CBT and its family of structured treatments.
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1151 to 1175 of 2,546Protocol for the psychotherapeutic group intervention for facilitating posttraumatic growth in nonmetastatic breast cancer patients.
Background: Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. In contrast, growing evidence has shown that posttraumatic growth can occur as a result of coping with breast cancer. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Group interventions may also increase social support, distress disclosure, and posttraumatic growth. The aim of this study is to evaluate how group-based interventions can facilitate posttraumatic growth and promote improved psychosocial adjustment to breast cancer. This article describes the study protocol and the applied research methods.
Methods: To measure the impact of a group-based intervention on posttraumatic growth, a multi-center randomized control…
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Manning V, Staiger PK, Hall K, Garfield JB, Flaks G, Leung D, Hughes LK, Lum JA, Lubman DI, Verdejo-Garcia A (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usAlcoholism, clinical and experimental research80 citations Cognitive Bias Modification Training During Inpatient Alcohol Detoxification Reduces Early Relapse: A Randomized Controlled Trial.
Background: Relapse is common in alcohol-dependent individuals and can be triggered by alcohol-related cues in the environment. It has been suggested that these individuals develop cognitive biases, in which cues automatically capture attention and elicit an approach action tendency that promotes alcohol seeking. The study aim was to examine whether cognitive bias modification (CBM) training targeting approach bias could be delivered during residential alcohol detoxification and improve treatment outcomes.
Methods: Using a 2-group parallel-block (ratio 1:1) randomized controlled trial with allocation concealed to the outcome assessor, 83 alcohol-dependent inpatients received either 4 sessions of CBM training where participants were implicitly trained to make avoidance movements in response to pictures of alcoholic beverages and approach movements in response to pictures of nonalcoholic b…
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The therapeutic alliance and therapist adherence as predictors of dropout from cognitive therapy for depression when combined with antidepressant medication.
Background: Previous psychotherapy research has examined the therapeutic alliance and therapist adherence as correlates or predictors of symptom change. While some initial evidence suggests the alliance is associated with risk of dropout in cognitive behavioral treatment for depression, evidence of such relations has been limited to date. We examined the relation of these psychotherapy process variables and dropout in the context of cognitive therapy for depression when provided in combination with pharmacotherapy.
Methods: Patients were randomized to the CT plus pharmacotherapy condition of a clinical trial for chronic or recurrent depression. Consistent with the spirit of personalized medicine, patients were treated until they met remission and recovery criteria (or reached the maximum allowable time in the study). In a sample of 176 patients, we examined observer-rated alliance and th…
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Feldman JM, Matte L, Interian A, Lehrer PM, Lu SE, Scheckner B, Steinberg DM, Oken T, Kotay A, Sinha S, Shim C (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehaviour research and therapy32 citations Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.
Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improv…
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Burke JD, Loeber R (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of abnormal child psychology22 citations Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.
Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress…
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Effects of a brief mindfulness-based intervention program for stress management among medical students: the Mindful-Gym randomized controlled study.
Pursuing undergraduate medical training can be very stressful and academically challenging experience. A 5-week mindfulness-based stress management (MBSM/Mindful-Gym) program was developed to help medical students cope with stress. The aim of this study was to evaluate the effectiveness of the intervention in reducing stress among students in a medical school in Malaysia. Seventy-five medical students participated in the program. They were stratified according to years of studies and randomly allocated to intervention (N = 37) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Awareness Attention Scale); perceived stress (with Perceived Stress Scale); mental distress (with General Health Questionnaire), and self-efficacy (with General Self-efficacy Scale). Hierarchical multiple regressions were used to analy…
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Solé B, Bonnin CM, Mayoral M, Amann BL, Torres I, González-Pinto A, Jimenez E, Crespo JM, Colom F, Tabarés-Seisdedos R, Reinares M, Ayuso-Mateos JL, Soria S, Garcia-Portilla MP, Ibañez Á, Vieta E, Martinez-Aran A, Torrent C, CIBERSAM Functional Remediation Group (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usEuropean neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology44 citations Functional remediation for patients with bipolar II disorder: improvement of functioning and subsyndromal symptoms.
