CBT and its family of structured treatments.
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Research library, full list
1501 to 1525 of 2,546A spirituality teaching program for depression: qualitative findings on cognitive and emotional change.
Objectives: This study was conducted with participants from a trial evaluating an 8-week spirituality teaching program to treat unipolar major depression. The objectives of this study were to understand the nature of the observed mood following participation in the spirituality based intervention.
Design: This study used the methods of a naturalistic inquiry.
Setting: A total of 15 interviewees were purposefully sampled from the trial population.
Intervention: The intervention consisted of audio CDs for home-based use that delivered lectures and stories about spirituality, suggested behavioural applications and included relaxation practices.
Main outcome measures: In-depth, semi-structured interviews were conducted with each participant 6 months post program completion. Interviews were audio recorded and transcribed verbatim. The data were coded for patterns of substantive core meaning i…
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Becoming happier takes both a will and a proper way: an experimental longitudinal intervention to boost well-being.
An 8-month-long experimental study examined the immediate and longer term effects of regularly practicing two assigned positive activities (expressing optimism and gratitude) on well-being. More important, this intervention allowed us to explore the impact of two metafactors that are likely to influence the success of any positive activity: whether one self-selects into the study knowing that it is about increasing happiness and whether one invests effort into the activity over time. Our results indicate that initial self-selection makes a difference, but only in the two positive activity conditions, not the control, and that continued effort also makes a difference, but, again, only in the treatment conditions. We conclude that happiness interventions are more than just placebos, but that they are most successful when participants know about, endorse, and commit to the intervention.
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A school-based expressive writing intervention for at-risk urban adolescents' aggressive behavior and emotional lability.
This school-based randomized controlled trial tested the efficacy of 2 expressive writing interventions among youth living in high-violence urban neighborhoods. Seventeen classrooms (n = 258 seventh graders; 55% female; 91% African American/Black) from 3 public schools were randomized to 3 conditions in which they wrote 8 times about a nonemotional topic (control condition) or about experiencing and witnessing violence following either a standard or an enhanced expressive writing protocol. Outcomes were assessed 1 month prior and 2 and 6 months postintervention and included teacher-rated emotional lability and aggressive behavior and child-rated physical aggression. Intent-to-treat, mixed-model analyses controlled for preintervention measures of outcomes, sex, race, and family structure. At 2 months postintervention, relative to controls, students in the standard expressive writing condi…
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An effectiveness trial of a selected dissonance-based eating disorder prevention program for female high school students: Long-term effects.
Objective: Efficacy trials found that a dissonance-based eating disorder prevention program in which female high school and college students with body image concerns critique the thin ideal reduced eating disorder risk factors, eating disorder symptoms, and future eating disorder onset. The present effectiveness trial tested whether this program produces effects through long-term follow-up when high school clinicians recruit students and deliver the intervention under real-world conditions.
Method: Female high school students with body image concerns (N = 306; M age = 15.7 years, SD = 1.1) were randomized to the dissonance intervention or an educational brochure control condition and completed assessments through 3-year follow-up.
Results: Dissonance participants showed significantly greater decreases in body dissatisfaction at 2-year follow-up and eating disorder symptoms at 3-year foll…
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Free C, Knight R, Robertson S, Whittaker R, Edwards P, Zhou W, Rodgers A, Cairns J, Kenward MG, Roberts I (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usLancet (London, England)520 citations Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial.
Background: Smoking cessation programmes delivered via mobile phone text messaging show increases in self-reported quitting in the short term. We assessed the effect of an automated smoking cessation programme delivered via mobile phone text messaging on continuous abstinence, which was biochemically verified at 6 months.
Methods: In this single-blind, randomised trial, undertaken in the UK, smokers willing to make a quit attempt were randomly allocated, using an independent telephone randomisation system, to a mobile phone text messaging smoking cessation programme (txt2stop), comprising motivational messages and behavioural-change support, or to a control group that received text messages unrelated to quitting. The system automatically generated intervention or control group texts according to the allocation. Outcome assessors were masked to treatment allocation. The primary outcome wa…
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Promoting positive parenting practices in primary pare: outcomes and mechanisms of change in a randomized controlled risk reduction trial.
The aim of the present study was to evaluate whether a short parent-training program (PT) reduces risk factors related to development of childhood socio-emotional and behavior problems in a non-clinical community sample. Data were obtained from parents in a randomized controlled trial (RCT) on PT for children aged 2 to 8 years (N=186) at pre-intervention, post-intervention and one-year-follow up. There were significant differences in the changes in the two groups, with reductions in harsh parenting and child behavior problems, an enhancement of positive parenting and of the parents' sense of competence in the intervention group. The effects on parenting and parents' satisfaction all lasted through one-year follow up. Our findings suggests that a shortened version of a well-structured parenting intervention, The Incredible Years program, implemented in primary care at community level, red…
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Initial preference for drinking goal in the treatment of alcohol problems: I. Baseline differences between abstinence and non-abstinence groups.
