CBT and its family of structured treatments.
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2051 to 2075 of 2,546Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course.
Introduction: College students' mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment, a recent trend on college campuses is to offer courses designed to teach students strategies for developing mental health or resilience. While these courses are exceptionally popular among students, a paucity of research investigates the health outcomes associated with participation. The purpose of this study is to investigate the acceptability, appropriateness, feasibility and preliminary effectiveness of a college course grounded in skills from dialectical behaviour therapy (DBT) titled, 'Wellness and Resilience for College and Beyond'.
Methods and analysis: During the spring and fall 2020 semesters, the course will be offered on five campuses in Southw…
matched on Dialectical Behavior Therapy (mesh), acceptance and commitment (text)
Dose-response patterns in low and high intensity cognitive behavioral therapy for common mental health problems.
Background: Cognitive-behavioral therapy (CBT) is effective for the treatment of common mental health problems, but the number of sessions required to maximize improvement in routine care remains unclear.
Aim: This study aimed to examine the dose-response effect in low (LiCBT) and high (HiCBT) intensity CBT delivered in stepped care services.
Methods: A multi-service data set included N = 102 206 patients across N = 16 services. The study included patients with case-level depression and/or anxiety symptoms who accessed LiCBT and/or HiCBT. Patients with posttreatment reliable and clinically significant improvement in standardized outcome measures (PHQ-9, GAD-7) were classified as treatment responders. Survival analyses assessed the number of sessions necessary to detect 50%, 75%, and 95% of treatment responders. The 50% and 95% percentiles were used to define the lower and upper boundarie…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Experiences from implementation of internet-delivered cognitive behaviour therapy for insomnia in psychiatric health care: a qualitative study applying the NASSS framework.
Background: Insomnia is a common diagnosis among patients in psychiatric health care and effective treatments are highly demanded. Previous research suggests that internet-delivered cognitive behavioural therapy for insomnia (ICBT-i) is helpful for a variety of patients and may be effective for psychiatric health care patients. Little is known about implementation of ICBT-i in psychiatric health care. The aim of this study was to explore experiences among therapists and managers who participated in a pilot implementation of ICBT-i in outpatient psychiatric health care, and to identify determinants for the implementation.
Methods: Semi-structured interviews were conducted with 7 therapists and 5 managers working in outpatient psychiatric health care and directly involved with the pilot implementation. Data were analysed using qualitative content analysis guided by the NASSS framework, com…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioural therapy (text)
Different patterns of treatment response to Cognitive-Behavioural Therapy for Insomnia (CBT-I) in psychosis.
People with psychosis benefit enormously from Cognitive Behavioural Therapy for Insomnia (CBTI), although some variability exists in treatment outcomes. While recent efforts have focused on profiling sleep at treatment initiation, an alternative methodological approach involves using treatment response as a starting point to better understand what constitutes an effective treatment. This study used Grade of Membership analysis (GoM) to estimate the occurrence of unique treatment outcomes and associated patient characteristics. Outcome measures included changes in sleep (self-reported latency, efficiency, duration, quality), functional outcomes (daytime dysfunction, negative mood, need for sleep medication) and treatment goal, collected in 50 individuals with a psychotic disorder and insomnia who underwent CBT-I treatment. Three distinct profiles were identified: (1) Strong responders, wh…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioural therapy (text)
Perinatal Anxiety and Depression in Minority Women.
Depression and anxiety are common during pregnancy and are experienced at higher rates among women who are racial and ethnic minorities. Because depression and anxiety influence maternal and infant outcomes, intervening to improve perinatal mental health should be a priority for all healthcare providers. However, in the United States, a number of barriers including lack of mental health providers, lack of perinatal behavioral health systems, and stigma, limit access to care. Universal screening has been recommended and here we examine how universal screening can help nurses improve the mental health of childbearing women. Interventions that are currently in use to improve perinatal anxiety and depression are reviewed and include: psychopharmacology, cognitive behavioral therapy, interpersonal psychotherapy, and mindfulness. Recommendations for future research and healthcare system change…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Blended Care-Cognitive Behavioral Therapy for Depression and Anxiety in Real-World Settings: Pragmatic Retrospective Study.
