Behavior Therapy Techniques Research Articles

The Treatment of Comorbid Anxiety in a Male With Poorly Controlled Diabetes in a Very Remote Primary Health Care Service

Rural Australians are shown to have poorer health and mental-health outcomes compared with their metropolitan counterparts, particularly for diabetes. Individuals with diabetes often meet criteria for comorbid mental-health conditions, such as anxiety and depression. Psychological treatment, as an adjunct to medical care, for individuals with diabetes is shown to improve overall health and wellbeing. This article describes a 38-year-old male who was referred to a very remote primary health care service by his diabetes educator for strategies to reduce work-related stress and improve his diabetes mismanagement. Mindfulness-based cognitive behavior therapy techniques were used, over six sessions, in the context of a rural and very remote community. Pre- and post-intervention measures showed a reduction in anxiety, distress, and improvement in his perception of his quality of life. Clinical implications for psychological treatment of diabetes and comorbid mental-health issues in rural and remote communities are discussed.

Positive Psychology in School-Based Psychological Intervention: A Study of the Evidence-Base

Psychological school-based (SB) interventions are long standing and increasingly influenced by the evolving evidence-base. The current consensus of interventions utilises predominantly cognitive behavioural therapy (CBT) techniques. Despite their efficacy, they possess a number of weaknesses and there is an argument to propose the application of positive psychology (PP) to address these shortcomings. This paper reviews the efficacy of PP interventions in schools by evaluating 28 articles from a number of databases, focusing on child, adolescent and school professionals’ populations globally. Included articles focus on SBPP interventions revealing outcomes for mental health or well-being in children and adolescents between the ages of 5 to 16. Articles with a solely educational focus were excluded. Meta-analysis and review articles in SB CBT are also considered as a comparison for the SB PP evidence base. Articles are synthesised according to intervention purpose. The results are varied revealing PP to be effective in improving positive traits and well-being, but a scarcity of data does not support the reliability of these findings for the purpose of introducing large-scale PP SB intervention programmes. Further, discrepancies in certain results are found due to sex differences highlighting the need for extensive research into such inconsistencies. An in-depth description of the context of school-based interventions and a discussion of these findings are provided. Conclusions are made regarding recommendations for future research.

Integrating substance use services into improving access to psychological therapies through multi-agency group work – a discussion document

Purpose – The main aim of this paper is to highlight innovative partnership working between voluntary sector General Practitioner's and primary and secondary mental health services to improve access to services. Many clients are turned away from services when they disclose substance use, this paper discusses why clients are excluded and how psychological therapies can engage clients in treatment using an alternative approach to health centres. It identifies the need for agencies to have multiple skills in working with both mental health and substance use to provide access to services. Design/methodology/approach – The improving access to psychological therapies (IAPT) group was developed to work with clients using psychological interventions to create, a more flexible approach to services for substance users with psychological difficulties and so the IAPT group was developed. To ensure group's stability it was thought that consistent staff from both organisations should remain in the programme for its duration. To ensure adequate staffing, two staff from the drug agency and three staff from the IAPT team were identified and had shown a firm commitment to work on the programme, and it was agreed that two staff were present at each meeting. The voluntary sector agency premises were chosen as the venue, due to their proximity to bus routes and the anonymity of the service location. The group convened for a period of six weeks and would be a closed group (start with the same group members and have no changes during the groups duration). This would allow clients to engage, work together and to gain confidence in supporting each other. It also allowed clients to work with existing group dynamics and to set boundaries. Establishing the group it was important that it met in the afternoon to allow clients to arrive. The group started at 1 p.m., and worked through until 4 p.m., starting with coffee and having a break within the afternoon. Time was also allocated at the end to talk to staff or other group members about any concerns. The programme included workbooks and hand outs to help clients continue the process at home. Information packs were given including helpline numbers and service information. The group was based using cognitive behavioural therapy techniques, mindfulness and dialectical behavioural therapy. Some motivational interviewing techniques and harm reduction messages as well as relapse prevention were included. Findings – Half the group reported that they had reduced their drug use, two went on to join group programmes. In total, 100 per cent agreed to continue to meet and support each other in a less formal setting. The group felt strongly that it should remain only about cannabis and not to introduce other drugs into the group. All clients felt the group should be a 12-week programme the staff running the group concurred with this. All participants felt the group was helpful but could have been 12 weeks, that it reduced their symptoms and enabled them to interact with others who understood their needs. Peer support was highlighted as the most useful. Two participants entered other drug programmes after the group. All participants associated their substance use with their mood. Originality/value – There are no other projects that have worked outside the IAPT model that integrate substance users and voluntary sector agencies. Provides a unique view of multi agency approach using IAPT in a non–General Practitioner setting with clients normally excluded from IAPT services due to drug use. Is about inclusion of a normally excluded group.

