CBT and its family of structured treatments.
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901 to 925 of 2,546Pentecost C, Farrand P, Greaves CJ, Taylor RS, Warren FC, Hillsdon M, Green C, Welsman JR, Rayson K, Evans PH, Taylor AH (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usTrials27 citations Combining behavioural activation with physical activity promotion for adults with depression: findings of a parallel-group pilot randomised controlled trial (BAcPAc).
Background: Depression is associated with physical inactivity, which may mediate the relationship between depression and a range of chronic physical health conditions. However, few interventions have combined a psychological intervention for depression with behaviour change techniques, such as behavioural activation (BA), to promote increased physical activity.
Methods: To determine procedural and clinical uncertainties to inform a definitive randomised controlled trial (RCT), a pilot parallel-group RCT was undertaken within two Improving Access to Psychological Therapies (IAPT) services in South West England. We aimed to recruit 80 adults with depression and randomise them to a supported, written self-help programme based on either BA or BA plus physical activity promotion (BAcPAc). Data were collected at baseline and 4 months post-randomisation to evaluate trial retention, intervention…
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Netmums: a phase II randomized controlled trial of a guided Internet behavioural activation treatment for postpartum depression.
Background: Despite the high prevalence of postnatal depression (PND), few women seek help. Internet interventions may overcome many of the barriers to PND treatment use. We report a phase II evaluation of a 12-session, modular, guided Internet behavioural activation (BA) treatment modified to address postnatal-specific concerns [Netmums Helping With Depression (NetmumsHWD)].
Method: To assess feasibility, we measured recruitment and attrition to the trial and examined telephone session support and treatment adherence. We investigated sociodemographic and psychological predictors of treatment adherence. Effectiveness outcomes were estimated with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Postnatal Bonding Questionnaire, and Social Provisions Scale.
Results: A total of 249 women were recruited via a UK parenting site,…
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Behavioural activation versus mindfulness-based guided self-help treatment administered through a smartphone application: a randomised controlled trial.
Objectives: Evaluating and comparing the effectiveness of two smartphone-delivered treatments: one based on behavioural activation (BA) and other on mindfulness.
Design: Parallel randomised controlled, open, trial. Participants were allocated using an online randomisation tool, handled by an independent person who was separate from the staff conducting the study.
Setting: General community, with recruitment nationally through mass media and advertisements.
Participants: 40 participants diagnosed with major depressive disorder received a BA treatment, and 41 participants received a mindfulness treatment. 9 participants were lost at the post-treatment.
Intervention ba: An 8-week long behaviour programme administered via a smartphone application. Mindfulness: An 8-week long mindfulness programme, administered via a smartphone application.
Main outcome measures: The Beck Depression Inventory…
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Behavioural activation: a pilot trial of transdiagnostic treatment for excessive worry.
Transdiagnostic interventions present pragmatic benefits in treatment dissemination and training of mental health professionals when faced with emotional disorders such as anxiety and depression. Excessive worry is a common feature across emotional disorders and represents an ideal candidate target for transdiagnostic intervention. The current pilot trial examined the efficacy of a behavioural activation treatment for worry (BAW) in a community population. 49 individuals experiencing excessive worry were randomised to waitlist or BAW receiving an 8 week group based intervention. Results demonstrated that BAW was successful in reducing excessive worry, depressive symptoms, cognitive avoidance, Intolerance of Uncertainty and improving problem solving orientation. Twice as many individuals showed clinically significant reductions in excessive worry after treatment compared to the waitlist c…
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Behavioural activation v. antidepressant medication for treating depression in Iran: randomised trial.
Background: Behavioural activation might be a viable alternative to antidepressant medication for major depressive disorder.
Aims: To compare the effectiveness of behavioural activation and treatment as usual (TAU, antidepressant medication) for major depressive disorder in routine clinical practice in Iran.
Method: Patients with major depressive disorder (n = 100) were randomised to 16 sessions of behavioural activation (n = 50) or antidepressant medication (n = 50) (IRCT138807192573N1). The main outcome was depression, measured with the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD), assessed at 0, 4, 13 and 49 weeks.
