy in people with depression and other medical conditions (e.g. cancer, diabetes and heart disease) were examined. In addition, the relationship between change in inflammatory markers and change in depressive symptoms following cognitive behaviour therapy, and the influence of pre-treatment inflammation on cognitive behaviour therapy treatment response were reviewed. A total of 23 studies investigating the anti-inflammatory effects of cognitive behaviour therapy were identified. In 14 of these studies, at least one reduction in an inflammatory marker was reported, increases were identified in three studies and no change was found in six studies. Three studies examined the relationship between change in inflammation and change in depressive symptoms following cognitive behaviour therapy. In two of these studies, change in depressive symptoms was associated with a change in at least one inflammatory marker. Finally, three studies examined the influence of pre-treatment inflammation on treatment outcome from cognitive behaviour therapy, and all indicated a poorer treatment response in people with higher premorbid inflammation. Preliminary evidence suggests

  2. Efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in Reducing Bullying Behaviour among in-School Adolescents in Ilorin, Nigeria

    Directory of Open Access Journals (Sweden)

    Yahaya Lasiele Alabi

    2015-01-01

    Full Text Available Bullying behaviour refers to repeated negative behaviour displayed by one or more person (s with the intention of hurting the feeling, personality and power of the victim. The objective of this study therefore was to find out the efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in reducing bullying behaviour among in-school adolescents in Ilorin, Nigeria. The study adopted the quasi-experimental research method using a 3×2 factorial design made up of three (3 row groups (two experimental and one control. Stratified random sampling technique was used to select three secondary schools on the basis of location to prevent experimental contamination. Self-report questionnaire was used to purposively select the participants. The primary dependent variable was bullying behaviour and respondents with high score on bullying items and low scores on victimisation items were selected to participate in the treatment. The findings revealed a significant reduction in the bullying behaviour of the in-school adolescents exposed to experimental treatments; Client-Centred Therapy (CCT produced significant reduction in the bullying behaviour among the in-school adolescents, and Rational-Emotive Behaviour Therapy (REBT produced significant reduction in the bullying behaviour of the in-school adolescents. It was recommended that CCT and REBT procedures should be employed in modifying bullying behaviours.

  3. The theories underpinning rational emotive behaviour therapy: where's the supportive evidence?

    Science.gov (United States)

    MacInnes, Douglas

    2004-08-01

    This paper examines the underlying theoretical philosophy of one of the most widely used cognitive behaviour therapies, rational emotive behaviour therapy. It examines whether two central theoretical principles are supported by research evidence: firstly, that irrational beliefs lead to dysfunctional emotions and inferences and that rational beliefs lead to functional emotions and inferences and, secondly, that demand beliefs are the primary core irrational belief. The established criteria for evaluating the efficacy of the theories are detailed and used to evaluate the strength of evidence supporting these two assumptions. The findings indicate there is limited evidence to support these theories. Copyright 2004 Elsevier Ltd.

  4. Changes in the self during cognitive behavioural therapy for social anxiety disorder: A systematic review.

    Science.gov (United States)

    Gregory, Bree; Peters, Lorna

    2017-03-01

    A consistent feature across cognitive-behavioural models of social anxiety disorder (SAD) is the central role of the self in the emergence and maintenance of the disorder. The strong emphasis placed on the self in these models and related empirical research has also been reflected in evidence-based treatments for the disorder. This systematic review provides an overview of the empirical literature investigating the role of self-related constructs (e.g., self-beliefs, self-images, self-focused attention) proposed in cognitive models of SAD, before examining how these constructs are modified during and following CBT for SAD. Forty-one studies met the inclusion criteria. Guided by Stopa's (2009a, b) model of self, most studies examined change in self-related content, followed by change in self-related processing. No study examined change in self-structure. Pre- to post-treatment reductions were observed in self-related thoughts and beliefs, self-esteem, self-schema, self-focused attention, and self-evaluation. Change in self-related constructs predicted and/or mediated social anxiety reduction, however relatively few studies examined this. Papers were limited by small sample sizes, failure to control for depression symptoms, lack of waitlist, and some measurement concerns. Future research directions are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. PO23 - Behavioural therapy via a video conference

    DEFF Research Database (Denmark)

    Grejsen, Judy; Aaslet, Lone; Debes, Nanette Marinette Monique Mol

    2016-01-01

    UNLABELLED: Theme: Therapy and technology Methods: Since December 2014, 10 patients have participated and finished the therapy. The first and last session took place at the Tourette clinic and sessions 2-11 were offered via video conference. Before and after BT, Yale Global Tics Severity Scale...... and PedsQl (Quality of Life) were used to assess the effectiveness of BT. We compared these patients with 10 patients with traditional BT. RESULTS: Both in the group with video conference BT and in the group with traditional BT, we found a decrease in motor, vocal, and total tics and global severity score...

  6. What predicts outcome, response, and drop-out in CBT of depressive adults? a naturalistic study.

    Science.gov (United States)

    Schindler, Amrei; Hiller, Wolfgang; Witthöft, Michael

    2013-05-01

    The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT. 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment. Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.

  7. The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa - a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schauenburg Henning

    2009-04-01

    Full Text Available Abstract Background Anorexia nervosa is a serious eating disorder leading to high morbidity and mortality as a result of both malnutrition and suicide. The seriousness of the disorder requires extensive knowledge of effective treatment options. However, evidence for treatment efficacy in this area is remarkably weak. A recent Cochrane review states that there is an urgent need for large, well-designed treatment studies for patients with anorexia nervosa. The aim of this particular multi-centre study is to evaluate the efficacy of two standardized outpatient treatments for patients with anorexia nervosa: focal psychodynamic (FPT and cognitive behavioural therapy (CBT. Each therapeutic approach is compared to a "treatment-as-usual" control group. Methods/Design 237 patients meeting eligibility criteria are randomly and evenly assigned to the three groups – two intervention groups (CBT and FPT and one control group. The treatment period for each intervention group is 10 months, consisting of 40 sessions respectively. Body weight, eating disorder related symptoms, and variables of therapeutic alliance are measured during the course of treatment. Psychotherapy sessions are audiotaped for adherence monitoring. The treatment in the control group, both the dosage and type of therapy, is not regulated in the study protocol, but rather reflects the current practice of established outpatient care. The primary outcome measure is the body mass index (BMI at the end of the treatment (10 months after randomization. Discussion The study design surmounts the disadvantages of previous studies in that it provides a randomized controlled design, a large sample size, adequate inclusion criteria, an adequate treatment protocol, and a clear separation of the treatment conditions in order to avoid contamination. Nevertheless, the study has to deal with difficulties specific to the psychopathology of anorexia nervosa. The treatment protocol allows for dealing with the

  8. The Effects of Improvisational Music Therapy on Joint Attention Behaviours in Children with Autistic Spectrum Disorder

    DEFF Research Database (Denmark)

    Kim, Jinah

    2006-01-01

    into unstructured and structured parts. There were four different types of dependent measurements; the Pervasive Developmental Disorder Behavior Inventory (PDDBI), the Early Social Communication Scales (ESCS), the Mother Play Intervention Profile (MPIP) and DVD analyses of selected session data. 10 children, all......This research investigated the effects of improvisational music therapy on joint attention behaviours in children with autistic spectrum disorder. The study was designed to look at these behaviours in two different conditions, improvisational music therapy and free play, and use both standardized...... male, age between 3-6 year old, with clear diagnoses of autistic spectrum disorder completed the trial. The overall results from the PDDBI, the ESCS and session analysis were generally in favour of music therapy over free play, indicating improvisational music therapy was more effective at improving...

  9. A single blind randomized controlled trial of cognitive behavioural therapy in a help-seeking population with an At Risk Mental State for psychosis: the Dutch Early Detection and Intervention Evaluation (EDIE-NL trial

    Directory of Open Access Journals (Sweden)

    Delespaul Philippe

    2010-03-01

    Full Text Available Abstract Background Psychotic disorders are a serious mental health problem. Intervention before the onset of psychosis might result in delaying the onset, reducing the impact or even preventing the first episode of psychosis. This study explores the effectiveness of cognitive behavioural therapy (CBT in targeting cognitive biases that are involved in the formation of delusions in persons with an ultra-high risk for developing psychosis. A single blind randomised controlled trial compares CBT with treatment as usual in preventing or delaying the onset of psychosis. Method/design All help seeking patients aged 14 to 35 years referred to the mental health services in three regions in the Netherlands are pre-screened with the Prodromal Questionnaire during a period of two years. Patients with a score of 18 or more on the sub-clinical positive symptoms items (45 items in total will be assessed with the Comprehensive Assessment of At Risk Mental State (CAARMS. In a different pathway to care model all referrals from the mental health services in Amsterdam to the specialized psychosis clinic of the Academic Medical Centre in Amsterdam are also assessed with the CAARMS. The primary outcome is the transition rate to psychosis according to the CAARMS-criteria. Group differences will be analysed with chi-square tests and survival analyses. Discussion CBT is a highly tolerated treatment. The psycho-educational CBT approach may prove to be a successful strategy since most people with an At Risk Mental State (ARMS are distressed by odd disturbing experiences. Giving explanations for and normalising these experiences may reduce the arousal (distress and therefore may prevent people from developing a catastrophic delusional explanation for their odd experiences and thus prevent them from developing psychosis. Screening the entire help-seeking population referred to community mental health services with a two-stage strategy, as compared with traditional referral

  10. The efficacy of a brief group CBT program in treating patients diagnosed with bulimia nervosa: a brief report.

    Science.gov (United States)

    Jones, Allan; Clausen, Loa

    2013-09-01

    The aim of the study was to evaluate the efficacy of a brief group cognitive behavior therapy (CBT) program in treating a large cohort of patients diagnosed with bulimia nervosa. Treatment outcome defined as reductions in bulimia related behavioral symptoms and bulimia related distress was examined in 205 consecutive new patients enrolled in an eight-session group CBT program. Significant reductions in eating disorder pathology were found on all measures of bulimia related behavioral symptoms, as well as on all measures of bulimia related distress. There is strong evidence for the efficacy of brief group CBT in treating patients with bulimia nervosa. © 2013 Wiley Periodicals, Inc.

  11. The efficacy of a brief group CBT program in treating patients diagnosed with bulimia nervosa: a brief report

    DEFF Research Database (Denmark)

    Jones, A.; Clausen, Loa

    2013-01-01

    OBJECTIVE: The aim of the study was to evaluate the efficacy of a brief group cognitive behavior therapy (CBT) program in treating a large cohort of patients diagnosed with bulimia nervosa. METHOD: Treatment outcome defined as reductions in bulimia related behavioral symptoms and bulimia related...... distress was examined in 205 consecutive new patients enrolled in an eight-session group CBT program. RESULTS: Significant reductions in eating disorder pathology were found on all measures of bulimia related behavioral symptoms, as well as on all measures of bulimia related distress. DISCUSSION......: There is strong evidence for the efficacy of brief group CBT in treating patients with bulimia nervosa....