The Effectiveness of Applying Behavior Therapy’s Techniques on Social Interaction of Autistic Children

This study was designed and implemented aimed to determine the efficacy of behavior therapy techniques on improving casting, social interaction in autism children. This study was semi-experimental and without controlled group. Sample included sixteen 7-14-year-old children who were selected by available sampling method from special autism school children in the city of Tehran. These children were participated for 2 months in therapy sessions with a psychologist specializing management. For the treatment, documented procedures were used by Ivar Lovas titled Treatment intervention by Applied Behavior Analysis . Garez test was used for data collection. For the analysis of data, T test of affiliated groups and the SPSS software were used. Results showed that the techniques of treatment behavioral cause to increase social interaction in autistic children. This confirms the fact that no child should be abandoned without an education program fit the children needs.

Exposure Therapy for Phobias

Reid Wilson’s approach to treating anxiety disorders draws upon cognitive behavior therapy techniques to create a brief, aggressive, paradoxical treatment for people who suffer from anxiety disorders. Research has shown that exposure therapy is by far the most effective way to get lifelong results in the treatment of specific phobias. Not many therapists had a chance to see live therapy sessions with real clients and neither to access a good training specific for phobia. In the help of those trainee therapists eager to have rapid and long-lasting results with their clients comes the video in which Reid Wilson is giving step-by-step specific instruction to both trainee-therapists and client. Reid conducts two sessions with a real client, Mary, who experiences different phases and facets of claustrophobia: the fear of using elevators (especially crowded ones), the fear of traveling in tunnels without being able to see the light at the end as humorously dr. Wilson noticed, the fear of parking in tight and dark parking structures and most of all, the fear of flying, which is the most invalidating for dr. Wilson’s client.

The Effects of Behavioral Speech Therapy on Speech Sound Production With Adults Who Have Cochlear Implants

In this study, the authors examined the treatment efficacy of a behavioral speech therapy protocol for adult cochlear implant recipients. The authors used a multiple-baseline, across-behaviors and -participants design to examine the effectiveness of a therapy program based on behavioral principles and methods to improve the production of target speech sounds in 3 adults with cochlear implants. The authors included probe items in a baseline protocol to assess generalization of target speech sounds to untrained exemplars. Pretest and posttest scores from the Arizona Articulation Proficiency Scale, Third Revision (Arizona-3; Fudala, 2000) and measurement of speech errors during spontaneous speech were compared, providing additional measures of target behavior generalization. The results of this study provided preliminary evidence supporting the overall effectiveness and efficiency of a behavioral speech therapy program in increasing percent correct speech sound production in adult cochlear implant recipients. The generalization of newly trained speech skills to untrained words and to spontaneous speech was demonstrated. These preliminary findings support the application of behavioral speech therapy techniques for training speech sound production in adults with cochlear implants. Implications for future research and the development of aural rehabilitation programs for adult cochlear implant recipients are discussed.

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy.The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.