Results: Symptom reduction was greater in the behavioural activation group than in the TAU group on both the BDI and the HRSD at 13 and 49 weeks in multilevel analysis. Baseline depression severity was a moderator, with relatively bett…
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Richards DA, Hill JJ, Gask L, Lovell K, Chew-Graham C, Bower P, Cape J, Pilling S, Araya R, Kessler D, Bland JM, Green C, Gilbody S, Lewis G, Manning C, Hughes-Morley A, Barkham M (2013)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMJ (Clinical research ed.)145 citations Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial.
Objective: To compare the clinical effectiveness of collaborative care with usual care in the management of patients with moderate to severe depression.
Design: Cluster randomised controlled trial.
Setting: 51 primary care practices in three primary care districts in the United Kingdom.
Participants: 581 adults aged 18 years and older who met ICD-10 (international classification of diseases, 10th revision) criteria for a depressive episode on the revised Clinical Interview Schedule. We excluded acutely suicidal patients and those with psychosis, or with type I or type II bipolar disorder; patients whose low mood was associated with bereavement or whose primary presenting problem was alcohol or drug abuse; and patients receiving psychological treatment for their depression by specialist mental health services. We identified potentially eligible participants by searching computerised case …
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Cost utility of behavioural activation delivered by the non-specialist.
Behavioural activation by non-specialists appears effective in the treatment of depression. We examined incremental cost-effectiveness of behavioural activation (n = 24) v. treatment as usual (n = 23) in a randomised controlled trial. Intention-to-treat analyses indicated a quality-adjusted life-year (QALY) difference in favour of behavioural activation of 0.20 (95% CI 0.01-0.39, P = 0.042), incremental cost-effectiveness ratio of £5756 per QALY and a 97% probability that behavioural activation is more cost-effective at a threshold value of £20,000. Results are promising for dissemination of behavioural activation but require replication in a larger study.
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Mechanisms of change in dialectical behaviour therapy and cognitive behaviour therapy for borderline personality disorder: a critical review of the literature.
Background: Little is known about the "active ingredients" of psychological therapy for Borderline Personality Disorder (BPD) despite a growing evidence base documenting its clinical effectiveness. This information can be used by clinicians to inform service planning and care pathways. Aims: The aim of this study was to review published empirical research investigating the potential mechanisms underlying therapeutic change in Dialectical Behaviour Therapy (DBT) and Cognitive Behaviour Therapy (CBT) for BPD.Method: A thorough search of the PsychInfo, CINAHL Plus, PubMed, MEDLINE and EMBASE databases revealed research into potential mechanisms of change. Results: A total of 52 abstracts were reviewed. After a full text screen of the most relevant studies, 14 met inclusion criteria. Twelve examined DBT and two CBT. Mechanisms of change identified broadly fell into three categories: emotion …
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Development and Open Trial of a Psychosocial Intervention for Young Children With Chronic Tics: The CBIT-JR Study.
The Comprehensive Behavioral Intervention for Tic Disorders (CBIT) has demonstrated efficacy in large randomized controlled trials for children (≥9 yrs), adolescents and adults with Tourette Syndrome and Chronic Tic Disorders. Given the early age of onset for tic disorders, a large portion of affected individuals with chronic tic disorders are less than 9 years of age and appropriate developmental adaptations of behavioral treatment have not yet been tested. The goal of this study was to adapt and evaluate the acceptability and utility of a family-based adaptation of CBIT for children under 9 years of age. Children 5-8 years of age (N = 15) with chronic tics were recruited from three study sites. CBIT was adapted for use with young children and included habit reversal strategies introduced in a developmentally appropriate game format and function-based interventions to reduce family acco…
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Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial.
Study objective: Recently, the use of multicomponent insomnia treatment has increased. This study compares the effect of single component and multicomponent behavioral treatments for insomnia in older adults after intervention and at 3 months and 1 yr posttreatment.