  12. A Critical Review of Negative Affect and the Application of CBT for PTSD.

    Science.gov (United States)

    Brown, Wilson J; Dewey, Daniel; Bunnell, Brian E; Boyd, Stephen J; Wilkerson, Allison K; Mitchell, Melissa A; Bruce, Steven E

    2016-06-14

    Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.

  13. Cognitive Behaviour Therapies and Their Implications for Applied Educational Psychology Practice

    Science.gov (United States)

    Rait, Shami; Monsen, Jeremy J.; Squires, Garry

    2010-01-01

    This paper critically considers the growing interest in the use of Cognitive Behaviour Therapies to support children and young people presenting with a wide range of social-emotional difficulties. This focus has emerged since the prevalence of such difficulties in children and young people has increased over the past four decades, and the…

  14. Benefits of music therapy on behaviour disorders in subjects diagnosed with dementia: a systematic review.

    Science.gov (United States)

    Gómez-Romero, M; Jiménez-Palomares, M; Rodríguez-Mansilla, J; Flores-Nieto, A; Garrido-Ardila, E M; González López-Arza, M V

    2017-05-01

    Dementia is characterised by cognitive deterioration and the manifestation of psychological and behavioural symptoms, especially changes in perception, thought content, mood, and conduct. In addition to drug therapy, non-pharmacological treatments are used to manage these symptoms, and one of these latter treatments is music therapy. Since this novel technique in non-verbal, it can be used to treat patients with dementia at any stage, even when cognitive deterioration is very severe. Patients' responses to music are conserved even in the most advanced stages of the disease DEVELOPMENT: A literature research was carried out using the following databases: Academic Search Complete, PubMed, Science Direct y Dialnet. The period of publication was 2003 to 2013 and the search keywords were 'Music Therapy, Dementia, Behaviour, Behaviour Disorders y Behavioural Disturbances'. Out of the 2188 studies that were identified, 11 studies met inclusion criteria for the systematic review. Music therapy is beneficial and improves behavior disorders, anxiety and agitation in subjects diagnosed with dementia. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Cognitive Behaviour Therapies and Their Implications for Applied Educational Psychology Practice

    Science.gov (United States)

    Rait, Shami; Monsen, Jeremy J.; Squires, Garry

    2010-01-01

    This paper critically considers the growing interest in the use of Cognitive Behaviour Therapies to support children and young people presenting with a wide range of social-emotional difficulties. This focus has emerged since the prevalence of such difficulties in children and young people has increased over the past four decades, and the…

  16. Fostering Emotional Adjustment among Nigerian Adolescents with Rational Emotive Behaviour Therapy

    Science.gov (United States)

    Adomeh, Ilu O. C.

    2006-01-01

    This study examined the efficacy of Albert Ellis' Rational Emotive Behaviour Therapy (REBT) in fostering emotional adjustment among Nigerian adolescents. Fifty senior secondary school students were randomly selected and divided equally into experimental and control groups. The experimental group was treated with REBT twice a week for six weeks.…

  17. Predictors of outcome for cognitive behaviour therapy in binge eating disorder

    NARCIS (Netherlands)

    Lammers, M.W.; Vroling, M.S.; Ouwens, M.A.; Engels, R.C.M.E.; Strien, T. van

    2015-01-01

    The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N=304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6months later (N=190). We asse

  18. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.; Smits, P; Geurts, A.C.H.; Heugten, C.M. van; Fasotti, L.

    2015-01-01

    AIM: Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. METHOD OF PROTOCOL DEVELOPMENT: This intervention was based on cognitive behavioural therapy principles and was

  19. An augmented cognitive behavioural therapy for treating post-stroke depression: Description of a treatment protocol

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.C.; Smits, P.; Geurts, A.C.H.; Heugten, C.M. van; Fasotti, L.

    2015-01-01

    Aim Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. Method of protocol development This intervention was based on cognitive behavioural therapy principles and was sh

  20. Parent-Child Interaction Therapy for Child Disruptive Behaviour Disorders: A Meta-Analysis

    Science.gov (United States)

    Ward, Michelle A.; Theule, Jennifer; Cheung, Kristene

    2016-01-01

    Background: Numerous studies have looked at the efficacy of Parent-Child Interaction Therapy (PCIT) for young children with externalizing behaviour problems. Objective: The present study compiled these results through a comprehensive review to provide greater clarity regarding the efficacy of this treatment. Methods: Using a random effects model,…

  1. Managing resistance in cognitive behavioural therapy: the application of motivational interviewing in mixed anxiety and depression.

    Science.gov (United States)

    Westra, Henny A

    2004-01-01

    While cognitive behavioural therapy is highly effective in the treatment of anxiety and depression, a substantive number of individuals either refuse treatment, fail to respond to treatment or respond only partially. Arguably, ambivalence about change or about engaging in treatment tasks may in part be related to incomplete recovery rates in cognitive behavioural therapy. Motivational interviewing is a client-centred, directive treatment originally developed in the addictions domain whose goal is to enhance motivation for change by understanding and resolving ambivalence. This method has consistently received support for enhancing outcomes in the addictions domain, particularly when used as an adjunct to further treatment. As yet, motivational methods have not been generalized to the treatment of prevalent mental health problems, such as anxiety and depression. The present paper presents the application of a treatment targeting motivation (motivational interviewing adapted for anxiety and depression) to the management of resistance in cognitive behavioural therapy for 3 clients with mixed anxiety and depression. Motivational interviewing is conceived as an adjunct to highly effective traditional cognitive behavioural therapy methods, which is indicated for use with clients resistant to and significantly ambivalent about change-based techniques for managing anxiety or alleviating depression.

  2. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.C.; Smits, P.; Geurts, A.C.H.; Heugten, C.M. van; Fasotti, L.

    2015-01-01

    Aim Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. Method of protocol development This intervention was based on cognitive behavioural therapy principles and was

  3. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.; Smits, P; Geurts, A.C.H.; Heugten, C.M. van; Fasotti, L.

    2015-01-01

    AIM: Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. METHOD OF PROTOCOL DEVELOPMENT: This intervention was based on cognitive behavioural therapy principles and was

  4. Parent–child interaction therapy for preschool children with disruptive behaviour problems in the Netherlands

    Directory of Open Access Journals (Sweden)

    Abrahamse Mariëlle E

    2012-06-01

    Full Text Available Abstract Background Persistent high levels of aggressive, oppositional and impulsive behaviours, in the early lives of children, are significant risk factors for adolescent and adult antisocial behaviour and criminal activity. If the disruptive behavioural problems of young children could be prevented or significantly reduced at an early age, the trajectory of these behavioural problems leading to adolescent delinquency and adult antisocial behaviour could be corrected. Parent–Child Interaction Therapy (PCIT is a short-term, evidence-based, training intervention for parents dealing with preschool children, who exhibit behavioural problems. Recently, PCIT was implemented in a Dutch community mental health setting. This present study aims to examine the short-term effects of PCIT on reducing the frequency of disruptive behaviour in young children. Methods This study is based on the data of 37 referred families. Whereby the results of which are derived from an analysis of parent reports of the Eyberg Child Behavior Inventory (ECBI, obtained during each therapeutic session. Furthermore, demographic information, extracted from client files, was also utilized. However, it must be noted that eleven families (27.5% dropped out of treatment before the treatment protocol was completed. To investigate the development of disruptive behaviour, a non-clinical comparison group was recruited from primary schools (N = 59. Results The results of this study indicate that PCIT significantly reduces disruptive behaviour in children. Large effect sizes were found for both fathers and mothers reported problems (d = 1.88, d = 1.99, respectively, which is similar to American outcome studies. At post treatment, no differences were found concerning the frequency of behavioural problems of children who completed treatment and those who participated in the non-clinical comparison group. Conclusion The findings of this study suggest that PCIT is potentially an

  5. A Randomised Controlled Comparison of Second-Level Treatment Approaches for Treatment-Resistant Adults with Bulimia Nervosa and Binge Eating Disorder: Assessing the Benefits of Virtual Reality Cue Exposure Therapy.

    Science.gov (United States)

    Ferrer-García, Marta; Gutiérrez-Maldonado, José; Pla-Sanjuanelo, Joana; Vilalta-Abella, Ferran; Riva, Giuseppe; Clerici, Massimo; Ribas-Sabaté, Joan; Andreu-Gracia, Alexis; Fernandez-Aranda, Fernando; Forcano, Laura; Riesco, Nadine; Sánchez, Isabel; Escandón-Nagel, Neli; Gomez-Tricio, Osane; Tena, Virginia; Dakanalis, Antonios

    2017-08-14

    A question that arises from the literature on therapy is whether second-level treatment is effective for patients with recurrent binge eating who fail first-level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive-behavioural treatment (CBT) programme benefit from additional CBT (A-CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e.g. urge to binge in response to a cue and anxiety experienced in the presence of binge-related cues). We assessed the effectiveness of virtual reality-CET as a second-level treatment strategy for 64 patients with bulimia nervosa and binge eating disorder who had been treated with limited results after using a structured CBT programme, in comparison with A-CBT. The significant differences observed between the two groups at post-treatment in dimensional (behavioural and attitudinal features, anxiety, food craving) and categorical (abstinence rates) outcomes highlighted the superiority of virtual reality-CET over A-CBT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  6. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2015-10-01

    are ongoing  IRB approval has been sought and obtained for all necessary modifications , and continuing review approval was obtained  The study was...competence, therapy quality, and therapist training. Behaviour Research and Therapy, 49, 373-378. Meichenbaum, D. (1985). Stress inoculation...settings: A high priority focus area. Behaviour Research and Therapy, 47, 980-989. Ruzek, J. I., Rosen, R. C., Marceau, L., Larson, M. J., Garvert, D. W

  7. A Randomized Controlled Trial of Online versus Clinic-Based CBT for Adolescent Anxiety

    Science.gov (United States)

    Spence, Susan H.; Donovan, Caroline L.; March, Sonja; Gamble, Amanda; Anderson, Renee E.; Prosser, Samantha; Kenardy, Justin

    2011-01-01

    Objective: The study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents. Method: Participants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or…

  8. Cbt for anxiety disorders in children with and without autism spectrum disorders

    NARCIS (Netherlands)

    van Steensel, F.J.A.; Bögels, S.M.