A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder

BackgroundBipolar disorder (BD) is a chronic and disabling psychiatric disorder characterized by recurrent episodes of mania/hypomania and depression. Dialectical behavior therapy (DBT) techniques have been shown to effectively treat borderline personality disorder, a condition also marked by prominent affective disturbances. The utility of DBT techniques in treating BD has been largely unexplored. The purpose of this research was to conduct a pilot study of a DBT-based psychoeducational group (BDG) in treating euthymic, depressed, or hypomanic Bipolar I or II patients. MethodsIn this experiment, 26 adults with bipolar I or II were randomized to intervention or wait-list control groups and completed the Beck depression inventory II, mindfulness-based self-efficacy scale, and affective control scale at baseline and 12 weeks. The BDG intervention consisted of 12 weekly 90-min sessions which taught DBT skills, mindfulness techniques, and general BD psychoeducation. ResultsUsing RM-ANOVA, subjects in BDG demonstrated a trend toward reduced depressive symptoms, and significant improvement in several MSES subscales indicating greater mindful awareness, and less fear toward and more control of emotional states (ACS). These findings were supported with a larger sample of patients who completed the BDG. Furthermore, group attendees had reduced emergency room visits and mental health related admissions in the six months following BDG. LimitationsThe small sample size in RCT affects power to detect between group differences. How well improvements after the12-week BDG were maintained is unknown. ConclusionsThere is preliminary evidence that DBT skills reduce depressive symptoms, improve affective control, and improve mindfulness self-efficacy in BD. Its application warrants further evaluation in larger studies.

Estudio de un caso de mutismo selectivo: evaluación e intervención en el contexto escolar

Children with selective mutism present a complicated set of symptoms, as they not only refuse to speak in certain social situations (e.g. at school), despite talking in others, but also appear shy and anxious, and often suffer problems associated with overprotective families and/or bilinguism. In this case we have studied an 8-year-old male with selective mutism, who has attended school since he was 3 years old and does not speak at school. The objective was to enable the child to communicate orally with different people in different settings at the school. We used behavioural therapy techniques such as: Relaxation and breathing techniques, stimulus fading, self modeling and positive reinforcement. The treatment program was very positive because the boy has now begun to speak to different people at the school. Nevertheless we recommend that more work be done because the pupil only spoke to his teacher once during which he was in a state of high muscle and autonomic activation.

Self-reflection in cognitive behavioural therapy and supervision

Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the ability to perceive other people's inner emotions, kindles altruism, and increases attunement to subtle signals indicating what others need or want. Self-reflection may be practised by the therapists themselves using traditional cognitive behavioural therapy techniques, or it may be learned in the course of supervision. If therapists are unable to recognize their own thoughts and feelings, or the effects of their attitudes in a therapeutic situation, then they are helpless against these thoughts and feelings, which may control the therapist's behaviour to the disadvantage of the client and therapist alike. Training and supervision focused on self-reflection are beneficial to both supervisees and their clients. The more experienced the supervisor is, the more self-reflection used in therapy and supervision.

Online self-administered training for post-traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study

This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-based practice; however, there is a dearth of well-controlled outcome studies of these approaches. For the current trial, 168 mental health providers treating post-traumatic stress disorder (PTSD) were assigned to web-based training plus supervision, web-based training, or training-as-usual (control). A novel standardized patient (SP) assessment was developed and implemented for objective measurement of changes in clinical skills, while on-line self-report measures were used for assessing changes in knowledge, perceived self-efficacy, and practice related to cognitive behavioral therapy (CBT) techniques. Eligible participants were all actively involved in mental health treatment of veterans with PTSD. Study methodology illustrates ways of developing training content, recruiting participants, and assessing knowledge, perceived self-efficacy, and competency-based outcomes, and demonstrates the feasibility of conducting prospective studies of training efficacy or effectiveness in large healthcare systems.