Aims: To compare baseline characteristics of clients initially preferring abstinence with those preferring non-abstinence at the screening stage of a randomized controlled trial of treatment for alcohol problems (UKATT) and to identify predictors of goal preference from client characteristics present before the preference was stated.
Methods: From discussions with clients entering the trial (N = 742), screeners noted whether clients were aiming for abstinence 'probably yes' or 'probably no'. Differences between the two groups thus formed were explored by univariate comparisons among client characteristics recorded at baseline assessment and by logistic regression analysis with pre-existing characteristics as independent variables.
Results: Across all UKATT sites, 54.3% of clients expressed a preference for abstinence and 45.7% for non-abstinence. In univariate comparisons, clients prefer…
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The effects of counting blessings on subjective well-being: a gratitude intervention in a Spanish sample.
This study examined a gratitude intervention repeating Emmons and McCullough study (2003) in a Spanish sample, Participants were randomly assigned to one of three conditions (gratitude, hassles and any event) and kept daily records during 2 weeks of gratitude, affect, quality of relationships, physical and subjective well-being. We added design features to assess the intervention long-term impact (follow-up measures), and to improve the design control (pre-treatment measures). Following the cited authors' analysis, i.e., comparing groups only in the post-test, we replicated their results, finding differences in positive affect and gratitude between the gratitude condition and the hassles condition. However, when including both the pre and the follow-up measures in the analysis, results were replicated only partially, as the difference in gratitude disappeared. Moreover, the difference in…
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Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change.
Parent-centred interventions for childhood obesity aim to improve parents' skills and confidence in managing children's dietary and activity patterns, and in promoting a healthy lifestyle in their family. However, few studies assess changes in parenting over the course of treatment. This study describes the evaluation of a lifestyle-specific parenting program (Group Lifestyle Triple P) on multiple child and parent outcomes. One-hundred-and-one families with overweight and obese 4- to 11-year-old children participated in an intervention or waitlist control condition. The 12-week intervention was associated with significant reductions in child BMI z score and weight-related problem behaviour. At the end of the intervention, parents reported increased confidence in managing children's weight-related behaviour, and less frequent use of inconsistent or coercive parenting practices. All short-…
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Muraven M (2010)randomised controlled trialMEDLINE-indexed journal, not yet read by usPsychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors78 citations Practicing self-control lowers the risk of smoking lapse.
Recent research has suggested that practicing small acts of self-control can lead to an improvement in self-control performance. Because smoking cessation requires self-control, it was hypothesized that a treatment that builds self-control should help in quitting smoking. A total of 122 smokers either practiced small acts of self-control for 2 weeks before quitting smoking or practiced a task that increased their awareness of self-control or feelings of confidence, without exercising self-control. Their smoking status was assessed using daily telephone calls and biochemically verified. Individuals who practiced self-control remained abstinent longer than those who practiced tasks that did not require self-control. Supplemental analyses suggested that the increased survival times were a product of building self-control strength and were not produced by changes in feelings that practicing …
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Ledgerwood DM, Petry NM (2010)randomised controlled trialMEDLINE-indexed journal, not yet read by usPsychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors78 citations Subtyping pathological gamblers based on impulsivity, depression, and anxiety.
This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index-Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity…
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A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers: the COPE randomized trial.
Context: Optimal treatment to postpone functional decline in patients with dementia is not established.
Objective: To test a nonpharmacologic intervention realigning environmental demands with patient capabilities.
Design, setting, and participants: Prospective 2-group randomized trial (Care of Persons with Dementia in their Environments [COPE]) involving patients with dementia and family caregivers (community-living dyads) recruited from March 2006 through June 2008 in Pennsylvania.
Interventions: Up to 12 home or telephone contacts over 4 months by health professionals who assessed patient capabilities and deficits; obtained blood and urine samples; and trained families in home safety, simplifying tasks, and stress reduction. Control group caregivers received 3 telephone calls and educational materials.
Main outcome measures: Functional dependence, quality of life, frequency of agitate…
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Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth.
Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper reports findings from a pilot randomized controlled trial assessing the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention. Four urban public schools were randomized to an intervention or wait-list control condition (n=97 fourth and fifth graders, 60.8% female). It was hypothesized that the 12-week intervention would reduce involuntary stress responses and improve mental health outcomes and social adjustment. Stress responses, depressive symptoms, and peer relations were assessed at baseline…
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Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.
Objective: To follow distressed married couples for 5 years after their participation in a randomized clinical trial.