Design: A randomized, controlled study.
Setting: Veterans Affairs medical center.
Participants: 179 older adults (mean age, 68.9 yr ± 8.0; 115 women [64.2%]) with chronic primary insomnia.
Interventions: Participants were randomly assigned to 6 wk of stimulus control therapy (SCT), sleep restriction therapy (SRT), the 2 therapies combined into a multicomponent intervention (MCI), or a wait-list control group.
Measurements and results: Primary outcomes were subjective (daily sleep diary) and objective (actigraphy) measures of sleep-onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), a…
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Healing grief - an online self-help intervention programme for bereaved Chinese with prolonged grief: study protocol for a randomised controlled trial.
Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements. Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reapprai…
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Sizoo BB, Kuiper E (2017)cohort or longitudinalMEDLINE-indexed journal, not yet read by usResearch in developmental disabilities65 citations Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders.
Anxiety and depression co-occur in 50-70% of adults with autism spectrum disorder (ASD) but treatment methods for these comorbid problems have not been systematically studied. Recently, two ASD-tailored protocols were published: mindfulness based stress reduction (MBSR) and cognitive behavioural therapy (CBT). We wanted to investigate if both methods are equally effective in reducing anxiety and depression symptoms among adults with ASD. 59 adults with ASD and anxiety or depression scores above 7 on the Hospital Anxiety and Depression Scale, gave informed consent to participate; 27 followed the CBT protocol, and 32 the MBSR treatment protocol. Anxiety and depression scores, autism symptoms, rumination, and global mood were registered at the start, at the end of the 13-week treatment period, and at 3-months follow-up. Irrational beliefs and mindful attention awareness were used as process…
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Rimes KA, Chalder T (2010)cohort or longitudinalMEDLINE-indexed journal, not yet read by usJournal of psychosomatic research93 citations The Beliefs about Emotions Scale: validity, reliability and sensitivity to change.
Objective: Beliefs about the unacceptability of experiencing or expressing negative emotions have been noted in individuals with a range of problems, including chronic fatigue syndrome (CFS), irritable bowel syndrome, somatization disorder, depression, eating disorders, social phobia, posttraumatic stress disorder, and borderline personality disorder. These beliefs are likely to have implications for emotion regulation and processing, and are addressed explicitly or implicitly within many therapies including cognitive behavior therapy (CBT), mindfulness-based cognitive therapy (MBCT), and Acceptance and Commitment Therapy (ACT). This article describes the development, validation, and internal reliability of the Beliefs about Emotions Scale (BES), a self-report questionnaire to assess such beliefs.
Methods: The new scale was completed by people with CFS (n=121) and healthy controls (n=73)…
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Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia.
Background: Migraine frequently co-occurs with and is triggered by sleep disturbance, particularly insomnia, and the large majority of patients with chronic migraine (CM) have comorbid insomnia. Limited evidence suggests that behavioral regulation of sleep may reduce migraine frequency, but studies to date have not assessed the viability of stimulus control and sleep restriction interventions or included objective measurement of sleep parameters. The aim of this study, thus, was to pilot-test the efficacy of a brief behavioral insomnia intervention for adults with CM and comorbid insomnia; headache diaries and actigraphy were included to assess outcomes throughout the trial.
Methods: This randomized parallel-arm pilot trial recruited adults with both CM and comorbid insomnia. Participants were randomly assigned to three 30-minute biweekly sessions of cognitive-behavioral therapy for inso…
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Lillis J, Niemeier HM, Thomas JG, Unick J, Ross KM, Leahey TM, Kendra KE, Dorfman L, Wing RR (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usObesity (Silver Spring, Md.)56 citations A randomized trial of an acceptance-based behavioral intervention for weight loss in people with high internal disinhibition.
Objective: To determine whether an acceptance-based behavioral intervention (ABBI) produces better weight losses than standard behavioral treatment (SBT) among individuals reporting high internal disinhibition.