    2015-01-01

    Objective: The effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders in children with autism spectrum disorders (ASD) was examined, and compared with children without ASD. Method: Children with ASD and comorbid anxiety disorders (n = 79, 58 boys; Mage = 11.76) and children with a

  9. Types of parental involvement in CBT with anxious youth : A preliminary meta-analysis

    NARCIS (Netherlands)

    Manassis, Katharina; Lee, Trevor Changgun; Bennett, Kathryn; Zhao, Xiu Yan; Mendlowitz, Sandra; Duda, Stephanie; Saini, Michael; Wilansky, Pamela; Baer, Susan; Barrett, Paula; Bodden, Denise; Cobham, Vanessa E; Dadds, Mark R; Flannery-Schroeder, Ellen; Ginsburg, Golda; Heyne, David; Hudson, Jennifer L; Kendall, Philip C; Liber, Juliette; Masia-Warner, Carrie; Nauta, Maaike H; Rapee, Ronald M; Silverman, Wendy; Siqueland, Lynne; Spence, Susan H; Utens, Elisabeth; Wood, Jeffrey J

    2014-01-01

    OBJECTIVE: Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingen

  10. Cbt for anxiety disorders in children with and without autism spectrum disorders

    NARCIS (Netherlands)

    van Steensel, F.J.A.; Bögels, S.M.

    2015-01-01

    Objective: The effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders in children with autism spectrum disorders (ASD) was examined, and compared with children without ASD. Method: Children with ASD and comorbid anxiety disorders (n = 79, 58 boys; Mage = 11.76) and children with

  11. Cognitive-behavioural therapy and recovery of a delusional dysmorphophobia case.

    Science.gov (United States)

    Cuevas-Yust, Carlos; Delgado-Ríos, Patricia; Escudero-Pérez, Silvia

    2017-02-01

    We present the application of cognitive-behavioural therapy in a clinical case diagnosed with delusional dysmorphophobia. The psychometric scales used for evaluation were the Positive and Negative Syndrome Scale for Schizophrenia, Beck Anxiety and Depression inventories, the Rosenberg Self-Esteem Scale along with the degree of conviction in the delusional belief and in alternative explanations, and social functioning measured by patient reporting. The therapy included cognitive and behavioural techniques: evidence analysis, search for alternative explanations, logical and functional analysis, reality testing, progressive relaxation techniques, in vivo and imaginal exposure therapy. Evaluations were performed before and after the treatment and then at follow-up after 12 and 24 months. Progressively, the delusional conviction disappeared. There were significant improvements at an emotional level and the patient recovered social and work  functioning. The need to use psychological treatments for people with delusional disorder as first choice treatment must be considered.

  12. Service user experience of adapted dialectical behaviour therapy in a community adult mental health setting.

    Science.gov (United States)

    McSherry, Pamela; O'Connor, Caroline; Hevey, David; Gibbons, Pat

    2012-12-01

    Dialectical behaviour therapy (DBT), a skill-based cognitive behavioural treatment, is increasingly used in the treatment of borderline personality disorder (BPD). The study examined service users' perspective on the effectiveness of an adapted DBT programme, delivered within a community adult mental health setting. Semi-structured interviews and focus groups were conducted with eight participants with a diagnosis of BPD about their experience of the programme. Thematic analysis focused on two key themes: evaluation of therapy and treatment impact. Therapy-specific factors and personal challenges emerged as important themes. Treatment impact raised issues relating to a renewed sense of identity and changes in daily life. The study describes the positive and negative experiences of service users with BPD attending an adapted DBT programme.

  13. [Cognitive behavior therapy].

    Science.gov (United States)

    Munezawa, Takeshi

    2009-08-01

    Insomnia is one of the most frequently encountered disorders in general clinical practices. At present, the most commonly used therapy for insomnia is pharmacotherapy. There are some problems in pharmacotherapy such as side effects. Therefore nonpharmacological therapy for insomnia is needed. The cognitive behavior therapy for insomnia (CBT-I) is a nonpharmacological therapy attracting attention most. CBT-I not only alleviates insomnia symptoms in patients but also enables them to reduce/discontinue the use of hypnotics. I reviewed a study about the effectiveness of CBT-I and commented the future directions of CBT-I.

  14. Group cognitive behavioural treatment for insomnia in primary care: a randomized controlled trial.

    Science.gov (United States)

    Cape, J; Leibowitz, J; Whittington, C; Espie, C A; Pilling, S

    2016-04-01

    Insomnia disorder is common and often co-morbid with mental health conditions. Cognitive behavioural therapy (CBT) for insomnia is effective, but is rarely implemented as a discrete treatment. The aim of this study was to evaluate the effectiveness of brief CBT groups for insomnia compared to treatment as usual (TAU) for insomnia delivered by mental health practitioners in a primary-care mental health service. A total of 239 participants were randomized to either a five-session CBT group or to TAU. Assessments of sleep and of symptoms of depression and anxiety were carried out at baseline, post-treatment and at 20 weeks. Primary outcome was sleep efficiency post-treatment. Group CBT participants had better sleep outcomes post-treatment than those receiving TAU [sleep efficiency standardized mean difference 0.63, 95% confidence interval (CI) 0.34-0.92]. The effect at 20 weeks was smaller with a wide confidence interval (0.27, 95% CI -0.03 to 0.56). There were no important differences between groups at either follow-up period in symptoms of anxiety or depression. Dedicated CBT group treatment for insomnia improves sleep more than treating sleep as an adjunct to other mental health treatment.

  15. The discrepancy between subjective and objective measures of sleep in older adults receiving CBT for comorbid insomnia.

    Science.gov (United States)

    Lund, Hannah G; Rybarczyk, Bruce D; Perrin, Paul B; Leszczyszyn, David; Stepanski, Edward

    2013-10-01

    To examine the effect of cognitive-behavioral therapy for insomnia (CBT-I) on the underreporting of sleep relative to objective measurement, a common occurrence among individuals with insomnia. Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia. The self-report data were published previously in a randomized controlled trial demonstrating the efficacy of CBT-I compared with a placebo treatment. Self-report measures significantly underestimated sleep at pre-treatment and CBT-I led to a correction in this discrepancy. There were no significant changes in PSG after CBT-I. Path analysis showed that an increase in an objective proxy measure of sleep quality (i.e., decreased stage N1 sleep) after CBT-I was significantly related to improvements in self-report of sleep, with full mediation by reductions in discrepancy. This is the first CBT-I outcome study to analyze discrepancy changes and demonstrate that these changes account for a significant portion of self-report outcome. In addition, improved sleep quality as measured by a decrease in percentage of stage N1 sleep following treatment may be one mechanism that explains why sleep estimation is more accurate following CBT-I. © 2012 Wiley Periodicals, Inc.

  16. Rational Emotive Behavioural Therapy: The Evolution of a Revolution

    Science.gov (United States)

    Ellis, Debbie Joffe; Rovira, Montse

    2015-01-01

    Recognized as one of the most influential thinkers and psychologists, Albert Ellis PhD (1913-2007) revolutionized Psychology when he created the first cognitive psychotherapy, Rational Emotive Behavioral Therapy. After he passed away, Dr. Debbie Joffe Ellis continues spreading his legacy around the world. Psychologist, lecturer, writer, trainer, she dedicates her life to disseminate REBT and extend it through different statements, from the social to the educational, from the academic to the clinical. In this interview, she goes through her own history and her husband’s one, bringing us closer to understanding Albert Ellis as the leading figure in his field, and the oneness they experienced through their professional and personal relationship. PMID:27247638

  17. Rational Emotive Behavioural Therapy: The Evolution of a Revolution

    Directory of Open Access Journals (Sweden)

    Debbie Joffe Ellis

    2015-02-01

    Full Text Available Recognized as one of the most influential thinkers and psychologists, Albert Ellis PhD (1913-2007 revolutionized Psychology when he created the first cognitive psychotherapy, Rational Emotive Behavioral Therapy. After he passed away, Dr. Debbie Joffe Ellis continues spreading his legacy around the world. Psychologist, lecturer, writer, trainer, she dedicates her life to disseminate REBT and extend it through different statements, from the social to the educational, from the academic to the clinical. In this interview, she goes through her own history and her husband’s one, bringing us closer to understanding Albert Ellis as the leading figure in his field, and the oneness they experienced through their professional and personal relationship.

  18. Effectiveness of a CBT Intervention for Persistent Insomnia and Hypnotic Dependency in an Outpatient Psychiatry Clinic.

    Science.gov (United States)

    Taylor, Hannah Lund; Rybarczyk, Bruce D; Nay, William; Leszczyszyn, David

    2015-07-01

    To test cognitive-behavioral therapy for insomnia (CBT-I) in patients who not only receive psychiatric treatment in a outpatient psychiatry clinic but also continue to experience chronic insomnia despite receiving pharmacological treatment for sleep. CBT-I included an optional module for discontinuing hypnotic medications. Patients were randomized to 5 sessions of individual CBT-I (n = 13) or treatment as usual (n = 10). Sleep parameters were assessed using sleep diaries at pre- and posttreatment. Questionnaires measuring depression, anxiety, and health-related quality of life were also administered. CBT-I was associated with significant improvement in sleep, with 46% obtaining normal global sleep ratings after treatment. However, no changes in secondary outcomes (depression, anxiety, quality of life) were obtained and no patients elected to discontinue their hypnotic medications. Patients with complex, chronic psychiatric conditions can obtain sleep improvements with CBT-I beyond those obtained with pharmacotherapy alone; however, sleep interventions alone may not have the same effect on mental health outcomes in samples with more severe and chronic psychiatric symptoms and dependency on hypnotic medications. © 2015 Wiley Periodicals, Inc.

  19. An open trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Stevens, Jack; Bosse, Nicole R; Short, Jodie A; Bodley, Amy L; Van Ginkel, Judith B

    2011-11-01

    Research has demonstrated that low income mothers participating in home visitation programs have high rates of depression. This study used an open trial design to evaluate In-Home Cognitive Behavioral Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. 64 depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. There was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study. Public health implications for home visiting programs are discussed.

  20. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol.

    Science.gov (United States)

    Kootker, Joyce A; Rasquin, Sascha M C; Smits, Peter; Geurts, Alexander C; van Heugten, Caroline M; Fasotti, Luciano

    2015-09-01

    Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. This intervention was based on cognitive behavioural therapy principles and was shown feasible in a pilot study. In order to meet the specific needs of stroke patients (concerning both sensori-motor, cognitive, and behavioural problems), we incorporated motivational interviewing, grief resolution, and psycho-education. We emphasised for each session to take into account the cognitive deficits of the patients (i.e. be concrete, accessible, structured, specific, and repeat information). Moreover, we augmented the psychologist-administered therapy with the contribution of an occupational or movement therapist aimed at facilitating patients' goal-setting and attainment. The intervention consisted of 12 one-hour sessions with a psychologist and three or four one-hour sessions with an occupational or movement therapist. Currently, the effectiveness of the intervention is evaluated in a randomised controlled trial. The proposed psychological treatment protocol is innovative, as it applies cognitive behavioural therapy in a stroke-specific manner; moreover, it supports goal attainment by incorporating occupational or movement therapy sessions. © The Author(s) 2014.