Method: A total of 134 chronically and seriously distressed married couples were randomly assigned to approximately 8 months of either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Marital status and satisfaction were assessed approximately every 3 months during treatment and every 6 months for 5 years after treatment.
Results: Pre- to posttreatment effect sizes on marital satisfaction were d = 0.90 for IBCT and d = 0.71 for TBCT, which were not significantly different. However, data through 2-year follow-ups revealed statistically significant superiority of IBCT over TBCT in relationship satisfaction, but subsequent data showed increasing similarity and nonsignificant…
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OROS-methylphenidate or placebo for adult smokers with attention deficit hyperactivity disorder: racial/ethnic differences.
Objective: To explore racial/ethnic difference in OROS-methylphenidate (OMPH) efficacy when added to nicotine patch and counseling for treating nicotine dependence among smokers with attention deficit hyperactivity disorder (ADHD).
Method: Participants were adult smokers with ADHD (202 whites and 51 non-whites) randomly assigned to OMPH or placebo in a multi-site, randomized controlled trial. Study outcomes were complete, prolonged, and point-prevalence abstinence at the end of treatment, and weekly ratings of ADHD symptoms, tobacco withdrawal symptoms, and desire to smoke.
Results: The rate of four-week complete abstinence (no slips or lapses) was significantly higher with OMPH than placebo among non-white (OMPH=42.9%, placebo=13.3%, chi(2)(1)=5.20, p=0.02) but not white participants (OMPH=23.1%, placebo=23.5%, chi(2)(1)=0.00, p=0.95). Patterns of prolonged and point-prevalence abstinen…
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Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder.
Objective: Deliberate self-harm (DSH), general hospital admission and psychiatric hospital admission are common in women meeting criteria for borderline personality disorder (BPD). Dialectical behaviour therapy (DBT) has been reported to be effective in reducing DSH and hospitalization.
Method: A randomized controlled trial of 73 female subjects meeting criteria for BPD was carried out with intention-to-treat analyses and per-protocol analyses. The intervention was DBT and the control condition was treatment as usual plus waiting list for DBT (TAU+WL), with outcomes measured after 6 months. Primary outcomes were differences in proportions and event rates of: any DSH; general hospital admission for DSH and any psychiatric admission; and mean difference in length of stay for any hospitalization. Secondary outcomes were disability and quality of life measures.
Results: Both groups showed a …
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A mind-body program for older adults with chronic low back pain: results of a pilot study.
Objectives: Determine the impact of an 8-week mindfulness meditation program on disability, psychological function, and pain severity in community-dwelling older adults with chronic low back pain, and to test the education control program for feasibility.
Design: Randomized controlled trial. Participants. Forty community-dwelling older adults with moderate low back pain or greater for at least the previous 3 months. Intervention. Participants were randomized to an 8-week meditation program or an 8-week education control program.
Outcome measures: Disability, psychological function, and pain severity were assessed. The same measures were obtained for both groups at baseline, at the end of the program, and 4 months after program completion.
Results: Sixteen participants (80%) completed the meditation program and 19 (95%) completed the education program. Both the meditation and control grou…
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Behavioral therapy intervention trial to improve sleep quality and cancer-related fatigue.
Background: To determine whether sleep quality and fatigue associated with breast cancer adjuvant chemotherapy treatments can be improved with behavioral therapy (BT) [Individualized Sleep Promotion Plan (ISPP)] including modified stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene.
Methods: Randomized-controlled trial based on Piper Integrated Fatigue Model, 219 stages I-IIIA breast cancer patients. Prior to the initial chemotherapy treatment, BT participants developed an ISPP plan that was regularly reinforced and revised. Controls received healthy eating information and attention. Pittsburgh Sleep Quality Index (PSQI), daily diary, actigraph, and Piper Fatigue Scale (PFS) data were collected 2 days prior, during the 7 days after each treatment, and 30 days after the last treatment. Repeated measures analysis of variance was used.
Results: Prior to chemo…
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A cluster randomized controlled trial of child-focused psychiatric consultation and a school systems-focused intervention to reduce aggression.
Background: While school-based anti-bullying programs are widely used, there have been few controlled trials of effectiveness. This study compared the effect of manualized School Psychiatric Consultation (SPC), CAPSLE (a systems and mentalization focused whole school intervention), and treatment-as-usual (TAU) in reducing aggression and victimization among elementary school children.
Method: Participants were 1,345 third to fifth graders in nine elementary schools in a medium-sized Midwestern city who took part in a cluster-level randomized controlled trial with stratified restricted allocation, to assess efficacy after two years of active intervention and effectiveness after one year of minimal input maintenance intervention. Outcome measures included peer and self-reports of bullying, bystanding, and mentalizing behavior and classroom behavioral observations of disruptive and off-task …
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Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial.