The Psychology of Religion and Spirituality for Clinicians. Using Research in Your Practice

The Psychology of Religion and Spirituality for Clinicians. Using Research in Your Practice

A Video With Good Representation of Basic Cognitive–Behavioral Therapy Techniques but Limited Ethnic Diversity of Clients and Therapists

A Video With Good Representation of Basic Cognitive–Behavioral Therapy Techniques but Limited Ethnic Diversity of Clients and Therapists

Virtual reality therapy: an effective treatment for psychological disorders.

Behavioral therapy techniques for treating phobias often includes graded exposure of the patient to anxiety-producing stimuli (Systematic Desensitization). However, in utilizing systematic desensitization, research reviews demonstrate that many patients appear to have difficulty imaging the prescribed anxiety-evoking scene. They also express strong aversion to experiencing real situations. This chapter describes the Virtual Reality Therapy (VRT), a new therapeutical approach that can be used to overcome some of the difficulties inherent in the traditional treatment of phobias. VRT, like current imaginal and in vivo modalities, can generate stimuli that could be utilized in desensitization therapy. Like systematic desensitization therapy, VRT can provide stimuli for patients who have difficulty in imagining scenes and/or are too phobic to experience real situations. Unlike in vivo systematic desensitization, VRT can be performed within the privacy of a room, thus avoiding public embarrassment and violation of patient confidentiality. VRT can generate stimuli of much greater magnitude than standard in vivo techniques. Since VRT is under patient control, it appears safer than in vivo desensitization and at the same time more realistic than imaginal desensitization. Finally, VRT adds the advantage of greater efficiency and economy in delivering the equivalent of in vivo systematic desensitization within the therapist's office. The chapter also describes how to use virtual reality in the treatment of specific phobias: fear of flying, fear of heights, fear of being in certain situations (such as a dark barn, an enclosed bridge over a river, and in the presence of an animal [a black cat] in a dark room), and fear of public speaking.

O-46 - Group CBT of anxiety disorders

Anxiety disorders are chronic psychiatric conditions with a low rate of natural remission, producing substantial decreases in the quality of life and numerous specific social role impairment and disabilities. Over past 15 years, behavioral, cognitive, and cognitive behavioral procedures (primarily exposure and cognitive reconstruction based treatments) were found to be effective in the treatment of anxiety disorders.The purpose of this mini workshop is to present the main principals and techniques of a short-term group cognitive behavioral therapy for these patients. In our work, we combine education, cognitive reconstruction, behavioural experiments, exposure therapy, social skills training and problem solving approach. This program will demonstrate how to provide significant improvement even for those with the most severe anxiety disorders.Participants will learn theoretically and practically in exercises:(1) The cognitive and behavioral models of anxiety disorders(2) The main principles of group cognitive behavioral therapy for anxiety disorders(3) How to use CBT techniques useful for anxiety disorders in group:(4) Cognitive reconstruction; - social skills training with role playing; - behavioral experiments and exposure (including imaginal exposure); - problem solving. By the project IGA, MZ CR NT 11047-4/2010.

ECP06-01 - How to improve communication with persons with psychosis

This interactive workshop will focus on experiences and challenges of communicating with patients about psychosis. It is based on research identifying what works and what does not work in naturally occurring communication between psychiatrists and psychotic patients. It will include a voices simulation exercise, learning specific cognitive behaviour therapy techniques (e.g. Socratic questioning, normalising) and applying them in role play exercises. Participants will work in small groups and there will be time for feedback and questions with the larger group.

The Effectiveness of Collaborative Story Building and Telling in Facilitating Group Cohesion in a College Classroom Setting

This study tested the notion that the construction and telling of a collaborative group story would facilitate the development of group cohesion within the context of an actual classroom setting over the duration of the course. Participants were 125 students in 8 classes (4 experimental, 4 control) of a group psychotherapy course that focused on the principles and techniques of cognitive behavior therapy in conjunction with psychodrama techniques. Results showed significantly higher cohesion scores in the experimental condition compared to the control condition, suggesting that collaborative story building and telling is a viable strategy for improving group cohesion.

