CBT and its family of structured treatments.
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Research library, full list
1626 to 1650 of 2,546A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: a randomized controlled trial.
Background: Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which, critically, are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and limited mainly to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety.
Methods/design: This trial is the first evaluation of a short-term, transdiagnostic treatment protocol for treatment-seeking …
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Cognitive Behavioral Treatment for Acute Posttrauma Distress: A Randomized, Controlled Proof-of-Concept Study Among Hospitalized Adults With Burns.
Objective: (1) To evaluate the feasibility of conducting a randomized controlled trial (RCT) of the Safety, Meaning, Activation and Resilience Training (SMART) intervention vs nondirective supportive psychotherapy (NDSP) in an acutely hospitalized adult survivor of burn injury sample; and (2) to assess the preliminary effect of SMART on acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) symptom reduction as secondary prevention.
Design: Proof-of-concept, parallel group RCT design.
Setting: Regional burn center.
Participants: Acutely injured, hospitalized adult survivors of burn injury (N=50) were randomly assigned to SMART (n=28) or nondirective supportive psychotherapy (n=22). Due to dropout and missing data, final sample size was 40, SMART (n=21) and nondirective supportive psychotherapy (n=19).
Interventions: SMART is a manualized, 4…
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Zainal NH, Newman MG (2018)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of affective disorders33 citations Worry amplifies theory-of-mind reasoning for negatively valenced social stimuli in generalized anxiety disorder.
Background: Theory-of-mind (ToM) is the ability to accurately infer others' thoughts and feelings. In generalized anxiety disorder (GAD), cognitive and emotion regulation theories allude to the plausibility that ToM is conditional on the degree of individuals' state worry, a hallmark symptom. GAD and state worry may interact to predict ToM constructs. However, no experiments have directly tested such interactional hypotheses, and used ToM as a framework to advance understanding of social cognition in GAD. This study therefore aimed to address this gap.
Methods: 171 participants (69 GAD, 102 Controls) were randomly assigned to either a Worry or Relaxation induction and completed well-validated ToM decoding (Reading the Mind in the Eyes Test) and reasoning (Movie for the Assessment of Social Cognition) tasks.
Results: GAD status significantly interacted with state worry to predict accuracy…
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Efficacy of a Web-based, crowdsourced peer-to-peer cognitive reappraisal platform for depression: randomized controlled trial.
Background: Self-guided, Web-based interventions for depression show promising results but suffer from high attrition and low user engagement. Online peer support networks can be highly engaging, but they show mixed results and lack evidence-based content.
Objective: Our aim was to introduce and evaluate a novel Web-based, peer-to-peer cognitive reappraisal platform designed to promote evidence-based techniques, with the hypotheses that (1) repeated use of the platform increases reappraisal and reduces depression and (2) that the social, crowdsourced interactions enhance engagement.
Methods: Participants aged 18-35 were recruited online and were randomly assigned to the treatment group, "Panoply" (n=84), or an active control group, online expressive writing (n=82). Both are fully automated Web-based platforms. Participants were asked to use their assigned platform for a minimum of 25 min…
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Smits JA, Rosenfield D, Davis ML, Julian K, Handelsman PR, Otto MW, Tuerk P, Shiekh M, Rosenfield B, Hofmann SG, Powers MB (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usBiological psychiatry65 citations Yohimbine enhancement of exposure therapy for social anxiety disorder: a randomized controlled trial.
Background: Preclinical and clinical trials suggest that yohimbine may augment extinction learning without significant side effects. However, previous clinical trials have only examined adults with specific phobias. Yohimbine has not yet been investigated in the augmentation of exposure therapy for other anxiety disorders.
Methods: Adults (n = 40) with a DSM-IV diagnosis of social anxiety disorder were randomized to placebo or yohimbine HCl (10.8 mg) 1 hour before each of four exposure sessions. Outcome measures were collected at baseline, each treatment session, posttreatment, and 1-month follow-up.
Results: Yohimbine was well tolerated. Yohimbine augmentation, relative to placebo augmentation, resulted in faster improvement and better outcomes on self-report measures of social anxiety disorder severity (Liebowitz Social Anxiety Scale, d = .53) and depressed mood severity (Beck Depressi…
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Mindfulness-Based Program for Infertility: efficacy study.
Objective: To present and determine the impact of the Mindfulness-Based Program for Infertility (MBPI).
Design: Controlled clinical trial.
Setting: University research unit.
Patient(s): Fifty-five infertile women completed the MBPI, and 37 infertile women were assigned to a control group.
Intervention(s): The MBPI includes 10 weekly sessions, in a group format, with a duration of about 2 hours each (men attend three sessions).