Methods: Participants were 162 adults with overweight or obesity (mean BMI 37.6 kg/m2 ) randomly assigned to ABBI or SBT. Both interventions provided the same calorie intake target, exercise goal, and self-monitoring skills training. SBT incorporated current best practice interventions for addressing problematic thoughts and emotions. ABBI utilized acceptance-based techniques based on Acceptance and Commitment Therapy. ABBI and SBT were compared on weight change and internal disinhibition change over 24 months.
Results: Mixed models analysis showed mean weight loss at 24 months was -4.1% (SE = 0.88) for ABBI and -2.4% (SE = 0.87) for SBT (P = 0.204). Secondary analyses showed that…
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Brown RA, Reed KM, Bloom EL, Minami H, Strong DR, Lejuez CW, Lejuez CW, Kahler CW, Zvolensky MJ, Gifford EV, Hayes SC (2013)randomised controlled trialMEDLINE-indexed journal, not yet read by usNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco56 citations Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse.
Introduction: An inability to tolerate distress is a significant predictor of early smoking lapse following a cessation attempt. We conducted a preliminary randomized controlled trial to compare a distress tolerance (DT) treatment that incorporated elements of exposure-based therapies and Acceptance and Commitment Therapy to standard smoking cessation treatment (ST).
Methods: Smokers with a history of early lapse in prior quit attempts received either DT (N = 27; 9 2-hr group and 6 50-min individual sessions) or ST (N = 22; 6 90-min group and 1 20-min individual session), plus 8 weeks of transdermal nicotine patch.
Results: At the end of behavioral treatment, odds of abstinence among participants receiving DT were 6.46 times greater than among participants receiving ST (66.7% vs. 31.8%), equivalent to a medium- to large-effect size. Odds of abstinence for DT were still 1.73 times greater…
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The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial.
This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail support (n=250), or to a waiting list control group (n=126). All participants completed measures before and after the intervention to assess depression, anxiety and psychological flexibility. Participants in the experimental condition also completed these measures during the intervention (after three and six weeks) and at a three-month follow-up. With multilevel modelling, it was shown that the effects of the intervention on psychological distress were stronger for participants with higher levels of psychological flexibility. Furthermore, our study showed that improved psychological flexibility m…
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Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial.
Background: In order to reduce the high prevalence of depression, early interventions for people at risk of depression are warranted. This study evaluated the effectiveness of an early guided self-help programme based on acceptance and commitment therapy (ACT) for reducing depressive symptomatology.
Method: Participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the self-help programme with extensive email support (n=125), the self-help programme with minimal email support (n=125) or to a waiting list control group (n=126). Participants completed measures before and after the intervention to assess depression, anxiety, fatigue, experiential avoidance, positive mental health and mindfulness. Participants in the experimental conditions also completed these measures at a 3-month follow-up.
Results: In the experimental conditi…
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Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation.
This study evaluated a treatment combining bupropion with a novel acceptance and relationship focused behavioral intervention based on the acceptance and relationship context (ARC) model. Three hundred and three smokers from a community sample were randomly assigned to bupropion, a widely used smoking cessation medication, or bupropion plus functional analytic psychotherapy (FAP) and acceptance and commitment therapy (ACT). Objective measures of smoking outcomes and self-report measures of acceptance and relationship processes were taken at pretreatment, posttreatment, 6-month, and 1-year follow-up. The combined treatment was significantly better than bupropion alone at 1-year follow-up with 7-day point prevalence quit rates of 31.6% in the combined condition versus 17.5% in the medication-alone condition. Acceptance and the therapeutic relationship at posttreatment statistically mediate…
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A comparative study of 2 manual-based self-help interventions, acceptance and commitment therapy and applied relaxation, for persons with chronic pain.
Objective: The aim of this study was to compare 2 self-help-based interventions; a coping-oriented approach, applied relaxation (AR) and an acceptance-oriented approach, acceptance and commitment therapy (ACT), for persons with chronic pain.