Recently, Functional Remediation (FR) has proven to be effective in improving the functional outcome of euthymic bipolar patients. The aim of this study was to test the efficacy of the FR program in a subsample of euthymic bipolar II patients (BPII). A post-hoc analyses were undertaken using data of 53 BPII outpatients who had participated in a multicenter, rater-blind, randomized, controlled trial exploring the efficacy of FR (n=17) as compared with a Psychoeducation group (PSY) (n=19) and a treatment as usual control group (TAU n=17). The primary outcome variable was the functional improvement defined as the mean change in the Functioning Assessment Short Test (FAST) from baseline to endpoint after the intervention. Regarding the treatment effect, data reveal a significant functional improvement from baseline to endpoint, suggestive for an interaction between program pertinence and tim…
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BREATH: Web-Based Self-Management for Psychological Adjustment After Primary Breast Cancer--Results of a Multicenter Randomized Controlled Trial.
Purpose: Early breast cancer survivors (BCSs) report high unmet care needs, and easily accessible care is not routinely available for this growing population. The Breast Cancer E-Health (BREATH) trial is a Web-based self-management intervention to support the psychological adjustment of women after primary treatment, by reducing distress and improving empowerment.
Patients and methods: This multicenter, randomized, controlled, parallel-group trial evaluated whether care as usual (CAU) plus BREATH is superior to CAU alone. BREATH is delivered in sixteen fully automated weekly modules covering early survivorship issues. Two to 4 months post-treatment, BCSs were randomly assigned to receive CAU + BREATH (n = 70) or CAU alone (n = 80) using a stratified block design (ratio 1:1). Primary outcomes were distress (Symptom Checklist-90) and empowerment (Cancer Empowerment Questionnaire), assessed…
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The influence of cognitive control training on stress reactivity and rumination in response to a lab stressor and naturalistic stress.
Cognitive control impairments have been identified as an underlying mechanism for rumination, a key predictor of depression. Literature suggests that cognitive control training (CCT) targeting working memory functioning can increase effectiveness of existing antidepressant treatments to reduce rumination. However, it remains unclear whether CCT can also be implemented as a preventive intervention for depression, increasing resilience. For this purpose, at-risk undergraduate students (high trait ruminators) were allocated to a CCT or active control condition, consisting of 10 online training sessions. Working memory functioning was assessed preceding and following the training and reactivity to a lab stressor was assessed directly following training. Finally, at four weeks follow-up, brooding--the maladaptive form of rumination--was re-assessed in response to a naturalistic stressor (exam…
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Restoring depleted resources: Efficacy and mechanisms of change of an internet-based unguided recovery training for better sleep and psychological detachment from work.
Objective: This randomized controlled trial evaluated the efficacy of an Internet-based intervention, which aimed to improve recovery from work-related strain in teachers with sleeping problems and work-related rumination. In addition, mechanisms of change were also investigated.
Methods: A sample of 128 teachers with elevated symptoms of insomnia (Insomnia Severity Index [ISI] ≥ 15) and work-related rumination (Cognitive Irritation Scale ≥ 15) was assigned to either an Internet-based recovery training (intervention condition [IC]) or to a waitlist control condition (CC). The IC consisted of 6 Internet-based sessions that aimed to promote healthy restorative behavior. Self-report data were assessed at baseline and again after 8 weeks. Additionally, a sleep diary was used starting 1 week before baseline and ending 1 week after postassessment. The primary outcome was insomnia severity. Sec…
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A web-based psychoeducational program for informal caregivers of patients with Alzheimer's disease: a pilot randomized controlled trial.
Background: Although several face-to-face programs are dedicated to informal caregivers of persons with dementia, they are not always accessible to overburdened or isolated caregivers. Based on a face-to-face intervention program, we adapted and designed a Web-based fully automated psychoeducational program (called Diapason) inspired by a cognitive approach.