Main outcome measure(s): Standardized measures of depression, state anxiety, entrapment, defeat, internal and external shame, experiential avoidance, mindfulness, self-compassion, and infertility self-efficacy were endorsed pre- and post-MBPI.
Result(s): The MBPI group and the control group were shown to be equivalent at baseline. By the end of the MBPI, women who attended the program revealed a significant decrease in depressive symptoms, internal and external sha…
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Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems.
Purpose: The COVID-19 pandemic has resulted in a widespread adoption of videoconferencing as a communication medium in mental health service delivery. This review considers the empirical literature to date on using videoconferencing to deliver psychological therapy to adults presenting with mental health problems.
Method: Papers were identified via search of relevant databases. Quantitative and qualitative data were extracted and synthesized on uptake, feasibility, outcomes, and participant and therapist experiences.
Results: Videoconferencing has an established evidence base in the delivery of cognitive behavioural therapies for post-traumatic stress disorder and depression, with prolonged exposure, cognitive processing therapy, and behavioural activation non-inferior to in-person delivery. There are large trials reporting efficacy for health anxiety and bulimia nervosa compared with tr…
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Psychological Interventions for the Treatment of Chronic Pain in Adults.
The high prevalence and societal burden of chronic pain, its undertreatment, and disparities in its management have contributed to the acknowledgment of chronic pain as a serious public-health concern. The concurrent opioid epidemic, and increasing concern about overreliance on opioid therapy despite evidence of limited benefit and serious harms, has heightened attention to this problem. The biopsychosocial model has emerged as the primary conceptual framework for understanding the complex experience of chronic pain and for informing models of care. The prominence of psychological processes as risk and resilience factors in this model has prompted extensive study of psychological treatments designed to alter processes that underlie or significantly contribute to pain, distress, or disability among adults with chronic pain. Cognitive-behavioral therapy is acknowledged to have strong evide…
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[Intervention focused on resources to reduce anxiety and depression disorders in cancer patients: A pilot study].
Introduction: Cancer, a widespread chronic disease, represented 400,000 diagnoses in France in 2017. The diagnoses as well as the treatments are a major source of stress for most patients concerned. Secondary effects may be painful and disturbing (pain, nausea, fatigue, loss of social and/or professional status, anxiety of death), and may lead to maladaptive coping strategies (avoidant coping), psychological inflexibility, anxiety, depression, and suicide risks which are twice as important as in the general population. Research in the field of psychotherapy for cancer patients represents an important international target, in particular in what concerns enhanced patient quality of life during and after treatment. Cognitive Behavioral Therapy, Mindfulness-Based Stress Reduction, as well as adapted physical activity have shown promising results to enhance patients' quality of life at differ…
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Role of clinical psychology in UK hospices.
Objective: The National Institute of Clinical Excellence (NICE) (2004) guidance recommends a tiered approach to psychological care within cancer care. This includes the provision of Clinical Psychologists to support other professionals to deliver high-quality psychological care at levels 1 and 2 and to provide direct input to patients experiencing high levels of distress at level 4. However, little is known about the role of Clinical Psychology within UK Hospices currently. A survey of Clinical Psychologists working in this area was undertaken to address this gap in knowledge.
Methods: We conducted an anonymous online survey of Clinical Psychologists working in Hospice organisations across the UK. Recruitment was completed via professional networking groups, social media and by contacting UK Hospice organisations. The survey included quantitative and qualitative items about professionals…
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Mindfulness-based Cognitive Therapy for Obsessive-Compulsive Disorder: A Pilot Study.
Background: Cognitive-behavioral therapy (CBT) is the first-choice intervention for obsessive-compulsive disorder (OCD); however, a notable proportion of patients either do not respond to treatment or relapse after CBT. Mindfulness-based treatment has been suggested as an alternative or complementary therapeutic strategy for OCD. However, only a few studies have focused on its application in clinical samples.
Objective: To evaluate the impact of a new treatment, called "Mindfulness-based Cognitive Therapy for OCD." It is an 11-session manualized group intervention that integrates elements of CBT, mindfulness, compassion-focused therapy, and acceptance and commitment therapy.
Methods: The program was delivered to 35 patients with a primary diagnosis of OCD.
Results: Participants demonstrated good adherence to the intervention. There was a significant reduction in mean total score on the Y…
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Current approaches to managing fear of cancer recurrence; a descriptive survey of psychosocial and clinical health professionals.
Objective: Fear of cancer recurrence (FCR) is common amongst cancer survivors and help with this problem is the most frequently reported unmet need in this population. This study investigated how FCR is perceived and managed by clinical health professionals (medical and nursing staff) and psychosocial professionals in oncology settings.