Background: The past few decades saw considerable advances in research and dissemination of evidence-based psychotherapies, yet available treatment resources are not able to meet the high need for care for individuals suffering from depression or anxiety. Blended care psychotherapy, which combines the strengths of therapist-led and internet interventions, can narrow this gap and be clinically effective and efficient, but has rarely been evaluated outside of controlled research settings.
Objective: This study evaluated the effectiveness of a blended care intervention (video-based cognitive behavior therapy and internet intervention) under real-world conditions.
Methods: This is a pragmatic retrospective cohort analysis of 385 participants with clinical range depression and/or anxiety symptoms at baseline, measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disord…
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Self-guided online cognitive behavioural therapy for insomnia: A naturalistic evaluation in patients with potential psychiatric comorbidities.
Background: Insomnia is the most prevalent sleep disorder worldwide, and regularly co-occurs with anxiety and depression. Cognitive behavioural therapy is the gold standard treatment for insomnia (CBT-I), however demand for treatment providers drastically exceeds supply. Internet-delivered programs for insomnia (iCBT-I) improve treatment access. However the effects of unguided iCBT-I for individuals with comorbidities within a naturalistic setting remains unexplored. We developed a novel unguided iCBT-I program and evaluated its impact on insomnia, psychological distress, and wellbeing when accessed by the public.
Methods: 317 participants experiencing insomnia for over 3 months enrolled in the program. The program consisted of 4 lessons delivered online with automated web support. Insomnia symptoms, psychological distress, and general wellbeing were assessed at lesson 1 and 4. Intention…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioural therapy (text)
Subjective-objective sleep discrepancy in patients with insomnia during and after cognitive behavioural therapy: An actigraphy study.
Although patients with insomnia often show a discrepancy between self-reported and objective sleep parameters, the role of and change in this phenomenon during treatment remain unclear. The present study aimed to assess the effect of cognitive behavioural therapy for insomnia on subjective and objective sleep discrepancy of total sleep time, sleep-onset latency and wake after sleep onset. The total sleep time discrepancy was also assessed across the entire therapy. The second aim was to examine the treatment outcome of two insomnia groups differing in sleep perception. Thirty-six adults with insomnia (mean age = 46.7 years, SD = 13.9; 22 females) were enrolled in the final analyses. Patients underwent a 6-week group cognitive behavioural therapy for insomnia programme. Sleep diary and actigraphy measurements were obtained during the therapy. Patients who underestimated total sleep time (…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioural therapy (text)
Mavranezouli I, Megnin-Viggars O, Grey N, Bhutani G, Leach J, Daly C, Dias S, Welton NJ, Katona C, El-Leithy S, Greenberg N, Stockton S, Pilling S (2020)MEDLINE-indexed journal, not yet read by usPloS one58 citations Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults.
Background: Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of interventions for adults with PTSD.
Methods: A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.
Results: Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioural therapy (text)
Ogorek D, Isaacson J (2020)MEDLINE-indexed journal, not yet read by usJournal of Christian nursing : a quarterly publication of Nurses Christian Fellowship Biblical Counseling: An Alternative for Treating Depressive Symptoms.
Despite use of current standards of care-antidepressant medications and psychotherapy-to treat depressive symptoms, results experienced by patients and reported in the literature have been inconsistent. Religiously integrated cognitive behavioral therapy (RCBT) is an evidence-based alternative to cognitive behavioral therapy. A type of RCBT, biblical counseling is a viable option for patients experiencing depressive symptoms. Nurses need an awareness of biblical counseling as a therapeutic option for patients who are open to spiritually based care for depression.
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Internet-delivered cognitive behavior therapy with minimal therapist support for anxious children and adolescents: predictors of response.
Background: In general, Internet-delivered cognitive behavior therapy (iCBT) produces significant reductions in child and adolescent anxiety, but a proportion of participants continue to show clinical levels of anxiety after treatment. It is important to identify demographic, clinical, and family factors that predict who is most likely to benefit from iCBT in order to better tailor treatment to individual needs.