  1. Psychosocial interventions as adjunct therapy for patients with rheumatoid arthritis: a systematic review.

    Science.gov (United States)

    Dissanayake, Rukmal Kumari; Bertouch, James V

    2010-10-01

    To identify the psychological interventions for which there is consistent, high quality evidence of efficacy in the treatment of patients with rheumatoid arthritis (RA). A computer-aided search and manual screening of identified papers was conducted. Randomised controlled trials published in English in peer-reviewed journals, assessing the use of psychological interventions in adult patients with RA were included. Thirty-four papers published between 1981 and 2009 encompassing 31 studies with 2021 patients were included. There is consistent supportive evidence for the efficacy of disclosure therapy (four studies) and cognitive behavioural therapy (CBT) with maintenance therapy (five studies). There is supportive evidence for improvement with CBT of greater than 6 weeks duration (six studies) in the short-term but conflicting evidence for its long-term efficacy. There is some evidence for improvement with biofeedback-based interventions (two studies). There is conflicting evidence for the benefits of counselling (three studies), psychotherapy (two studies) mindfulness and meditation (two studies), and CBT of less than 6 weeks duration (six studies). There is limited evidence regarding relaxation therapy (two studies). Methodological limitations of the reviewed literature included failure of allocation concealment, blinding and conduction of intention-to-treat analysis, as well as the heterogeneity and choice of outcome measures. This review shows consistent supportive evidence for the use of disclosure therapy, and CBT with maintenance therapy as adjunct therapies in patients with RA. It also highlights methodological limitations in the current literature and the need for future research in this area.

  2. Cognitive behavioural therapy and mindfulness for stress and burnout: a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions.

    Science.gov (United States)

    Anclair, Malin; Lappalainen, Raimo; Muotka, Joona; Hiltunen, Arto J

    2017-08-29

    Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions. After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9). Both interventions decreased significantly stress and burnout. The within-group effect sizes were large in both interventions (CBT, g = 1.28-1.64; MF, g = 1.25-2.20). Hence, the results of this pilot study show that treating a group using either CBT or mindfulness can be an efficient intervention for reducing stress levels and burnout in parents of children with chronic conditions. © 2017 Nordic College of Caring Science.

  3. Treatment of child anxiety: an exploratory study of the role of maternal anxiety and behaviours in treatment outcome.

    Science.gov (United States)

    Creswell, Cathy; Willetts, Lucy; Murray, Lynne; Singhal, Meghna; Cooper, Peter

    2008-01-01

    Anxiety disorders are common among parents of anxious children and have been found to impede child treatment outcomes, yet it is unclear whether it is parental anxiety that needs to be targeted in therapy or associated parental behaviours. Twenty-two children (6-12 years) with a current anxiety disorder and their mothers received cognitive-behavioural treatment (CBT) for child anxiety. In addition, of the 12 mothers who met criteria for a current anxiety disorder, 6 received CBT for their own disorder. Assessments were made of the mother-child interaction. The main findings were: (1) children did less well from treatment where their mothers had a current anxiety disorder; (2) treatment of maternal anxiety disorder did not improve child treatment outcome; and (3) maternal overinvolvement and expression of fear was associated with child treatment outcome. The results suggest that in the context of maternal anxiety disorder, child treatment outcome may be improved by specifically targeting parenting behaviours.

  4. Does motivational interviewing improve retention or outcome in cognitive behaviour therapy for overweight and obese adolescents?

    Science.gov (United States)

    Brennan, Leah

    2016-01-01

    This study aimed to determine whether motivational interviewing improved retention and/or outcome in cognitive behaviour therapy for overweight and obese adolescents (M=14.4, SD=2.0; 52% female). The first 23 participants were allocated to a standard semi-structure assessment interview, the remaining 19 to a motivational interview, prior to commencing the intervention. The groups did not differ at baseline or on anthropometric (weight, BMI, BMI-z-score, waist circumference, waist-hip or waist-height ratio), body composition (percent body fat, fat mass, lean mass) or attrition measures post-treatment or post-maintenance (p>.01). MI did not improve retention or outcome of cognitive behaviour therapy for adolescent overweight and obesity.

  5. Treating enuresis in a patient with ADHD: application of a novel behavioural modification therapy.

    Science.gov (United States)

    Tajima-Pozo, Kazuhiro; Ruiz-Manrique, Gonzalo; Montañes, Francisco

    2014-06-10

    We report the case of a 6-year-old patient diagnosed with attention-deficit hyperactivity disorder (ADHD) and comorbid enuresis disorder, who was treated with methylphenidate for the past 3 months and a novel behavioural modification therapy by using an application called 'Enuresis Trainer'. This therapeutic application is basically an interactive 'Bedwetting Calendar', based on traditional cognitive behavioural modification therapies and positive reinforcement systems. Enuresis is defined as the failure of voluntary control of the urethral sphincter. The prevalence of enuresis is 15-20% in the child population; however, children with ADHD had a 2.7 times higher incidence of nocturnal enuresis. Bedwetting is a common cause of isolation in children as well as loss of self-esteem and other psychological distress for the child and the family.

  6. Affiliative behaviour and conflictual communication during brief family therapy of patients with anorexia nervosa.

    Directory of Open Access Journals (Sweden)

    Karyn Doba

    Full Text Available OBJECTIVE: Although patients with anorexia nervosa (AN present positive responses to family therapy, the key features of therapeutic changes still require identification. This study explores the role of conflictual communication and affiliative nonverbal behaviour in therapeutic change in brief strategic family therapy (BSFT for AN patients. METHODS: Ten female AN patients and their parents were included in the sample and took part in a 6-month follow-up of BSFT. The durations of conflictual communication and of affiliative nonverbal behaviour estimated by eye contact were compared between the first and the last sessions of family-based treatment using nonparametric statistical tests. RESULTS: An increase of the Body Mass Index associated with an increase in the conflictual communication expressed during BSFT sessions were observed. Moreover, affiliative nonverbal behaviour expressed by the father and the patient decrease, after a BSFT follow-up, in conflictual situations only. By contrast, no significant difference was observed in affiliative nonverbal behaviour expressed by the mother. CONCLUSION: The present study demonstrates that the impact of the BSFT differs between members of a family: the AN patient and the father have established a new form of emotional functioning with a decrease in emotional involvement. The study of the combination between verbal and nonverbal communication can represent an important step in the understanding of the mechanisms of therapeutic change.

  7. Affiliative Behaviour and Conflictual Communication during Brief Family Therapy of Patients with Anorexia Nervosa

    Science.gov (United States)

    Doba, Karyn; Pezard, Laurent; Berna, Guillaume; Vignau, Jean; Nandrino, Jean-Louis

    2013-01-01

    Objective Although patients with anorexia nervosa (AN) present positive responses to family therapy, the key features of therapeutic changes still require identification. This study explores the role of conflictual communication and affiliative nonverbal behaviour in therapeutic change in brief strategic family therapy (BSFT) for AN patients. Methods Ten female AN patients and their parents were included in the sample and took part in a 6-month follow-up of BSFT. The durations of conflictual communication and of affiliative nonverbal behaviour estimated by eye contact were compared between the first and the last sessions of family-based treatment using nonparametric statistical tests. Results An increase of the Body Mass Index associated with an increase in the conflictual communication expressed during BSFT sessions were observed. Moreover, affiliative nonverbal behaviour expressed by the father and the patient decrease, after a BSFT follow-up, in conflictual situations only. By contrast, no significant difference was observed in affiliative nonverbal behaviour expressed by the mother. Conclusion The present study demonstrates that the impact of the BSFT differs between members of a family: the AN patient and the father have established a new form of emotional functioning with a decrease in emotional involvement. The study of the combination between verbal and nonverbal communication can represent an important step in the understanding of the mechanisms of therapeutic change. PMID:23936421

  8. Irrational beliefs in posttraumatic stress responses: A Rational Emotive Behaviour Therapy approach

    OpenAIRE

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2015-01-01

    The current study aimed to test a key theoretical prediction of Rational Emotive Behaviour Therapy theory by assessing the role of general and trauma-specific irrational beliefs in the prediction of posttraumatic stress responses. A sample (N = 313) of trauma-exposed emergency service workers participated in the study. Structural equation modelling results demonstrated that an REBT-based model provided satisfactory model fit and explained 89% of variance in posttraumatic stress symptomology. ...

  9. Irrational beliefs in posttraumatic stress responses: A Rational Emotive Behaviour Therapy approach

    OpenAIRE

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2015-01-01

    The current study aimed to test a key theoretical prediction of Rational Emotive Behaviour Therapy theory by assessing the role of general and trauma-specific irrational beliefs in the prediction of posttraumatic stress responses. A sample (N = 313) of trauma-exposed emergency service workers participated in the study. Structural equation modelling results demonstrated that an REBT-based model provided satisfactory model fit and explained 89% of variance in posttraumatic stress symptomology. ...

  10. A Systematic Review of Cognitive Behavioral Therapy and Behavioral Activation Apps for Depression.

    Directory of Open Access Journals (Sweden)

    Anna Huguet

    Full Text Available Depression is a common mental health condition for which many mobile apps aim to provide support. This review aims to identify self-help apps available exclusively for people with depression and evaluate those that offer cognitive behavioural therapy (CBT or behavioural activation (BA. One hundred and seventeen apps have been identified after searching both the scientific literature and the commercial market. 10.26% (n = 12 of these apps identified through our search offer support that seems to be consistent with evidence-based principles of CBT or BA. Taking into account the non existence of effectiveness/efficacy studies, and the low level of adherence to the core ingredients of the CBT/BA models, the utility of these CBT/BA apps are questionable. The usability of reviewed apps is highly variable and they rarely are accompanied by explicit privacy or safety policies. Despite the growing public demand, there is a concerning lack of appropiate CBT or BA apps, especially from a clinical and legal point of view. The application of superior scientific, technological, and legal knowledge is needed to improve the development, testing, and accessibility of apps for people with depression.