Objective: This study aimed to evaluate through a pilot unblinded randomized controlled trial the efficacy and acceptability of a Web-based psychoeducational program for informal caregivers of persons with Alzheimer's disease (PWAD) based on a mixed methods research design.
Methods: We recruited and randomized offline 49 informal caregivers of a PWAD in a day care center in Paris, France. They either received the Web-based intervention and usual care for 3 months (experimental group, n=25) or only usual care (control group, n=24). Ca…
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Internet-Based Exposure and Behavioral Activation for Complicated Grief and Rumination: A Randomized Controlled Trial.
This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated grief and grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated grief, posttraumatic stress, depression, grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated grief, posttraumatic stress, and grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated grief and grief rumination (d=0.6-1.2), and for BA on complicated grief, posttraumatic str…
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Cognitive existential couple therapy (CECT) in men and partners facing localised prostate cancer: a randomised controlled trial.
Objectives: To assess the efficacy of cognitive existential couple therapy (CECT) for relationship function, coping, cancer distress and mental health in men with localised prostate cancer and in their partners.
Patients subjects and methods: A randomised controlled trial was conducted with 62 couples randomly assigned to the six-session CECT programme or care as usual. The couple's relationship function (primary outcome), and coping, cancer distress and mental health (secondary outcomes) were evaluated at T0 (baseline), T1 (after treatment) and T2 (9 months from T0). A repeated-measures analysis of covariance model, which incorporated T0 measurements as a covariate, was used to compare treatment groups at T1 and T2.
Results: After CECT, patients reported significantly greater use of adaptive coping (P = 0.03) and problem-focused coping (P = 0.01). These gains were maintained at follow-u…
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Philipsen A, Jans T, Graf E, Matthies S, Borel P, Colla M, Gentschow L, Langner D, Jacob C, Groß-Lesch S, Sobanski E, Alm B, Schumacher-Stien M, Roesler M, Retz W, Retz-Junginger P, Kis B, Abdel-Hamid M, Heinrich V, Huss M, Kornmann C, Bürger A, Perlov E, Ihorst G, Schlander M, Berger M, Tebartz van Elst L, Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study (COMPAS) Consortium (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usJAMA psychiatry92 citations Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.
Importance: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence in adulthood. There is a recognized need to assess the efficacy of psychotherapy in adult ADHD.
Objective: To evaluate the efficacy of cognitive behavioral group psychotherapy (GPT) compared with individual clinical management (CM) and that of methylphenidate hydrochloride compared with placebo.
Design, setting, and participants: Prospective, multicenter, randomized clinical trial of 18- to 58-year-old outpatients with ADHD from 7 German study centers. Patients were recruited between January 2007 and August 2010, treatment was finalized in August 2011, and final follow-up assessments occurred in March 2013.
Interventions: Sessions of GPT and CM were held weekly for the first 12 weeks and monthly thereafter (9 months). Patients received either methylphenidate or placebo for 1 …
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Exposure therapy changes dysfunctional evaluations of somatic symptoms in patients with hypochondriasis (health anxiety). A randomized controlled trial.
Dysfunctional evaluations of somatic symptoms are considered a central factor in maintaining hypochondriasis. The aim of the current study was to investigate whether exposure therapy (ET) without cognitive restructuring is sufficient to change dysfunctional evaluations of somatic symptoms. The current study was based on a randomized controlled trial and compared patients with hypochondriasis (N=73) receiving ET or cognitive therapy (CT) to a wait list (WL) control group. In both the ET and CT groups, dysfunctional symptom evaluations changed significantly compared with the WL group. No differences between the ET and CT groups emerged. The relationship between the treatment condition (active treatment vs. WL) and reductions in health anxiety was mediated by changes in somatic symptom evaluations only in a specific card sorting procedure. We conclude that addressing dysfunctional symptom e…
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Corbett A, Owen A, Hampshire A, Grahn J, Stenton R, Dajani S, Burns A, Howard R, Williams N, Williams G, Ballard C (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of the American Medical Directors Association122 citations The Effect of an Online Cognitive Training Package in Healthy Older Adults: An Online Randomized Controlled Trial.