Method: This study is a randomized control trial (N=90) with a mixed between-within participants design with repeated measures. Interventions in both conditions comprised an initial face-to-face session, a 7-week manual-based self-help intervention including weekly therapist telephone support and a concluding face-to-face session. Outcome measures included satisfaction with life, depression, anxiety, acceptance of chronic pain, level of function, and pain intensity. Effects were measured at preintervention and postintervention and at 6 and 12 months after the end of intervention.
Results: The results show that the ACT condition increased their level …
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Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial.
Objective: The current study examined the efficacy of an early intervention based on acceptance and commitment therapy (ACT) for depressive symptomatology. The ACT intervention is aimed at increasing the acceptance of negative thoughts and emotions and living a mindful and value-based life.
Method: Adults with mild to moderate depressive symptomatology were randomly assigned to the ACT intervention (n=49) or to a waiting list (n=44). The mean age of the participants was 49 years. The majority of the participants was female and of Dutch origin. All the participants completed measures before and after the intervention, as well as three months later at follow-up to assess depression (CES-D), anxiety (HADS-A), fatigue (CIS), alcohol use and acceptance (AAQ-II).
Results: The ACT intervention led to statistically significant reduction in depressive symptomatology (Cohen's d=.60). These reducti…
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The effectiveness of an Acceptance and Commitment Therapy self-help intervention for chronic pain.
Objective: To evaluate the effectiveness of an Acceptance Commitment Therapy based self-help book for people with chronic pain.
Method: This was a randomized 2 group study design. Over a 6-week period, 6 participants read the self-help book and completed exercises from it with weekly telephone support whereas 8 others formed a wait-list control group. Subsequently, 5 of the wait-list participants completed the intervention. Participants completed preintervention and postintervention questionnaires for acceptance, values illness, quality of life, satisfaction with life, depression, anxiety, and pain. Initial outcome data were collected for 8 control participants and 6 intervention participants. Including the wait-list controls, a total of 11 participants completed preintervention and postintervention measures. Whilst completing the self-help intervention, each week participants' rated the…
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Mental health promotion as a new goal in public mental health care: a randomized controlled trial of an intervention enhancing psychological flexibility.
Objectives: We assessed whether an intervention based on acceptance and commitment therapy (ACT) and mindfulness was successful in promoting positive mental health by enhancing psychological flexibility.
Methods: Participants were 93 adults with mild to moderate psychological distress. They were randomly assigned to the group intervention (n = 49) or to a waiting-list control group (n = 44). Participants completed measures before and after the intervention as well as 3 months later at follow-up to assess mental health in terms of emotional, psychological, and social well-being (Mental Health Continuum-Short Form) as well as psychological flexibility (i.e., acceptance of present experiences and value-based behavior, Acceptance and Action Questionnaire-II).
Results: Regression analyses showed that compared with the participants on the waiting list, participants in the ACT and mindfulness i…
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Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders.
Acceptance and commitment therapy (ACT) has previously been shown to alter stigmatizing attitudes and to be relatively useful for psychologically inflexible participants. The present study is the first to bring those two findings together by comparing ACT to an education intervention for reducing stigma toward people with psychological disorders, and examining whether results differ for psychologically inflexible versus flexible individuals. A sample of college students (N =95) was randomly assigned to a 2(1)2h ACT or educational workshop. Measures were taken before and after the workshop and at a 1-month follow-up. ACT reduced mental health stigma significantly regardless of participants' pre-treatment levels of psychological flexibility, but education reduced stigma only among participants who were relatively flexible and non-avoidant to begin with. Acceptance could be an important ave…
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Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial.
The present study investigates the efficacy of an Internet-based cognitive-behavioral therapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n = 55) were randomly assigned to either the treatment group or a waiting list control condition. The 5-week intervention consisted of three modules: (1) exposure to bereavement cues; (2) cognitive reappraisal; and (3) integration and restoration. The Impact of Event Scale (IES), a failure to adapt scale, and the depression and anxiety subscales of the Brief Symptom Inventory (BSI) were used to assess treatment outcomes. Participants in the treatment group (n = 26) improved significantly relative to participants in the waiting condition on symptoms …
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