  11. Efficacy of cognitive behavioral therapy (CBT) combined with drug in treatment of schizophrenia%认知行为疗法联合药物治疗精神分裂症的临床疗效

    Institute of Scientific and Technical Information of China (English)

    袁松; 王旭东; 黄胜强

    2015-01-01

    目的 探讨认知行为疗法(CBT)联合药物治疗精神分裂症的疗效.方法 选取精神分裂症患者86例,分为观察组与对照组各43例.对照组仅药物治疗,观察组联合CBT治疗,治疗8周前后,评价两组PANSS、IPROS、WHO QOL-BREF评分.结果 治疗8周后,两组PANSS、IPROS评分均降低,且观察组PANSS、IPROS评分均低于对照组,对照组WHO QOL-BREF中仅心理、社会关系评分提高,观察组除生理评分外其余各项评分及总分均提高,除生理评分外观察组各项评分及总分均高于对照组(P<0.05).结论 在药物治疗的基础上对精神分裂症患者进行系统的认知行为治疗具有较好的效果,且提高患者的生活质量.

  12. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders

    Science.gov (United States)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  13. Predicting rapid response to cognitive-behavioural treatment for panic disorder: the role of hippocampus, insula, and dorsolateral prefrontal cortex.

    Science.gov (United States)

    Reinecke, Andrea; Thilo, Kai; Filippini, Nicola; Croft, Alison; Harmer, Catherine J

    2014-11-01

    Although cognitive-behavioural therapy (CBT) is an effective first-line intervention for anxiety disorders, treatments remain long and cost-intensive, difficult to access, and a subgroup of patients fails to show any benefits at all. This study aimed to identify functional and structural brain markers that predict a rapid response to CBT. Such knowledge will be important to establish the mechanisms underlying successful treatment and to develop more effective, shorter interventions. Fourteen unmedicated patients with panic disorder underwent 3 T functional and structural magnetic resonance imaging (MRI) before receiving four sessions of exposure-based CBT. Symptom severity was measured before and after treatment. During functional MRI, patients performed an emotion regulation task, either viewing negative images naturally, or intentionally down-regulating negative affect by using previously taught strategies of cognitive reappraisal. Structural MRI images were analysed including left and right segmentation and volume estimation. Improved response to brief CBT was predicted by increased pre-treatment activation in bilateral insula and left dorsolateral prefrontal cortex (dlPFC) during threat processing, as well as increased right hippocampal gray matter volume. Previous work links these regions to improved threat processing and fear memory activation, suggesting that the activation of such mechanisms is crucial for exposure-based CBT to be effective.

  14. Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders.

    Science.gov (United States)

    Lester, Kathryn J; Roberts, Susanna; Keers, Robert; Coleman, Jonathan R I; Breen, Gerome; Wong, Chloe C Y; Xu, Xiaohui; Arendt, Kristian; Blatter-Meunier, Judith; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Heiervang, Einar R; Herren, Chantal; Hogendoorn, Sanne M; Hudson, Jennifer L; Krause, Karen; Lyneham, Heidi J; McKinnon, Anna; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Rey, Yasmin; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Smith, Patrick; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Eley, Thalia C

    2016-02-01

    We previously reported an association between 5HTTLPR genotype and outcome following cognitive-behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, with most reporting no association between genotype and CBT outcome. To replicate the association between 5HTTLPR and CBT outcome in child anxiety from the Genes for Treatment study (GxT Cohort 2, n = 829). Logistic and linear mixed effects models were used to examine the relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both cohorts were performed. There was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2. Mega-analyses identified a significant association between 5HTTLPR and remission from all anxiety disorders at follow-up (odds ratio 0.45, P = 0.014), but not primary anxiety disorder outcomes. The association between 5HTTLPR genotype and CBT outcome did not replicate. Short-allele homozygotes showed more positive treatment outcomes, but with small, non-significant effects. Future studies would benefit from utilising whole genome approaches and large, homogenous samples. © The Royal College of Psychiatrists 2016.

  15. Efficacy of cognitive behavioural therapy delivered over the Internet for depressive symptoms: A systematic review and meta-analysis.

    Science.gov (United States)

    Sztein, Dina M; Koransky, Charles E; Fegan, Leah; Himelhoch, Seth

    2017-01-01

    Introduction Cognitive behavioural therapy has been shown to improve depressive symptoms in adults with mild to moderate depression. To overcome many of the barriers associated with delivering this treatment, attempts have been made to deliver cognitive behavioural therapy via the Internet. The objective of this meta-analysis is to assess whether Internet-based cognitive behavioural therapy delivered to adults with depressive symptoms leads to a reduction in these symptoms as compared to those who receive no therapy. Methods In September 2015, the Cochrane, PubMed and PsycInfo databases were searched; studies were also found through bibliography searches. Studies were included if they were randomized controlled trials published in English between 2005-2015 conducted with adults >18 years of age experiencing mild to moderate depression where study subjects received Internet-based cognitive behavioural therapy, and the control group was placed on a wait-list. The search yielded 257 articles; 14 of these were included in the meta-analysis. Results Internet delivered cognitive behavioural therapy had a medium effect on reducing depressive symptoms at the end of the study period (standardized mean difference: 0.74, confidence interval: 0.62-0.86, p cognitive behavioural therapy also has a large sustained effect in maintaining reduction of depressive symptoms in follow-up measures done 3-6 months after the conclusion of the therapy (standardized mean difference: 0.83, confidence interval: 0.69-0.99, p Cognitive behavioural therapy delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable or unwilling to access traditional face-to-face therapy.

  16. Improving access to psychological therapies (IAPT) and treatment outcomes: epistemological assumptions and controversies.

    Science.gov (United States)

    Williams, C H J

    2015-06-01

    Cognitive behaviour therapy (CBT) is recommended as a primary treatment choice in England, for anxiety and depression, by the National Institute for Health and Care Excellence (NICE). It has been argued that CBT has enjoyed political and cultural dominance and this has arguably led to maintained government investment in England for the cognitive and behavioural treatment of mental health problems. The government programme 'Improving Access to Psychological Therapies' (IAPT) aims to improve the availability of CBT. The criticism of the NICE evidence-based guidelines supporting the IAPT programme, has been the dominance of the gold standard randomized controlled trial methodology, with a focus on numerical outcome data, rather than a focus on a recovery narrative. RCT-based research is influenced by a philosophical paradigm called positivism. The IAPT culture is arguably influenced by one research paradigm and such an influence can skew services only towards numerical outcome data as the only truth of 'recovery'. An interpretative paradigm could assist in shaping service-based cultures, alter how services are evaluated and improve the richness of CBT research. This paper explores the theory of knowledge (epistemology) that underpins the evidence-based perspective of CBT and how this influences service delivery. The paper argues that the inclusion of service user narrative (qualitative data) can assist the evaluation of CBT from the user's perspective and can understand the context in which people live and how they access services. A qualitative perspective is discussed as a research strategy, capturing the lived experience of under-represented groups, such as sexual, gender and ethnic minorities. Cognitive behaviour therapy (CBT) has enjoyed political and cultural dominance within mental healthcare, with renewed government investment in England for the'Improving Access to Psychological Therapies' (IAPT) programme. The criticism of the evidence-based guidelines

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  19. Short- and Long-Term Effects of CBT-I in Groups for School-Age Children Suffering From Chronic Insomnia: The KiSS-Program.

    Science.gov (United States)

    Schlarb, Angelika A; Bihlmaier, Isabel; Velten-Schurian, Kerstin; Poets, Christian F; Hautzinger, Martin

    2016-09-20

    This intervention study evaluates the short- and long-term effects of cognitive behavior therapy for insomnia (CBT-I) in groups for school-age children and their parents, named the KiSS-program. CBT-I was implemented in three sessions for children and three sessions for parents. All in all, 112 children with chronic childhood insomnia were randomly assigned to a wait-list (WL) control or treatment condition. According to subjective measures as well as objective wrist actigraphy, children in the CBT-I condition reported greater improvements in sleep behavior immediately after the treatment compared to the WL group. Improvements in sleep behavior after CBT-I persisted over the 3-, 6-, and 12-month follow-up assessments. The present study is the first randomized controlled trial that provides evidence for the long-term effectiveness of CBT-I in treating school-age children with chronic insomnia.

  20. The role of perceived partner alliance on the efficacy of CBT-I: preliminary findings from the Partner Alliance in Insomnia Research Study (PAIRS).

    Science.gov (United States)

    Ellis, Jason G; Deary, Vincent; Troxel, Wendy M

    2015-01-01

    Despite cognitive behavioral therapy for insomnia (CBT-I) being effective, barriers to adherence have been documented. Perceived partner alliance has been shown to influence adherence and treatment outcome across a range of other health conditions. The present study examined patients' perceptions regarding the role of their partner in CBT-I and the impact of perceived partner alliance on treatment outcome. Twenty-one patients were interviewed, following CBT-I, to examine the areas where partners were thought to influence the process of CBT-I. The majority of statements made during interviews explicitly mentioned a partner's influence (65%). Additionally, the production of more positive partner statements was associated with better treatment outcome (using the Insomnia Severity Index). The integration of perceived partner alliance into CBT-I is discussed.

  1. Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland

    LENUS (Irish Health Repository)

    O’Shea, M. P.

    2014-05-01

    Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour.\\r\

  2. Active music therapy improves cognition and behaviour in chronic vascular encephalopathy: a case report.

    Science.gov (United States)

    Giovagnoli, Anna Rita; Oliveri, Serena; Schifano, Letizia; Raglio, Alfredo

    2014-02-01

    This study describes the effects of active music therapy (AMT) on cognition and behaviour in chronic vascular encephalopathy. A single case study investigated different cognitive and psycho-behavioural changes after AMT. An adult patient with memory, attention, and verbal fluency deficits associated with Vascular Cognitive Impairment-No Dementia (VCI-ND) was treated. A four-months AMT course was based on creative and interactive music playing. Sixteen sessions were conducted simultaneously to the pharmacological therapy. Cognitive performances, mood, interpersonal interactions, and perceived abilities were assessed using standardized neuropsychological and psycho-behavioural measurements. At baseline, the patient reported a tendency to feel tense, nervous, and angry and difficulties in memory and visuospatial performances, frequently accompanied by attention drops. The social network was a habitual component of the patient's life, but not a source of sharing of personal experiences, safety or comfort. Neuropsychological tests showed deficits in object and figure naming, verbal fluency, short and long-term verbal memory, short-term spatial memory, selective attention, and visuomotor coordination. After AMT, the cognitive profile significantly improved in attention, visuomotor coordination, and verbal and spatial memory. Such positive changes were confirmed at the three-months follow-up. An increase of the interpersonal interactions and consistent reduction of anxiety were also observed. In selected patients with VCI-ND, a well-structured AMT intervention added to standard therapy may contribute in determining a stable improvement of cognitive and psycho-behavioural aspects. Controlled studies are needed to confirm these promising results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Cognitive-Behavioural Therapies for Young People in Outpatient Treatment for Non-Opioid Drug Use:

    DEFF Research Database (Denmark)

    Filges, Trine; Knudsen, Anne-Sofie Due; Svendsen, Majken

    2015-01-01

    users’ positive expectations about drug use, to enhance their self-confidence to resist drugs, and to improve their skills for problem-solving and for coping with daily life stressors. OBJECTIVES The objective of this review is to assess the effectiveness of CBT for young people (aged 13...... literature databases, citations in other reviews and in the included primary studies, hand searches of relevant journals, and Internet searches using Google. We also corresponded with researchers in the CBT field. No language or date restrictions were applied to the searches. SELECTION CRITERIA Studies were...... the screening criteria and were excluded. Four records were unobtainable. A total of seven unique studies, reported in 17 papers, were included in the review. Meta-analysis was used to examine the effects of CBT on drug use reduction, social and family functioning, school problems, treatment retention...