Methods: Participants were 175 young people (7-18 years) with an anxiety disorder, and at least one of their parents, who completed an iCBT intervention with minimal therapist support. Multilevel modeling (MLM) examined predictors of response to iCBT as measured by the slope for changes in the primary outcome measures of child- and parent-reported anxiety scores, from pretreatment, to 12-weeks, 6-month, and 12-month follow-ups, controlling for pretreatment total clinician severit…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Pilot evaluation of the Sleep Ninja: a smartphone application for adolescent insomnia symptoms.
Objectives: The aim of this study was to test the feasibility, acceptability and preliminary effects of a recently developed smartphone application, Sleep Ninja, for adolescent sleep difficulties.
Setting: The study was conducted online with Australian individuals recruited through the community.
Participants: Participants were 50 young people aged 12-16 years with sleep difficulties.
Design: A single-arm pre-post design was used to evaluate feasibility, acceptability and sleep and mental health variables at baseline and postintervention.
Intervention: Cognitive-behavioural therapy for insomnia informed the development of the Sleep Ninja. The core strategies covered by the app are psychoeducation, stimulus control, sleep hygiene and sleep-related cognitive therapy. It includes six training sessions (lessons), a sleep tracking function, recommended bedtimes based on sleep guidelines, remi…
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Mallorquí-Bagué N, Vintró-Alcaraz C, Verdejo-García A, Granero R, Fernández-Aranda F, Magaña P, Mena-Moreno T, Aymamí N, Gómez-Peña M, Del Pino-Gutiérrez A, Mestre-Bach G, Menchón JM, Jiménez-Murcia S (2019)MEDLINE-indexed journal, not yet read by usEuropean psychiatry : the journal of the Association of European Psychiatrists48 citations Impulsivity and cognitive distortions in different clinical phenotypes of gambling disorder: Profiles and longitudinal prediction of treatment outcomes.
Background: Impulsivity and cognitive distortions are hallmarks of gambling disorder (GD) but it remains unclear how they contribute to clinical phenotypes. This study aimed to (1) compare impulsive traits and gambling-related distortions in strategic versus non-strategic gamblers and online versus offline gamblers; (2) examine the longitudinal association between impulsivity/cognitive distortions and treatment retention and relapse.
Methods: Participants seeking treatment for GD (n = 245) were assessed for gambling modality (clinical interview), impulsive traits (Urgency, Premeditation, Perseverance and Sensation Seeking [UPPS] scale) and cognitive distortions (Gambling Related Cognitions Scale) at treatment onset, and for retention and relapse (as indicated by the clinical team) at the end of treatment. Treatment consisted of 12-week standardized cognitive behavioral therapy, conducted…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment.
In this article, a clinical protocol for delivering a flexible, spiritually integrated cognitive-behavioral therapy, called spiritual psychotherapy for inpatient, residential, and intensive treatment (SPIRIT), is presented, and its implementation is described.
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Stepped Care as an Implementation and Service Delivery Model for Cognitive Behavioral Therapy for Psychosis.
Cognitive behavioral therapy for schizophrenia spectrum disorders is an evidence-based treatment that is recommended by United States schizophrenia treatment guidelines. Based on recent estimates, only 0.3% of individuals with a primary psychotic disorder are able to access this treatment in the United States. Stepped care interventions have shown promise as an applied treatment delivery model in other settings and for other psychotherapeutic interventions. The current paper describes how the stepped care model can be applied to CBT for psychosis in the US to increase access to the intervention in community mental health settings by leveraging the multidisciplinary team.
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Interoceptive deficits in patients with obsessive-compulsive disorder in the time course of cognitive-behavioral therapy.
Interoception is impaired in different psychiatric disorders and is also associated with emotions. Only one study could show a higher interoceptive accuracy (IAcc) in patients with obsessive-compulsive disorder (OCD). Based on the predictive coding system we assume contrary results, indicating a decreased IAcc in patients with OCD. So far, there is no study investigating the effect of cognitive-behavioral therapy on IAcc in patients with OCD. Therefore, we hypothesize that patients with OCD improve their IAcc during the time course of therapy compared to healthy controls. Twenty-six patients with OCD from the Psychosomatic Clinic in Windach were examined in the time course of cognitive-behavioral therapy. They were compared to 26 matched healthy controls. IAcc via the heartbeat perception task as well as questionnaire data (OCD-, depression- and anxiety symptoms) were assessed. Results s…
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Implementing trauma-focused CBT for children of veterans in the VA: Providing comprehensive services to veterans and their families.