Introduction: Cognitive training (CT) offers a potential approach for dementia prevention and maintenance of cognitive function in older adults. Online delivery provides a cost-effective means of implementing CT compared with in-person interventions, with the potential of providing an effective public health intervention for risk reduction.
Methods: A double-blind 6-month online randomized controlled trial in adults older than 50 randomized to General CT, Reasoning CT, or control. The primary outcome was instrumental activities of daily living (IADL) in adults older than 60. Secondary outcomes were reasoning, verbal short-term memory, spatial working memory, verbal learning (VL), and digit vigilance in adults older than 50. Secondary analyses were performed with a group defined as showing age-associated impairment in reasoning according to baseline scores in this domain.
Results: A total…
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Predicting Optimal Outcomes in Cognitive Therapy or Interpersonal Psychotherapy for Depressed Individuals Using the Personalized Advantage Index Approach.
Introduction: Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT) and interpersonal psychotherapy (IPT).
Methods: 134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI), a measure of the predicted advantage in on…
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Compensatory cognitive training for people with first-episode schizophrenia: results from a pilot randomized controlled trial.
Cognitive training or remediation now has multiple studies and meta-analyses supporting its efficacy in improving cognition and functioning in people with schizophrenia. However, relatively little is known about cognitive training outcomes in early psychosis. We conducted a pilot randomized controlled trial of Compensatory Cognitive Training (CCT) compared to Treatment as Usual (TAU) in 27 participants with first-episode psychosis who had received treatment for psychosis for less than six months. Assessments of cognition (MATRICS Consensus Cognitive Battery; MCCB) and functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B) were administered at baseline and following the 12-week treatment. The CCT condition, compared to TAU, was associated with significant improvements on the MCCB composite score, as well as MCCB subtests measuring processing speed (Trail Making) and …
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Impulsivity-focused group intervention to reduce binge eating episodes in patients with binge eating disorder: study protocol of the randomised controlled IMPULS trial.
Introduction: The core symptom of binge eating disorder (BED) is recurrent binge eating that is accompanied by a sense of loss of control. BED is frequently associated with obesity, one of the main public health challenges today. Experimental studies deliver evidence that general trait impulsivity and disorder-specific food-related impulsivity constitute risk factors for BED. Cognitive-behavioural treatment (CBT) is deemed to be the most effective intervention concerning BED. We developed a group intervention based on CBT and especially focusing on impulsivity. We hypothesise that such an impulsivity-focused group intervention is able to increase control over impulsive eating behaviour, that is, reduce binge eating episodes, further eating pathology and impulsivity. Body weight might also be influenced in the long term.
Methods and analysis: The present randomised controlled trial invest…
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Conklin HM, Ogg RJ, Ashford JM, Scoggins MA, Zou P, Clark KN, Martin-Elbahesh K, Hardy KK, Merchant TE, Jeha S, Huang L, Zhang H (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of clinical oncology : official journal of the American Society of Clinical Oncology119 citations Computerized Cognitive Training for Amelioration of Cognitive Late Effects Among Childhood Cancer Survivors: A Randomized Controlled Trial.
Purpose: Children receiving CNS-directed therapy for cancer are at risk for cognitive problems, with few available empirically supported interventions. Cognitive problems indicate neurodevelopmental disruption that may be modifiable with intervention. This study evaluated short-term efficacy of a computerized cognitive training program and neural correlates of cognitive change.