Methods: Clinical health professionals and psychosocial professionals in oncology settings received emailed invitations from their professional organisation to participate in an online survey.
Results: Data from 77 clinical health professionals and 64 psychosocial professionals indicate that FCR is perceived as common and challenging to manage. Thirty-one percent of psychosocial professionals estimated FCR is present in >50% of cancer survivors seen in their practise. Only a minority (21%) of clinical staff reported always referring patients with high lev…
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European Guidelines for Obesity Management in Adults.
Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk) can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, mainte…
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Outcomes for 18 to 25-year-olds with borderline personality disorder in a dedicated young adult only DBT programme compared to a general adult DBT programme for all ages 18.
Aim: Targeting young adults with borderline personality disorder (BPD) for treatment may carry significant social and clinical benefits. We aimed to evaluate a community-based Dialectical Behaviour Therapy (DBT) programme delivered exclusively to young adults with BPD.
Methods: We describe a naturally occurring non-equivalent, quasi-experimental comparison of outcomes for young adults (18-25 years) with BPD following 1 year of treatment in either a young adult only DBT programme or a general adult DBT programme (18+ years). Twenty-four young adults enrolled in a community-based young adult DBT programme open only to 18- to 25-year-olds with BPD. Another 13 young adults, also 18-25 years, enrolled in a general adult DBT programme open to all ages above 18 years. Both treatment conditions offered all modes of standard DBT for 1 year. Participants completed a battery of self-report measures…
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A novel cognitive-behavioral stress management method for multiple sclerosis. A brief report of an observational study.
Objectives: Psychological stress is an important risk factor for multiple sclerosis (MS) onset, relapse, neurological symptoms and psychosocial adjustment to the disease. Mounting evidence suggests that stress management could halt the disease progression and improve patients' wellbeing. The aim of this study was to investigate the effectiveness of a novel cognitive-behavioral stress management technique (called Pythagorean Self-Awareness Intervention - PSAI) routinely used in our clinics in patients with MS.
Methods: In this observational study, 148 MS patients receiving PSAI for 8-weeks were compared patients who followed only usual care. Measurements included cognitive function, psychological distress and physical fatigue. Propensity score (PS) methods (given the observational design) and linear mixed models were employed to address study's endpoints.
Results: A total of 128 (86.5%) o…
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Cultural adaptation of cognitive stimulation therapy (CST) for Chinese people with dementia: multicentre pilot study.
Objective: Ageing of the Chinese population will drive a continued surge in dementia prevalence. Empirically tested non-pharmacological interventions developed in western cultures may be implemented in Chinese. Cognitive Stimulation Therapy (CST) that originated in the UK has proven benefits on cognition and quality of life in people with dementia. We investigated the feasibility and cultural appropriateness of CST in Hong Kong Chinese (CST-HK).
Methods: Mixed methods research was conducted following the formative method for adapting psychotherapy. A culturally adapted CST-HK, developed involving multidisciplinary stakeholders, was tested in a pilot multicentre study in people with mild dementia (n = 30) receiving community or residential care. Changes in cognition and quality of life were measured. Opinions from family caregivers and group facilitators (n = 25) were collected through fo…
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Comparison of a gratitude-based and cognitive restructuring intervention for body dissatisfaction and dysfunctional eating behavior in college women.
Researchers have investigated the efficacy of a gratitude intervention for decreasing body dissatisfaction (BD) in an internet treatment-seeking sample and demonstrated it worked equally well to decrease BD as cognitive restructuring. We extend this research by testing the efficacy of a gratitude intervention on BD, along with common sequelae of BD: dysfunctional eating, negative mood, and depressive symptoms. Females were randomly assigned to Gratitude, Cognitive Restructuring, or Control conditions. Pre- to post-intervention period comparisons found the gratitude intervention to perform better than the other conditions at increasing body esteem, decreasing BD, reducing dysfunctional eating, and reducing depressive symptoms.
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Hoyer J, Wiltink J, Hiller W, Miller R, Salzer S, Sarnowsky S, Stangier U, Strauss B, Willutzki U, Leibing E (2016)cohort or longitudinalMEDLINE-indexed journal, not yet read by usClinical psychology & psychotherapy40 citations Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia: Results from a Large Multicentre Trial.
Unlabelled: We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed.
Method: Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied.
Results: Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-trea…
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Interventions targeting mental health self-stigma: A review and comparison.
Objective: With growing awareness of the impact of mental illness self-stigma, interest has arisen in the development of interventions to combat it. The present article briefly reviews and compares interventions targeting self-stigma to clarify the similarities and important differences between the interventions.