Military families experience unique stressful circumstances such as frequent moves, service-related physical and mental health difficulties, and separation from support. Although many families exhibit high resilience in response to these stressors, military children are at an increased risk for emotional and behavioral difficulties, exposure to intimate partner violence, and child maltreatment. These potential problems not only affect child functioning, but often also negatively impact family and veteran outcomes. Although the Department of Defense has enhanced efforts to address child and family trauma among military families, many veterans' families are still not receiving timely, evidence-based treatment. With many veterans receiving care through Veterans Affairs (VA) medical centers, incorporating family treatment into VA services is important for promoting optimal veteran outcomes. …
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Changes in Decentering and Reappraisal Temporally Precede Symptom Reduction During Emotion Regulation Therapy for Generalized Anxiety Disorder With and Without Co-Occurring Depression.
Emotion Regulation Therapy (ERT) has demonstrated efficacy in both open and randomized trials for generalized anxiety disorder (GAD) with and without co-occurring depression. An important goal in ERT is to teach clients adaptive emotion regulation, including healthier metacognitive abilities such as decentering and cognitive reappraisal. A few studies thus far have demonstrated a mediating role for these metacognitive abilities in other cognitive behavioral therapies (CBTs) for GAD. However, a drawback to most of these has been the ability to demonstrate a causal role for improved metacognitive abilities in outcome. In the present study, we utilized multilevel time-lagged segment analyses to explore the temporal dynamics between session-by-session changes in metacognition and anxiety outcomes from ERT. Thirty-one young adults diagnosed with GAD with and without co-occurring depression re…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Acceptability, tolerability, and potential efficacy of cognitive behavioural therapy for Insomnia Disorder subtypes defined by polysomnography: A retrospective cohort study.
In this retrospective cohort study, we describe acceptability, tolerability and potential efficacy of cognitive behavioural therapy (CBT) in Insomnia Disorder subtypes, derived from polysomnography (PSG): insomnia with normal-sleep duration (I-NSD) and insomnia with short-sleep duration (I-SSD). All research volunteers were offered access to digital CBT, single component sleep restriction therapy and face-to-face group CBT. Follow-up occurred at three months post-treatment using the insomnia severity index (ISI). 96 participants (61 females, mean age of 41 years) were grouped into either normal-sleep (n = 53) or short-sleep (n = 43). CBT was acceptable to 63% of participants (normal-sleep = 31, short-sleep = 29), with 28 completing therapy (tolerability: normal-sleep = 11, short-sleep = 17). For potential efficacy, 39 (normal-sleep = 20, short-sleep = 19) out of 96 participants (41%) com…
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Large-Scale Dissemination of Internet-Based Cognitive Behavioral Therapy for Youth Anxiety: Feasibility and Acceptability Study.
Background: Internet-based cognitive behavioral therapy (iCBT) for child and adolescent anxiety has demonstrated efficacy in randomized controlled trials, but it has not yet been examined when disseminated as a public health intervention. If effective, iCBT programs could be a promising first-step, low-intensity intervention that can be easily accessed by young people.
Objective: The objective of our study was to examine the feasibility and acceptability of a publicly available online, self-help iCBT program (BRAVE Self-Help) through exploration of program adherence, satisfaction, and changes in anxiety.
Methods: This study was an open trial involving the analysis of data collected from 4425 children and adolescents aged 7-17 years who presented with elevated anxiety at registration (baseline) for the iCBT program that was delivered through an open-access portal with no professional supp…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
The relation between outcome expectation, therapeutic alliance, and outcome among depressed patients in group cognitive-behavioral therapy.
Objective: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy.
Method: This study focused on such associative chains among 91 depressed outpatients who completed 10 weeks of group cognitive-behavioral therapy. We conducted simple and multiple mediation analyses, accounting for the nested data structure.