Patient and methods: A total of 68 survivors of childhood acute lymphoblastic leukemia (ALL) or brain tumor (BT) with identified cognitive deficits were randomly assigned to computerized cognitive intervention (male, n = 18; female, n = 16; ALL, n = 23; BT, n = 11; mean age ± standard deviation, 12.21 ± 2.47 years) or waitlist (male, n = 18; female, n = 16; ALL, n = 24; BT, n = 10; median age ± standard deviation, 11.82 ± 2.42 years). Intervention participants were asked to complete 25 training sessions at home wi…
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Attention Bias Modification training in individuals with depressive symptoms: A randomized controlled trial.
Background and objectives: Negative attentional biases are often considered to have a causal role in the onset and maintenance of depressive symptoms. This suggests that reduction of such biases may be a plausible strategy in the treatment of depressive symptoms. The present clinical randomized controlled trial examined long-term effects of a computerized attention bias modification (ABM) procedure on individuals with elevated depressive symptoms.
Methods: In a double-blind study design, 77 individuals with ongoing mild to severe symptoms of depression were randomly assigned to one of three conditions: 1) ABM training (n = 27); 2) placebo (n = 27); 3) assessment-only (n = 23). In both the ABM and placebo conditions, participants completed 8 sessions of 216-trials (1728 in total) during a 2-week period. Assessments were conducted at pre-training and post-training (0, 2, 4, 8-week, 3, 7-mo…
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Ruggiero KJ, Price M, Adams Z, Stauffacher K, McCauley J, Danielson CK, Knapp R, Hanson RF, Davidson TM, Amstadter AB, Carpenter MJ, Saunders BE, Kilpatrick DG, Resnick HS (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of the American Academy of Child and Adolescent Psychiatry54 citations Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial.
Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents.
Method: A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were ado…
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Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: nonsignificant effects in pilot effectiveness trial with college students.
Objective: Conduct a pilot trial testing whether a brief cognitive-behavioral (CB) group reduced depressive symptoms and secondary outcomes relative to bibliotherapy and brochure controls in college students with elevated depressive symptoms.
Method: 82 college students (M age=19.0, SD=0.9; 70% female, 80% White) with elevated self-assessed depressive symptoms were randomized to a 6-session CB group, bibliotherapy, or educational brochure control condition, completing assessments at pretest, posttest, and at 6- and 12-month follow-up.
Results: Planned contrasts found no significant effects for CB group on depressive symptoms compared to either bibliotherapy or brochure controls at posttest (d=-.08 and .06, respectively) or over follow-up (d=-.04 and -.10, respectively). There were no intervention effects for social adjustment and substance use, though CB group participants had improved k…
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Denny BT, Ochsner KN (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usEmotion (Washington, D.C.)150 citations Behavioral effects of longitudinal training in cognitive reappraisal.
Although recent emotion regulation research has identified effective regulatory strategies that participants can employ during single experimental sessions, a critical but unresolved question is whether one can increase the efficacy with which one can deploy these strategies through repeated practice. To address this issue, we focused on one strategy, reappraisal, which involves cognitively reframing affective events in ways that modulate one's emotional response to them. With a commonly used reappraisal task, we assessed the behavioral correlates of four laboratory sessions of guided practice in down-regulating responses to aversive photos. Two groups received practice in one of two types of reappraisal tactics: psychological distancing and reinterpretation. A third no-regulation control group viewed images in each session without instructions to regulate. Three key findings were observ…
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Life enhancing activities for family caregivers of people with frontotemporal dementia.
Aberrant psychological and behavioral symptoms are common in patients with dementia. These symptoms have negative consequences for family caregivers, causing stress and burden. Frontotemporal dementia (FTD) symptoms cause more pronounced stress and burden on caregivers than those associated with Alzheimer dementia. In this randomized, attention control pilot study, we delivered 5-weekly, one-on-one, positive affect intervention sessions to family caregivers of people with FTD. The program, Life Enhancing Activities for Family Caregivers: LEAF was conducted in-person or by videoconference with caregivers across the United States. Measures of affect, caregiver mood, stress, distress, and caregiver burden were assessed at baseline, end of sessions, and 1 month after completion. Twenty-four caregivers (12 intervention and 12 attention control) participated. At the end of the intervention, sc…
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