Method: We conducted a narrative review of published literature on interventions targeting self-stigma.
Results: Six intervention approaches (Healthy Self-Concept, Self-Stigma Reduction Program, Ending Self-Stigma, Narrative Enhancement and Cognitive Therapy, Coming Out Proud, and Anti-Stigma Photo-Voice Intervention) were identified and are discussed, and data is reviewed on format, group-leader backgrounds, languages, number of sessions, primary mechanisms of action, and the current state of data on their efficacy.
Conclusions and implications for practice: We conclude with a …
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Acute phase cognitive therapy for recurrent major depressive disorder: who drops out and how much do patient skills influence response?
Objective: The aims were to predict cognitive therapy (CT) noncompletion and to determine, relative to other putative predictors, the extent to which the patient skills in CT for recurrent major depressive disorder predicted response in a large, two-site trial.
Method: Among 523 outpatients aged 18e70, exposed to 12e14 weeks of CT, 21.6% dropped out. Of the 410 completers, 26.1% did not respond. To predict these outcomes, we conducted logistic regression analyses of demographics, pre-treatment illness characteristics and psychosocial measures, and midtreatment therapeutic alliance.
Results: The 17-item Hamilton Rating Scale for Depression (HRSD17) scores at entry predicted dropout and nonresponse. Patients working for pay, of non-Hispanic white race, who were older, or had more education were significantly more likely to complete. Controlling for HRSD17, significant predictors of nonresp…
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Treatment of chronic non-cancer pain.
Chronic pain is a pervasive problem that affects the patient, their significant others, and society in many ways. The past decade has seen advances in our understanding of the mechanisms underlying pain and in the availability of technically advanced diagnostic procedures; however, the most notable therapeutic changes have not been the development of novel evidenced-based methods, but rather changing trends in applications and practices within the available clinical armamentarium. We provide a general overview of empirical evidence for the most commonly used interventions in the management of chronic non-cancer pain, including pharmacological, interventional, physical, psychological, rehabilitative, and alternative modalities. Overall, currently available treatments provide modest improvements in pain and minimum improvements in physical and emotional functioning. The quality of evidence…
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Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients' experiences.
OBJECTIVE. Severe health anxiety (hypochondriasis) is a common and disabling condition for which existing psychological treatments have limited effects (Thomson & Page, 2007). Hence, it is a priority to examine both the efficacy and acceptability of new psychological treatments for health anxiety. The aim of this study was to explore the experiences of participants with severe health anxiety who received Mindfulness-based Cognitive Therapy (MBCT) as part of a randomized controlled trial. DESIGN. Semi-structured interviews were carried out 3 months after participants completed MBCT in order to explore their experiences of the course and subsequent self-managed practice. METHODS. Interpretative Phenomenological Analysis (Smith, 1996) was used to analyze interview transcripts from nine participants who had received MBCT. RESULTS. Two main themes emerged from the analysis: (1) My awareness o…
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[French validation of the anger reactions and goals scale (RBC)].
Background: The study presents the French validation of a German scale (AERZ) [Diagnostica 49 (2003) 97-109, revised Eur J Pers (2009)] measuring anger regulation. The French validation (RBC scale) comprises two subscales measuring seven anger reactions and seven anger goals. Disentangling dimensions related to anger reactions and anger goals, respectively, is the main advantage of this scale. In addition to seven cognitive-behavioral anger reactions (i.e., venting, rumination, submission, feedback, distraction, humor and downplaying the incident's negative impact), the RBC scale also addresses the cognitive representations underlying anger reactions by exploring anger goals (i.e., enforcing personal standards, enforcing social standards, downregulating affect, avoiding conflicts, protecting one's reputation, weighing costs and gaining revenge).
Method: The original scale was translated …
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The Fear of Positive Evaluation Scale: psychometric properties in a clinical sample.
Cognitive models of social anxiety suggest that fear of negative evaluation (FNE) is the central cognitive dimension underlying the disorder. The Fear of Positive Evaluation Scale (FPES; Weeks, Heimberg, & Rodebaugh, 2008) was recently developed to assess an additional cognitive dimension purported to underlie social anxiety disorder (SAD), but its psychometric properties have yet to be examined in clinical populations. The present study, with 133 treatment-seeking patients, examined the applicability of the FPES with a clinical sample. Results indicated that the FPES was factorially distinct from a measure assessing FNE, and patients with SAD (n=51) had higher mean scores on the FPES than patients with other anxiety disorders (n=82). The FPES also showed adequate reliability (internal consistency), good convergent and discriminant validity, acceptable criterion-related validity in predi…
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Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?
Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination parti…
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