Results: As predicted, we found: (i) The relations between baseline outcome expectation and both posttreatment anxiety and depression were mediated by alliance q…
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Chand SP, Chibnall JT, Slavin SJ (2018)MEDLINE-indexed journal, not yet read by usAcademic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry14 citations Cognitive Behavioral Therapy for Maladaptive Perfectionism in Medical Students: A Preliminary Investigation.
Objectives: Maladaptive perfectionism is associated with psychological distress and psychopathology. Medical students have been found to be particularly prone to maladaptive perfectionism. Recent research has indicated that Cognitive Behavioral Therapy (CBT) that targets unhealthy perfectionism leads to reductions in perfectionism and related distress. This preliminary investigation aimed to evaluate the efficacy of a CBT program directed at medical students who had significant levels of maladaptive perfectionism. The impact on associated psychological distress was also assessed.
Methods: The study used a case series methodology with an A-B design plus follow-up. First-year medical students who screened positive for maladaptive perfectionism and consented for the study (N = 4) were assessed at baseline to evaluate the levels of maladaptive perfectionism, anxiety, and depression. They par…
matched on Cognitive Behavioral Therapy (mesh), cognitive behavioral therapy (text)
Treatment processes and demographic variables as predictors of dropout from trauma-focused cognitive behavioral therapy (TF-CBT) for youth.
Objective: Premature dropout is a significant concern in trauma-focused psychotherapy for youth. Previous studies have primarily examined pre-treatment demographic and symptom-related predictors of dropout, but few consistent findings have been reported. The current study examined demographic, symptom, and in-session process variables as predictors of dropout from Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth.
Method: Participants were a diverse sample of Medicaid-eligible youth (ages 7-17; n = 108) and their nonoffending caregivers (n = 86), who received TF-CBT through an effectiveness study in a community setting. In-session process variables were coded from audio-recorded sessions, and these and pre-treatment demographic variables and symptom levels were examined as predictors of dropout prior to receiving an adequate dose of TF-CBT (<7 sessions). Twenty-nine children…
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Meyer EC, Walser R, Hermann B, La Bash H, DeBeer BB, Morissette SB, Kimbrel NA, Kwok OM, Batten SV, Schnurr PP (2018)MEDLINE-indexed journal, not yet read by usJournal of traumatic stress51 citations Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes.
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur and are associated with worse outcomes together than either disorder alone. A lack of consensus regarding recommendations for treating PTSD-AUD exists, and treatment dropout is a persistent problem. Acceptance and Commitment Therapy (ACT), a transdiagnostic, mindfulness- and acceptance-based form of behavior therapy, has potential as a treatment option for PTSD-AUD. In this uncontrolled pilot study, we examined ACT for PTSD-AUD in 43 veterans; 29 (67%) completed the outpatient individual therapy protocol (i.e., ≥ 10 of 12 sessions). Clinician-assessed and self-reported PTSD symptoms were reduced at posttreatment, ds = 0.79 and 0.96, respectively. Self-reported symptoms of PTSD remained lower at 3-month follow-up, d = 0.88. There were reductions on all alcohol-related outcomes (clinician-assessed and s…
matched on Acceptance and Commitment Therapy (mesh), acceptance and commitment (text)
Adapted CBT to Stabilize Sleep on Psychiatric Wards: a Transdiagnostic Treatment Approach.
Background: Almost all patients admitted at acute crisis to a psychiatric ward experience clinically significant symptoms of insomnia. Ward environments pose challenges to both sleep and the delivery of therapy. Despite this, there is no description of how to adapt cognitive behavioural therapy (CBT) for insomnia to overcome these challenges.
Aims: (i) To describe the key insomnia presentations observed in the Oxford Ward Sleep Solution (OWLS) trial and (ii) outline key adaptations aimed to increase accessibility and hence effectiveness of CBT for insomnia for a ward setting.
Methods: Trial therapists collaboratively agreed the key insomnia presentations and therapy adaptations based on their individual reflective logs used during the trial.
Results: Three key insomnia presentations are outlined. These are used to illustrate the application of 10 CBT for insomnia therapy adaptations. The…
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