Dialectical behaviour therapy (DBT) has proven to be an effective treatment in borderline personality disorder (BPD). However, the effectiveness in BPD of DBT skills training (DBT-ST) alone is not known. This study aimed at comparing the efficacy of DBT-ST and standard group therapy (SGT) for outpatients with BPD. Sixty patients meeting the DSM-IV diagnostic criteria for BPD, as assessed by two semi-structured diagnostic interviews, were included in a 3-month, single-blind randomised controlled trial. A total of 13 weekly group psychotherapy sessions of 120 min of either SGT or DBT-ST were conducted. Assessments were carried out every 2 weeks by two blinded evaluators. Observer-rater, self-report scales and behavioural reports were used as outcome measures. DBT-ST was associated with lower dropout rates, 34.5% compared to 63.4% with SGT. It was superior to SGT in improving several mood a…
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Parent training with behavioral couples therapy for fathers' alcohol abuse: effects on substance use, parental relationship, parenting, and CPS involvement.
This pilot study examined effects of Parent Skills with Behavioral Couples Therapy (PSBCT) on substance use, parenting, and relationship conflict among fathers with alcohol use disorders. Male participants (N = 30) entering outpatient alcohol treatment, their female partners, and a custodial child (8 to 12 years) were randomly assigned to (a) PSBCT; (b) Behavioral Couples Therapy (BCT); or (c) Individual-Based Treatment (IBT). Children were not actively involved in treatment. Parents completed measures of substance use, couples' dyadic adjustment, partner violence, parenting, and Child Protection Services (CPS) involvement at pretreatment, posttreatment, 6- and 12-month follow-up. PSBCT was comparable to BCT on substance use, dyadic adjustment, and partner violence; both groups showed clinically meaningful effects over IBT. Compared to BCT, PSBCT resulted in larger effect sizes on parent…
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Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting.
Despite the overall efficacy of psychotherapy, dropouts are substantial, many clients do not benefit, therapists vary in effectiveness, and there may be a crisis of confidence among consumers. A research paradigm called patient-focused research--a method of enhancing outcome via continuous progress feedback--holds promise to address these problems. Although feedback has been demonstrated to improve individual psychotherapy outcomes, no studies have examined couple therapy. The current study investigated the effects of providing treatment progress and alliance information to both clients and therapists during couple therapy. Outpatients (N = 410) at a community family counseling clinic were randomly assigned to 1 of 2 groups: treatment as usual (TAU) or feedback. Couples in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatme…
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Self-regulatory failure and intimate partner violence perpetration.
Five studies tested the hypothesis that self-regulatory failure is an important predictor of intimate partner violence (IPV) perpetration. Study 1 participants were far more likely to experience a violent impulse during conflictual interaction with their romantic partner than they were to enact a violent behavior, suggesting that self-regulatory processes help individuals refrain from perpetrating IPV when they experience a violent impulse. Study 2 participants high in dispositional self-control were less likely to perpetrate IPV, in both cross-sectional and residualized-lagged analyses, than were participants low in dispositional self-control. Study 3 participants verbalized more IPV-related cognitions if they responded immediately to partner provocations than if they responded after a 10-s delay. Study 4 participants whose self-regulatory resources were experimentally depleted were mor…
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One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue.
Purpose: To determine 1-year outcomes of a four-component behavioral therapy (BT) sleep intervention (Individualized Sleep Promotion Plan [ISPP]) versus a healthy eating control (HEC) on cancer-related fatigue in women receiving breast cancer adjuvant chemotherapy treatment (CTX).
Patients and methods: A total of 219 participants from 12 oncology clinics were randomly assigned in a clinical trial. Before CTX, research nurses coached intervention participants to develop a BT plan including stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. BT plans were revised before each CTX and 30, 60, and 90 days after the last CTX and reinforced 7 to 9 days later. HEC participants received nutritional information and equal attention. Pittsburgh Sleep Quality Index (PSQI), Daily Diary, Wrist Actigraph, and Piper Fatigue Scale measures and Repeated Linear Mixed Model a…
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Planning to break unwanted habits: habit strength moderates implementation intention effects on behaviour change.
Implementation intention formation promotes effective goal striving and goal attainment. However, little research has investigated whether implementation intentions promote behaviour change when people possess strong antagonistic habits. Experiment 1 developed relatively habitual responses that, after a task switch, had a detrimental impact on task performance. Forming an if-then plan reduced the negative impact of habit on performance. However, the effect of forming implementation intentions was smaller among participants who possessed strong habits as compared to participants who had weaker habits. Experiment 2 provided a field test of the role of habit strength in moderating the relationship between implementation intentions and behaviour in the context of smoking. Implementation intentions reduced smoking among participants with weak or moderate smoking habits, but not among particip…
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