  4. Evidence-based practice behaviours: a comparison amongst occupational therapy students and clinicians.

    Science.gov (United States)

    Thomas, Aliki; Saroyan, Alenoush; Snider, Laurie M

    2012-04-01

    Occupational therapy graduates are expected to demonstrate entry-level competencies in evidence-based practice. To support students during the course of professional education in developing the knowledge, skills, and attitudes for integrating scientific findings into clinical practice, educators must identify the process by which these competencies are developed. To identify the differences in evidence-based practice decisions amongst occupational therapy students and experienced clinicians. Using a vignette depicting an older client with a history of falls, participants' evidence-based practice decisions were compared to a reference model. In the initial steps of the process, knowledge of evidence-based practice concepts appeared to be dependent upon formal instruction, whereas expert-like behaviours in the integration of evidence for decision-making seemed to be a function of clinical experience. Academic and clinical educators can use identified gaps in knowledge and synthesis of concepts to update the evidence-based practice content in occupational therapy curricula and fieldwork.

  5. Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial.

    Science.gov (United States)

    Luk, Edwin K; Gorelik, Alexandra; Irving, Louis; Khan, Fary

    2017-03-06

    To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Prospective controlled clinical trial. A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

  6. The use of automated assessments in internet-based CBT: The computer will be with you shortly

    Directory of Open Access Journals (Sweden)

    Elizabeth C. Mason

    2014-10-01

    Full Text Available There is evidence from randomized control trials that internet-based cognitive behavioral therapy (iCBT is efficacious in the treatment of anxiety and depression, and recent research demonstrates the effectiveness of iCBT in routine clinical care. The aims of this study were to implement and evaluate a new pathway by which patients could access online treatment by completing an automated assessment, rather than seeing a specialist health professional. We compared iCBT treatment outcomes in patients who received an automated pre-treatment questionnaire assessment with patients who were assessed by a specialist psychiatrist prior to treatment. Participants were treated as part of routine clinical care and were therefore not randomized. The results showed that symptoms of anxiety and depression decreased significantly with iCBT, and that the mode of assessment did not affect outcome. That is, a pre-treatment assessment by a psychiatrist conferred no additional treatment benefits over an automated assessment. These findings suggest that iCBT is effective in routine care and may be implemented with an automated assessment. By providing wider access to evidence-based interventions and reducing waiting times, the use of iCBT within a stepped-care model is a cost-effective way to reduce the burden of disease caused by these common mental disorders.

  7. Terapia cognitivo-comportamental dos transtornos alimentares Cognitive-behavioural therapy of eating disorders

    Directory of Open Access Journals (Sweden)

    Mônica Duchesne

    2002-12-01

    Full Text Available A terapia cognitivo-comportamental é uma intervenção breve, semi-estruturada e orientada para metas, que tem sido amplamente utilizada nos centros de pesquisa e tratamento de transtornos alimentares. O presente artigo tem por objetivo descrever as principais estratégias cognitivas e comportamentais utilizadas no tratamento ambulatorial dos transtornos alimentares. Vários ensaios clínicos avaliaram a eficácia da terapia cognitivo-comportamental, indicando que ela favorece a remissão ou diminuição da freqüência de episódios de compulsão alimentar, dos comportamentos purgativos e da restrição alimentar. Tem sido relatada também melhora do humor, do funcionamento social, e diminuição da preocupação com peso e formato corporal.The cognitive-behavioural therapy is a brief, semi-structured and goal oriented intervention, which has been largely used in research and treatment centers specialized on eating disorders. The present article describes the main cognitive and behavioral strategies used in the outpatient treatment of eating disorders. Several clinical studies assessed the effectiveness of cognitive-behavioural therapy, indicating the remission or the reduction of the frequency of binge eating episodes, purgative behaviours and food restriction. Social and mood improvement, as well as reduction of weight and body shape concerns, have also been reported.

  8. Cognitive behavioural therapy in multiple sclerosis: a randomized controlled pilot study of acceptance and commitment therapy.

    Science.gov (United States)

    Nordin, Linda; Rorsman, Ia

    2012-01-01

    The aim of this study was to design a trial that could evaluate the effect of acceptance and commitment therapy as a group-intervention for multiple sclerosis patients with psychological distress. Randomized controlled trial with assessment at pretreatment, end of treatment, and at 3-month follow-up. Multiple sclerosis outpatients with elevated symptoms of anxiety and/or depression (n = 21). Patients were randomly assigned to acceptance and commitment therapy or relaxation training. Both treatments consisted of 5 sessions over 15 weeks containing didactic sessions, group discussions, and exercises. Outcome was assessed by self-rated symptoms of anxiety, depression, and a measure of acceptance. At 3-month follow-up, the relaxation training group had a significant decline in anxiety symptoms whereas the acceptance and commitment therapy group showed a maintained improvement in rated acceptance at follow-up. The results reflect the different emphases of the therapies. Acceptance and commitment therapy is aimed at living an active, valued life and increasing acceptance, while relaxation training focuses directly on coping strategies to handle emotional symptoms. The results are preliminary, but supportive of further study of brief group interventions for reducing psychological distress in patients with multiple sclerosis.

  9. Guided parent-delivered cognitive behavioral therapy for childhood anxiety: Predictors of treatment response.

    Science.gov (United States)

    Thirlwall, Kerstin; Cooper, Peter; Creswell, Cathy

    2017-01-01

    Guided Parent-delivered Cognitive Behaviour Therapy (GPD-CBT) is a brief, effective treatment for childhood anxiety disorders, however not all children respond favourably. To examine predictors of response to GPD-CBT. Parents of 125 children (7-12 years) with an anxiety disorder received GPD-CBT over 2.6 or 5.3h. Recovery was measured post treatment and six months later. Younger children and those with primary Generalised Anxiety Disorder (GAD) improved more post treatment, but older children and those without primary GAD had better outcomes at six month follow up. Fewer children allocated to 2.6h had recovered post treatment compared to those allocated to the 5.2h intervention, but did not differ significantly six months later. The identification of predictors of short and longer-term treatment outcomes can guide treatment decisions following this low-intensity approach. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Increasing access to Cognitive Behaviour Therapy in Low and Middle Income Countries: A strategic framework.

    Science.gov (United States)

    Beck, Andrew; Nadkarni, Abhijit; Calam, Rachel; Naeem, Farooq; Husain, Nusrat

    2016-08-01

    Cognitive Behaviour Therapy has been demonstrated to be an effective intervention in outpatient and inpatient settings for a wide range of presenting mental health problems including depression, Obsessive Compulsive Disorder, Post traumatic Stress Disorder, Social Anxiety Disorder, Panic Disorder and Somatorform Disorder. There is likely to be an unmet need for this therapeutic approach in most Low and Middle Income Countries (LMIC). However, the training of therapists to deliver this intervention has historically been a lengthy and expensive process, with already highly trained staff such as psychiatrists and psychologists undertaking additional training of up to one year duration in order to develop expertise in this area. This paper proposes that a model where training, supervision, leadership and service evaluation is provided by a small number of highly trained staff to front-line non-specialist staff who will then deliver manualised therapy. These front-line staff may also be conceptualised as part of a stepped care model where self-help and manualised therapy approaches are used in the first instance. Where patient functioning does not improve there is then the possibility of being stepped-up for treatment by a more specialised and highly trained therapist. This approach may help in meeting the huge mental health treatment gap in LMIC. This paper also suggests that lessons learnt from the dissemination of behaviourally informed parenting interventions internationally can be applied to the dissemination of this therapeutic approach.

  11. Mirror box therapy added to cognitive behavioural therapy in three chronic complex regional pain syndrome type I patients : a pilot study

    NARCIS (Netherlands)

    Tichelaar, Y. I. G. Vladimir; Geertzen, Jan H. B.; Keizer, Doeke; van Wilgen, C. Paul

    2007-01-01

    Complex regional pain syndrome type I is a disorder of the extremities with disability and pain as the most prominent features. This paper describes the results of cognitive behavioural therapy combined with mirror box therapy in three patients with chronic complex regional pain syndrome type I. Bef

  12. Mirror box therapy added to cognitive behavioural therapy in three chronic complex regional pain syndrome type I patients : a pilot study

    NARCIS (Netherlands)

    Tichelaar, Y. I. G. Vladimir; Geertzen, Jan H. B.; Keizer, Doeke; van Wilgen, C. Paul

    Complex regional pain syndrome type I is a disorder of the extremities with disability and pain as the most prominent features. This paper describes the results of cognitive behavioural therapy combined with mirror box therapy in three patients with chronic complex regional pain syndrome type I.

  13. Effectiveness of abbreviated CBT for insomnia in psychiatric outpatients: sleep and depression outcomes.

    Science.gov (United States)

    Wagley, J Nile; Rybarczyk, Bruce; Nay, William T; Danish, Steven; Lund, Hannah G

    2013-10-01

    To test the efficacy of cogntive-behavioral therapy for insomnia (CBT-I) as a supplement treatment for psychiatric outpatients. Comorbid insomnia is prevalent among individuals with varied psychiatric disorders and evidence indicates that CBT-I may be effective for reducing insomnia and other psychiatric symptoms. The present study randomly assigned 30 psychiatric outpatients (mean duration of treatment = 3.6 years) with low sleep quality and residual depressive symptoms to two sessions of CBT-I or a treatment as usual control group. Assessment included the Pittsburgh Sleep Quality Index (PSQI) for insomnia and the Patient Health Questionnaire (PHQ-9) for depression at pretreatment and 4 and 8 weeks posttreatment. Patients who received CBT-I demonstrated within group changes in PSQI and the PHQ-9 scores at both 4 and 8 weeks posttreatment, but did not show between-group differences. Additionally, 38% of the treatment participants achieved normal sleep at follow-up compared with none in the control condition. This study provides preliminary evidence that abbreviated behavioral treatment has beneficial effects on residual insomnia and depression in long-term psychiatric outpatients. © 2012 Wiley Periodicals, Inc.