The influence of depression on treatment for methamphetamine use

To determine whether the presence of comorbid depression influences response to psychological treatment for methamphetamine use. Randomised controlled clinical trial. Our study was conducted between 2001and 2005at two sites in Australia: the Hunter Region of New South Wales and the city of Brisbane, Queensland. The 214participants, who were all using methamphetamine at least once a week in the month prior to the study, were self-referred or referred from health services or drug and alcohol clinical services. Participants were divided into two groups based on whether or not they had depressive symptoms at baseline. The control group received only a self-help booklet; the two treatment groups received either two or four counselling sessions involving cognitive behaviour therapy and motivational interviewing techniques to manage methamphetamine use. Changes in methamphetamine use and depression at 5weeks and 6months after baseline. Over 70% of participants met criteria for depression at baseline, and depression was associated with significantly greater severity of methamphetamine use and related issues. Benzodiazepine use was significantly higher among depressed than non-depressed participants. Reductions in methamphetamine use between baseline and 5weeks were independently predicted by comorbid depression, in favour of increased change among those with baseline depression. Depressed participants who received three or four counselling sessions showed a significant reduction in depression at 5weeks. However, reductions in methamphetamine use and depression compared with baseline were no longer evident at 6months. Over the short term, comorbid depression did not negatively affect response to treatment, with some evidence of a dose-response treatment effect for reduction in depression. This was not maintained at 6months, indicating that methamphetamine-focused treatment may not enable people with comorbid depression to make sustained improvement at the level of their counterparts without depression. ACTRN12611000355976.

The Role of Social Schema in the Experience of Auditory Hallucinations: A Systematic Review and a Proposal for the Inclusion of Social Schema in a Cognitive Behavioural Model of Voice Hearing

The interpersonal nature of the voice-hearing experience has been highlighted in recent studies investigating whether social processes (or 'schemas') that guide interpersonal interactions also govern the relationship between voice hearer and voice. A systematic literature review of relevant studies was undertaken, including those that investigated how social processes interact with appraisals of voices, as well as affective and behavioural responding to voices. The review included 13 studies published between 2000 and 2010. Two well-replicated findings emerged from the review. First, voice hearers who perceive themselves to be of low social rank (inferior) relative to others also feel inferior in relation to their voice and behave accordingly. Second, responding to voices from a position of closeness/dependency is associated with least distress. The review advocates for an extension of the Chadwick and Birchwood cognitive behavioural model of voices to include the mediating role of social schemata in explaining the affective and behavioural responses to voices. Only two interventions have yet targeted social schema variables utilizing different therapeutic approaches, both with some success. These clinical studies, as well as clinical implications drawn from the reviewed literature, will be discussed. Social processes governing relationships in the real world are also at play in the relationship between voice hearer and voice. Social schemas also shape beliefs about-and responses to-voices and thus are important to target in therapy. Voice hearers may be able to develop a more equal, and thus less distressing, relationship with their voice by improving their perceived social rank relative to others. This may be achieved through assertiveness training, social skills training and/or self-esteem work. Cognitive behavioural therapy techniques can be instrumental in helping an individual to consider the beliefs they hold about their voices and the way in which they respond and relate to them. Addressing how past traumatic experiences have influenced the voice hearer's relationships with others and their voices in therapy is recommended.

Cognitive Behavioral Therapy Techniques for Pain in Lung Cancer Patients: A Systematic Review

Objectives: The objectives of this review are to establish the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. The specific question to be addressed in this review is: 1. What is the effectiveness of cognitive behavioral therapy techniques in treating pain in patients with lung cancer? Criteria for considering studies for this review Types of participants This review will consider studies that include patients with lung cancer. Types of interventions This review will consider studies that examined any intervention containing components of either behavioral and/or cognitive techniques for use in treatment of pain in patients with lung cancer pain, including any of the following: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation Types of outcome measures This review will consider studies that include outcome measures that examine the sensory components of pain (e.g., intensity, frequency, duration, or sensation).