  14. Child Maltreatment History and Response to CBT Treatment in Depressed Mothers Participating in Home Visiting.

    Science.gov (United States)

    Ammerman, Robert T; Peugh, James L; Teeters, Angelique R; Putnam, Frank W; Van Ginkel, Judith B

    2016-03-01

    Child maltreatment contributes to depression in adults. Evidence indicates that such experiences are associated with poorer outcomes in treatment. Mothers in home visiting programs display high rates of depression and child maltreatment histories. In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat maternal depression in home visiting. The purpose of this study was to examine the moderating effects of child maltreatment history on depression, social functioning, and parenting in mothers participating in a clinical trial of IH-CBT. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and then confirmation of major depressive disorder diagnosis. Measures of child maltreatment history, depression, social functioning, and parenting were administered at pre-treatment, post-treatment, and 3-month follow-up. Results indicated high rates of maltreatment in both conditions relative to the general population. Mixed model analyses found a number of main effects in which experiences of different types of trauma were associated with poorer functioning regardless of treatment condition. Evidence of a moderating effect of maltreatment on treatment outcomes was found for physical abuse and parenting and emotional abuse and social network size. Future research should focus on increasing the effectiveness of IH-CBT with depressed mothers who have experienced child maltreatment. © The Author(s) 2014.

  15. The Effect of Music Therapy Services on Classroom Behaviours of Newly Arrived Refugee Students in Australia--A Pilot Study

    Science.gov (United States)

    Baker, Felicity; Jones, Carolyn

    2006-01-01

    This pilot study examined the effects of a short-term music therapy program on the classroom behaviours of newly arrived refugee students who were attending an intensive "English as a Second Language" secondary school. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one…

  16. The Effect of Music Therapy Services on Classroom Behaviours of Newly Arrived Refugee Students in Australia--A Pilot Study

    Science.gov (United States)

    Baker, Felicity; Jones, Carolyn

    2006-01-01

    This pilot study examined the effects of a short-term music therapy program on the classroom behaviours of newly arrived refugee students who were attending an intensive "English as a Second Language" secondary school. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one or two…

  17. Using Repertory Grid Techniques to Measure Change Following Dialectical Behaviour Therapy with Adults with Learning Disabilities: Two Case Studies

    Science.gov (United States)

    McNair, Louisa; Woodrow, Ceri; Hare, Dougal

    2016-01-01

    Background: Government strategy indicates that individuals with learning disabilities should have access to adapted psychological therapies. Dialectical behaviour therapy (DBT) is recommended for the treatment of borderline personality disorder (BPD); however, there is little published research regarding whether it can be appropriately adapted for…

  18. Using Repertory Grid Techniques to Measure Change Following Dialectical Behaviour Therapy with Adults with Learning Disabilities: Two Case Studies

    Science.gov (United States)

    McNair, Louisa; Woodrow, Ceri; Hare, Dougal

    2016-01-01

    Background: Government strategy indicates that individuals with learning disabilities should have access to adapted psychological therapies. Dialectical behaviour therapy (DBT) is recommended for the treatment of borderline personality disorder (BPD); however, there is little published research regarding whether it can be appropriately adapted for…

  19. The Effect of Music Therapy Services on Classroom Behaviours of Newly Arrived Refugee Students in Australia--A Pilot Study

    Science.gov (United States)

    Baker, Felicity; Jones, Carolyn

    2006-01-01

    This pilot study examined the effects of a short-term music therapy program on the classroom behaviours of newly arrived refugee students who were attending an intensive "English as a Second Language" secondary school. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one…

  20. Using Cognitive Behavior Therapy in Clinical Work with African American Children and Adolescents: A Review of the Literature

    Science.gov (United States)

    Wilson, Courtney J.; Cottone, R. Rocco

    2013-01-01

    A comprehensive review of the literature on clinical work with African American youth with cognitive behavior therapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. (Contains 3…

  1. Using Cognitive Behavior Therapy in Clinical Work with African American Children and Adolescents: A Review of the Literature

    Science.gov (United States)

    Wilson, Courtney J.; Cottone, R. Rocco

    2013-01-01

    A comprehensive review of the literature on clinical work with African American youth with cognitive behavior therapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. (Contains 3…

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

    Science.gov (United States)

    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…

  3. Early Therapeutic Alliance and Treatment Outcome in Individual and Family Therapy for Adolescent Behavior Problems

    Science.gov (United States)

    Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.

    2006-01-01

    The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioral therapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…

  4. Development and Implementation of Health and Wellness CBT for Individuals with Depression and HIV

    OpenAIRE

    Kennard, B.; Brown, L; Hawkins, L; A. Risi; Radcliffe, J.; Emslie, G.; Mayes, T.; King, J.; Foxwell, A.; Buyukdura, J.; Bethel, J.; Naar-King, S.; Xu, J.; Lee, S.; Garvie, P.

    2014-01-01

    Rates of depression are reported to be between 22–33% in adults with HIV, which is double that of the general population. Depression negatively affects treatment adherence and health outcomes of those with medical illnesses. Further, it has been shown in adults that reducing depression may improve both adherence and health outcomes. To address the issues of depression and non-adherence, Health and Wellness (H&W) Cognitive Behavioral Therapy (CBT) and medication management (MM) treatment strat...

  5. EMDR and CBT for Cancer Patients: Comparative Study of Effects on PTSD, Anxiety, and Depression

    OpenAIRE

    Capezzani, L; Ostacoli, L; Cavallo, M; Carletto, S; Fernendez, I; Solomon, R; Pagani, M.; Cantelmi, T

    2013-01-01

    This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the followup stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR...

  6. Modified CBT using visualization for Autism Spectrum Disorder (ASD), anxiety and avoidance behavior – a quasi-experimental open pilot study

    Science.gov (United States)

    Ekman, Elizabeth; Hiltunen, Arto J

    2015-01-01

    In recent studies it has been suggested that Cognitive Behavior Therapy (CBT) is beneficial to people with Autism Spectrum Disorder (ASD) but that the method needs to be modified in relation to their cognitive profile. The aim of this study is to measure the effect of modified CBT, that is, using visualized language throughout the entire session for clients with ASD and anxiety and avoidance behavior. The modification of CBT in this study consists of focusing on CBT protocols for anxiety disorders and depression, while visualizing and systematizing “the invisible” in the conversation, in order for the clients to understand the social, cognitive and emotional context of self and others and how they should interact to avoid misunderstandings. ASD clients may need help to detect the invisible code of social interaction and communication. The level of anxiety and the frequency of target behavior were measured. Four assessments were made, two at the pre-assessment, and one in mid-therapy and end of therapy respectively. Generally, results suggest no improvement during pre-treatment period but a significant improvement during treatment. The values of the clients’ psychological, social and occupational ability to function improved on the Global Function Rating scale. The preliminary conclusion of this pilot study indicates that the use of visualized language throughout the CBT therapy sessions is a promising modification of current CBT protocols for individuals with ASD. After manualization, larger studies with randomized controlled study designs can replicate or challenge these results. PMID:26565732

  7. Modified CBT using visualization for Autism Spectrum Disorder (ASD), anxiety and avoidance behavior--a quasi-experimental open pilot study.

    Science.gov (United States)

    Ekman, Elizabeth; Hiltunen, Arto J

    2015-12-01

    In recent studies it has been suggested that Cognitive Behavior Therapy (CBT) is beneficial to people with Autism Spectrum Disorder (ASD) but that the method needs to be modified in relation to their cognitive profile. The aim of this study is to measure the effect of modified CBT, that is, using visualized language throughout the entire session for clients with ASD and anxiety and avoidance behavior. The modification of CBT in this study consists of focusing on CBT protocols for anxiety disorders and depression, while visualizing and systematizing "the invisible" in the conversation, in order for the clients to understand the social, cognitive and emotional context of self and others and how they should interact to avoid misunderstandings. ASD clients may need help to detect the invisible code of social interaction and communication. The level of anxiety and the frequency of target behavior were measured. Four assessments were made, two at the pre-assessment, and one in mid-therapy and end of therapy respectively. Generally, results suggest no improvement during pre-treatment period but a significant improvement during treatment. The values of the clients' psychological, social and occupational ability to function improved on the Global Function Rating scale. The preliminary conclusion of this pilot study indicates that the use of visualized language throughout the CBT therapy sessions is a promising modification of current CBT protocols for individuals with ASD. After manualization, larger studies with randomized controlled study designs can replicate or challenge these results.

  8. Cognitive-behavioral therapy versus other therapies: redux.

    Science.gov (United States)

    Baardseth, Timothy P; Goldberg, Simon B; Pace, Brian T; Wislocki, Andrew P; Frost, Nick D; Siddiqui, Jamila R; Lindemann, Abigail M; Kivlighan, D Martin; Laska, Kevin M; Del Re, Aaron C; Minami, Takuya; Wampold, Bruce E

    2013-04-01

    Despite the evidence suggesting that all treatments intended to be therapeutic are equally efficacious, the conjecture that one form of treatment, namely cognitive-behavioral therapy (CBT), is superior to all other treatment persists. The purpose of the current study was to (a) reanalyze the clinical trials from an earlier meta-analysis that compared CBT to 'other therapies' for depression and anxiety (viz., Tolin, 2010) and (b) conduct a methodologically rigorous and comprehensive meta-analysis to determine the relative efficacy of CBT and bona fide non-CBT treatments for adult anxiety disorders. Although the reanalysis was consistent with the earlier meta-analysis' findings of small to medium effect sizes for disorder-specific symptom measures, the reanalysis revealed no evidence for the superiority of CBT for depression and anxiety for outcomes that were not disorder-specific. Following the reanalysis, a comprehensive anxiety meta-analysis that utilized a survey of 91 CBT experts from the Association of Behavioral and Cognitive Therapists (ABCT) to consensually identify CBT treatments was conducted. Thirteen clinical trials met the inclusion criteria. There were no differences between CBT treatments and bona fide non-CBT treatments across disorder-specific and non-disorder specific symptom measures. These analyses, in combination with previous meta-analytic findings, fail to provide corroborative evidence for the conjecture that CBT is superior to bona fide non-CBT treatments.

  9. Clinical and cost-effectiveness of computerised cognitive behavioural therapy for depression in primary care: Design of a randomised trial

    Directory of Open Access Journals (Sweden)

    Severens Johan L

    2008-06-01

    Full Text Available Abstract Background Major depression is a common mental health problem in the general population, associated with a substantial impact on quality of life and societal costs. However, many depressed patients in primary care do not receive the care they need. Reason for this is that pharmacotherapy is only effective in severely depressed patients and psychological treatments in primary care are scarce and costly. A more feasible treatment in primary care might be computerised cognitive behavioural therapy. This can be a self-help computer program based on the principles of cognitive behavioural therapy. Although previous studies suggest that computerised cognitive behavioural therapy is effective, more research is necessary. Therefore, the objective of the current study is to evaluate the (cost- effectiveness of online computerised cognitive behavioural therapy for depression in primary care. Methods/Design In a randomised trial we will compare (a computerised cognitive behavioural therapy with (b treatment as usual by a GP, and (c computerised cognitive behavioural therapy in combination with usual GP care. Three hundred mild to moderately depressed patients (aged 18–65 will be recruited in the general population by means of a large-scale Internet-based screening (N = 200,000. Patients will be randomly allocated to one of the three treatment groups. Primary outcome measure of the clinical evaluation is the severity of depression. Other outcomes include psychological distress, social functioning, and dysfunctional beliefs. The economic evaluation will be performed from a societal perspective, in which all costs will be related to clinical effectiveness and health-related quality of life. All outcome assessments will take place on the Internet at baseline, two, three, six, nine, and twelve months. Costs are measured on a monthly basis. A time horizon of one year will be used without long-term extrapolation of either costs or quality of life

  10. Sleep quality predicts treatment outcome in CBT for social anxiety disorder.

    Science.gov (United States)

    Zalta, Alyson K; Dowd, Sheila; Rosenfield, David; Smits, Jasper A J; Otto, Michael W; Simon, Naomi M; Meuret, Alicia E; Marques, Luana; Hofmann, Stefan G; Pollack, Mark H

    2013-11-01

    Sleep quality may be an important, yet relatively neglected, predictor of treatment outcome in cognitive-behavioral therapy (CBT) for anxiety disorders. Specifically, poor sleep quality may impair memory consolidation of in-session extinction learning. We therefore examined sleep quality as a predictor of treatment outcome in CBT for social anxiety disorder and the impact of d-cycloserine (DCS) on this relationship. One hundred sixty-nine participants with a primary diagnosis of DSM-IV generalized social anxiety disorder were recruited across three sites. Participants were enrolled in 12 weeks of group CBT. Participants randomly received 50 mg of DCS (n = 87) or pill placebo (n = 82) 1 hr prior to sessions 3-7. Participants completed a baseline measure of self-reported sleep quality and daily diaries recording subjective feelings of being rested upon wakening. Outcome measures including social anxiety symptoms and global severity scores were assessed at each session. Poorer baseline sleep quality was associated with slower improvement and higher posttreatment social anxiety symptom and severity scores. Moreover, patients who felt more "rested" after sleeping the night following a treatment session had lower levels of symptoms and global severity at the next session, controlling for their symptoms and severity scores the previous session. Neither of these effects were moderated by DCS condition. Our findings suggest that poor sleep quality diminishes the effects of CBT for social anxiety disorder and this relation is not attenuated by DCS administration. Therapeutic attention to sleep quality prior to initiation of CBT and during the acute treatment phase may be clinically indicated. © 2013 Wiley Periodicals, Inc.

  11. Development and Implementation of Health and Wellness CBT for Individuals with Depression and HIV.

    Science.gov (United States)

    Kennard, B; Brown, L; Hawkins, L; Risi, A; Radcliffe, J; Emslie, G; Mayes, T; King, J; Foxwell, A; Buyukdura, J; Bethel, J; Naar-King, S; Xu, J; Lee, S; Garvie, P; London, C; Tanney, M; Thornton, S

    2014-05-01

    Rates of depression are reported to be between 22-33% in adults with HIV, which is double that of the general population. Depression negatively affects treatment adherence and health outcomes of those with medical illnesses. Further, it has been shown in adults that reducing depression may improve both adherence and health outcomes. To address the issues of depression and non-adherence, Health and Wellness (H&W) Cognitive Behavioral Therapy (CBT) and medication management (MM) treatment strategies have been developed specifically for youth living with both HIV and depression. H&W CBT is based on other studies with uninfected youth and upon research on adults with HIV. H&W CBT uses problem-solving, motivational interviewing, and cognitive-behavioral strategies to decrease adherence obstacles and increase wellness. The intervention is delivered in 14 planned sessions over a 6-month period, with three different stages of CBT. This paper summarizes the feasibility and acceptability data from an open depression trial with 8 participants, 16-24 years of age, diagnosed with HIV and with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of depression, conducted at two treatment sites in the Adolescent Trials Network (ATN). Both therapists and subjects completed a Session Evaluation Form (SEF) after each session, and results were strongly favorable. Results from The Quick Inventory of Depressive Symptomatology-Clinician (QIDS-C) also showed noteworthy improvement in depression severity. A clinical case vignette illustrates treatment response. Further research will examine the use of H&W CBT in a larger trial of youth diagnosed with both HIV and depression.

  12. Training Matters: The importance of Delivering Authentic CBT with Youth

    Directory of Open Access Journals (Sweden)

    Robert D Friedberg

    2014-12-01

    Full Text Available This short commentary discusses the problem of practitioners self-branding as cognitive behavioral therapists and authentic practice of CBT with youth. The adverse consequences of unmerited self-branding are described and training requirements for authentic CBT practice are delineated.

  13. Modifying CBT for Perinatal Depression: What Do Women Want?

    Science.gov (United States)

    O'Mahen, Heather; Fedock, Gina; Henshaw, Erin; Himle, Joseph A.; Forman, Jane; Flynn, Heather A.

    2012-01-01

    The evidence for the efficacy of CBT for depression during the perinatal period is mixed. This was a qualitative study that aimed to understand the perinatal-specific needs of depressed women in an effort to inform treatment modifications that may increase the relevance and acceptability of CBT during this period. Stratified purposeful sampling…

  14. CBT for depression: a pilot RCT comparing mobile phone vs. computer

    Directory of Open Access Journals (Sweden)

    Watts Sarah

    2013-02-01

    Full Text Available Abstract Background This paper reports the results of a pilot randomized controlled trial comparing the delivery modality (mobile phone/tablet or fixed computer of a cognitive behavioural therapy intervention for the treatment of depression. The aim was to establish whether a previously validated computerized program (The Sadness Program remained efficacious when delivered via a mobile application. Method 35 participants were recruited with Major Depression (80% female and randomly allocated to access the program using a mobile app (on either a mobile phone or iPad or a computer. Participants completed 6 lessons, weekly homework assignments, and received weekly email contact from a clinical psychologist or psychiatrist until completion of lesson 2. After lesson 2 email contact was only provided in response to participant request, or in response to a deterioration in psychological distress scores. The primary outcome measure was the Patient Health Questionnaire 9 (PHQ-9. Of the 35 participants recruited, 68.6% completed 6 lessons and 65.7% completed the 3-months follow up. Attrition was handled using mixed-model repeated-measures ANOVA. Results Both the Mobile and Computer Groups were associated with statistically significantly benefits in the PHQ-9 at post-test. At 3 months follow up, the reduction seen for both groups remained significant. Conclusions These results provide evidence to indicate that delivering a CBT program using a mobile application, can result in clinically significant improvements in outcomes for patients with depression. Trial registration Australian New Zealand Clinical Trials Registry ACTRN 12611001257954

  15. A meta-analysis of the effectiveness of individually oriented Cognitive Behavioral Treatment (CBT) for severe agressive behavior in adolescents

    NARCIS (Netherlands)

    Hoogsteder, L.M.; Stams, G.J.J.M.; Figge, M.A.; Changoe, K.; van Horn, J.E.; Hendriks, J.; Wissink, I.B.

    2015-01-01

    This meta-analysis, including six studies (13 effect sizes) and 164 adolescents, examined the effectiveness of individually oriented treatment (which means that the intervention contained at least an individual component, possibly in combination with group and/or family therapy) with CBT-elements

  16. Disorder-Specific Effects of CBT for Anxious and Depressed Youth: A Meta-Analysis of Candidate Mediators of Change

    Science.gov (United States)

    Chu, Brian C.; Harrison, Tara L.

    2007-01-01

    The commonalities between anxiety and depression have been discussed before, but few have delineated the potentially different mechanisms through which treatments work for these populations. The current study conducted a comprehensive review of child and adolescent randomized clinical trials that tested cognitive-behavioral therapy (CBT) for…

  17. Mechanisms of Efficacy of CBT for Cambodian Refugees with PTSD: Improvement in Emotion Regulation and Orthostatic Blood Pressure Response

    NARCIS (Netherlands)

    Hinton, D.E.; Hofmann, S.G.; Pollack, M.H.; Otto, M.W.

    2009-01-01

    Based on the results of a randomized controlled trial, we examined a model of the mechanisms of efficacy of culturally adapted cognitive-behavior therapy (CBT) for Cambodian refugees with pharmacology-resistant posttraumatic stress disorder (PTSD) and comordid orthostatic panic attacks (PAs). Twelve

  18. A Pilot Randomized Controlled Trial of Combined Trauma-Focused CBT and Sertraline for Childhood PTSD Symptoms

    Science.gov (United States)

    Cohen, Judith A.; Mannarino, Anthony P.; Perel, James M.; Staron, Virginia

    2007-01-01

    Objective: To examine the potential benefits of adding a selective serotonin reuptake inhibitor, sertraline, versus placebo, to trauma-focused cognitive-behavioral therapy (TF-CBT) for improving posttraumatic stress disorder and related psychological symptoms in children who have experienced sexual abuse. Method: Twenty-four 10- to 17-year-old…

  19. Sleep-related safety behaviors and dysfunctional beliefs mediate the efficacy of online CBT for insomnia: a randomized controlled trial

    NARCIS (Netherlands)

    Lancee, J.; Eisma, M.C.; van Straten, A.; Kamphuis, J.H.

    2015-01-01

    Several trials have demonstrated the efficacy of online cognitive behavioral therapy (CBT) for insomnia. However, few studies have examined putative mechanisms of change based on the cognitive model of insomnia. Identification of modifiable mechanisms by which the treatment works may guide efforts t

  20. Sleep-Related Safety Behaviors and Dysfunctional Beliefs Mediate the Efficacy of Online CBT for Insomnia : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Lancee, Jaap; Eisma, Maarten C.; van Straten, Annemieke; Kamphuis, Jan H.

    2015-01-01

    Several trials have demonstrated the efficacy of online cognitive behavioral therapy (CBT) for insomnia. However, few studies have examined putative mechanisms of change based on the cognitive model of insomnia. Identification of modifiable mechanisms by which the treatment works may guide efforts t