Cognitive Behavioral Therapy For Depression Research Articles

Effects of cognitive behavioral therapy on depression, anxiety, sleep and quality of life for patients with heart failure and coronary heart disease. a systematic review of clinical trials 2010 – 2020

Background: There is a growning evidence that CBT (Cognitive Behavioral Therapy) improves mental health of patients with chronic illnesses but its effectiveness is not well established in patients with heart diseases. The present systematic review was conducted to evaluate the effects of CBT in heart failure (HF) and coronary heart disease (CHD) patients.Methods: Pubmed, Cohraine and Google Scholar were searched for studies with randomized controlled trials. Studies were required to assess the effectiveness of CBT in depression, anxiety, sleep and quality of life of patients suffering from heart failure and coronary heart disease. SStudies identified were independently screened by two reviewers and critically appraised using the PedroScale.Results: Sixteen randomized controlled trials were included in the review. The majority of the studies indicated that CBT therapy was effective treatment for reducing depression and anxiety and can also be beneficial for sleeping disorders and improve quality of life of patients with heart failure and coronary heart disease. Althought face to face CBT therapy seems to be clinicaly effective, internet-based CBT therapy was not superior to a guided web-based discussion forum.Conclusions: CBT can improve psychological health and quality of life of cardiac patients and further enhance benefits of rehabilitation programs. Findings suggest that face-to-face CBT is superior to usual care and it can be incorporated in cardiac rehabilitations programs. Future studies are needed to identify the effectiveness of internet-based CBT on cardiac patients and address the factors that will increase treatment adherence.

Cognitive Behavior Therapy for Depression From an Evolutionary Perspective.

Evolutionary medicine attempts to solve a problem with which traditional medicine has struggled historically; how do we distinguish between diseased states and “healthy” responses to disease states? Fever and diarrhea represent classic examples of evolved adaptations that increase the likelihood of survival in response to the presence of pathogens in the body. Whereas, the severe mental disorders like psychotic mania or the schizophrenias may involve true “disease” states best treated pharmacologically, most non-psychotic “disorders” that revolve around negative affects like depression or anxiety are likely adaptations that evolved to serve a function that increased inclusive fitness in our ancestral past. What this likely means is that the proximal mechanisms underlying the non-psychotic “disorders” are “species typical” and neither diseases nor disorders. Rather, they are coordinated “whole body” responses that prepare the individual to respond in a maximally functional fashion to the variety of different challenges that our ancestors faced. A case can be made that depression evolved to facilitate a deliberate cognitive style (rumination) in response to complex (often social) problems. What this further suggests is that those interventions that best facilitate the functions that those adaptations evolved to serve (such as rumination) are likely to be preferred over those like medications that simply anesthetize the distress. We consider the mechanisms that evolved to generate depression and the processes utilized in cognitive behavior therapy to facilitate those functions from an adaptationist evolutionary perspective.

Does the working alliance mediate the therapist competence-outcome relationship in cognitive behavior therapy for depression?

Objective: This study examined whether the working alliance mediated the effect of therapist competence on subsequent depression symptomology during Cognitive Behavioral Therapy (CBT). We also tested the potential moderation effect of alliance on subsequent depressive symptomology, based on participants’ cognitive aptitude. Method: A total of 86 sessions were coded as the prediction interval across 50 patient-therapist dyads (age M = 39.22, SD = 8.78; 76% female). While accounting for prior depression, competence, and alliance levels, predictors were assessed early treatment (session 1; n = 45 sessions), mid-treatment (session 12; n = 41 sessions), and depressive symptomology was assessed at the subsequent session to the predictor assessments to investigate within-session variability of process variables. Results: Mediation analysis revealed that the effect of early treatment therapist competence on symptom change was mediated by alliance (indirect effect: β = −.17, 95% percentile bootstrap CI [−.32, −.01]). The positive association involving early treatment alliance and next session outcome was conditional upon low cognitive aptitude levels. Conclusions: Our result offers preliminary support for alliance as a mediator of the effect of competence, and that alliance-outcome relations vary as a function of client aptitude. These novel findings require replication and extension.

Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study

BackgroundInternet-delivered cognitive behavioural therapy (ICBT) is a promising treatment for refugee and immigrant populations suffering from common mental disorders. The aim of the present study was to investigate experiences of participating in a guided ICBT program among resettled Arabic-speaking individuals suffering from symptoms of anxiety and depression.MethodsTen individuals who had previously received ICBT consented to participate and were interviewed using semi-structured telephone interviews. The interviews were conducted 10 months after treatment termination. Data were transcribed and analysed using a Thematic Analysis framework.ResultsThe Thematic Analysis resulted in five overarching themes 1) The importance of being seen, 2) New ways of knowing and doing, 3) Treatment format not for everyone, 4) Changing attitudes towards mental health and help-seeking and 5) The healthcare system as a complex puzzle. Participants described varying levels of success in applying the new information learned from the treatment in their everyday lives. The results also indicate that participation in the ICBT program to some extent mitigated mental health stigma and acted as a precursor to other forms of treatment seeking.ConclusionsThe findings in the present study are largely in line with previous qualitative research studies on ICBT participants. Future research should investigate whether a more explicit focus on refugee-specific stressors and barriers to treatment engagement and implementation can increase adherence to ICBT programs in this population.

A randomized controlled trial of cognitive behavior therapy for reducing anxiety and depressive symptoms in patients with locoregional advanced nasopharyngeal carcinoma.

12121 Background: The purpose of this randomized trial was to compare the efficacy of cognitive behavioral therapy (CBT) versus treatment as usual (TAU) on anxiety and depression, response rates and acute adverse events in patients with locoregional advanced nasopharyngeal carcinoma (NPC) receiving chemoradiotherapy. To the best of our knowledge, this is the first randomized trial evaluating the effect of CBT for depression and anxiety in patients with locoregional advanced NPC treated with chemoradiotherapy. Methods: A total of 202 patients with diagnosis of stage III-IVa (8th AJCC) NPC were randomly assigned to receive CBT plus chemoradiotherapy (CBT group, n = 101) or treatment as usual (TAU) plus chemoradiotherapy (TAU group, n = 101). Patients in the CBT group received a series of six CBT sessions for 6 weeks during concurrent chemoradiotherapy. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS) score at baseline, the completion of chemoradiotherapy, 1 and 3 months after chemoradiotherapy. Response rates and adverse events were also evaluated. This trial is registered with chictr.org.cn, number ChiCTR2000034701. Results: Patients in the CBT group showed significantly less depression and anxiety than patients in the TAU group after the completion of CBT (P < 0.01). Complete response (CR) rate was significantly higher in CBT group than in TAU group (100% vs. 93.1%，P = 0.014). Compared with the TAU group, the CBT group showed a significantly lower incidence of acute adverse events including anemia, fatigue, mucositis, insomnia and weight losing (P < 0.05). Conclusions: The addition of CBT to chemoradiotherapy significantly reduced depressive and anxiety symptoms. CBT combined with chemoradiotherapy is associated with improved response rates, with reduced incidence of acute toxic effects in patients with locoregional advanced nasopharyngeal carcinoma. Clinical trial information: ChiCTR2000034701.

583 Treating Insomnia in Youth Depression: A Randomized Controlled Trial of CBT for Depression vs. CBT for Insomnia

Abstract Introduction Insomnia is often comorbid with depression in youths and both may reciprocally exacerbate clinical outcomes and lead to a constellation of detrimental consequences. The present study aimed to test the efficacy of cognitive behavioral therapy (CBT) for insomnia (CBT-I) and CBT for depression (CBT-D), when compared with waitlist control, in youths with comorbid insomnia and depression. Methods 112 participants aged 12–24 years old (67.9% female) with insomnia and depression according to DSM-5 diagnostic criteria were randomised to one of the following conditions: 8-week group CBT-I (n=33), 8-week group CBT-D (n=39), or waiting-list control (n=40). Insomnia (Insomnia Severity Index, ISI) and depressive symptoms (Hamilton Rating Scale for Depression, HAMD) were assessed at baseline and post-intervention. The two active treatment groups were additionally followed up at post-treatment one-month. Results Linear mixed model showed that both treatment groups (CBT-D: Cohen’s d = -0.44, p<.001; CBT-I: Cohen’s d =-0.56, p<.001) had significantly lower ISI scores at post-intervention follow-up, as compared to the waitlist group. There was a significant difference in clinically meaningful improvement in insomnia (a reduction of ISI score ≥ 6 from baseline to post-intervention follow-up) between the groups (CBT-I: 73.1%; CBT-D: 40.0%; WL: 28.6%; p=.002). Moreover, there was a significant difference in remission of depression (HAMD≤7) at post-intervention follow-up (CBT-D: 75.9%; CBT-I: 81.5%; WL: 22.9%) (p <.001). Both CBT-D and CBT-I resulted in comparable improvements in insomnia and depressive symptoms at one-month follow-up (p>.05). Conclusion Preliminary evidence from this study supports the efficacy of CBT-I for improving both sleep and mood in youths with comorbid insomnia and depression. Support (if any) This work was supported by Early Career Scheme, Research Grants Council, Hong Kong SAR (Ref. 27613017).

Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data

Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. We did a systematic review and individual participant data component network meta-analysis (cNMA) of iCBT trials for depression. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomised controlled trials (RCTs) published from database inception to Jan 1, 2019, that compared any form of iCBT against another or a control condition in the acute treatment of adults (aged ≥18 years) with depression. Studies with inpatients or patients with bipolar depression were excluded. We sought individual participant data from the original authors. When these data were unavailable, we used aggregate data. Two independent researchers identified the included components. The primary outcome was depression severity, expressed as incremental mean difference (iMD) in the Patient Health Questionnaire-9 (PHQ-9) scores when a component is added to a treatment. We developed a web app that estimates relative efficacies between any two combinations of components, given baseline patient characteristics. This study is registered in PROSPERO, CRD42018104683. We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42·0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1·83 [95% credible interval (CrI) -2·90 to -0·80]) and that relaxation might be harmful (1·20 [95% CrI 0·17 to 2·27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0·32 [95% CrI 0·13 to 0·93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components. The individual patient data cNMA revealed potentially helpful, less helpful, or harmful components and delivery formats for iCBT packages. iCBT packages aiming to be effective and efficient might choose to include beneficial components and exclude ones that are potentially detrimental. Our web app can facilitate shared decision making by therapist and patient in choosing their preferred iCBT package. Japan Society for the Promotion of Science.

Exploring the Role of Persuasive Design in Unguided Internet-Delivered Cognitive Behavioral Therapy for Depression and Anxiety Among Adults: Systematic Review, Meta-analysis, and Meta-regression

BackgroundInternet-delivered cognitive behavioral therapy (ICBT) is an effective treatment that can overcome barriers to mental health care. Various research groups have suggested that unguided ICBT (ie, ICBT without therapist support) and other eHealth interventions can be designed to enhance user engagement and thus outcomes. The persuasive systems design framework captures most design recommendations for eHealth interventions, but there is little empirical evidence that persuasive design is related to clinical outcomes in unguided ICBT.ObjectiveThis study aims to provide an updated meta-analysis of randomized controlled trials of unguided ICBT for depression and anxiety, describe the frequency with which various persuasive design principles are used in such interventions, and use meta-regression to explore whether a greater number of persuasive design elements predicts efficacy in unguided ICBT for depression and anxiety.MethodsWe conducted a systematic review of 5 databases to identify randomized controlled trials of unguided ICBT for depression and anxiety. We conducted separate random effects meta-analyses and separate meta-regressions for depression and anxiety interventions. Each meta-regression included 2 steps. The first step included, as a predictor, whether each intervention was transdiagnostic. For the meta-regression of ICBT for depression, the first step also included the type of control condition. The number of persuasive design principles identified for each intervention was added as a predictor in the second step to reveal the additional variance in effect sizes explained by persuasive design.ResultsOf the 4471 articles we identified in our search, 46 (1.03%) were eligible for inclusion in our analyses. Our meta-analyses showed effect sizes (Hedges g) ranging from 0.22 to 0.31 for depression interventions, depending on the measures taken to account for bias in the results. We found a mean effect size of 0.45 (95% CI 0.33-0.56) for anxiety interventions, with no evidence that the results were inflated by bias. Included interventions were identified as using between 1 and 13 persuasive design principles, with an average of 4.95 (SD 2.85). The meta-regressions showed that a greater number of persuasive design principles predicted greater efficacy in ICBT for depression (R2 change=0.27; B=0.04; P=.02) but not anxiety (R2 change=0.05; B=0.03; P=.17).ConclusionsThese findings show wide variability in the use of persuasive design in unguided ICBT for depression and anxiety and provide preliminary support for the proposition that more persuasively designed interventions are more efficacious, at least in the treatment of depression. Further research is needed to clarify the role of persuasive design in ICBT.

Cognitive Bias and Medication Use Moderate the Relation of Socratic Questioning and Symptom Change in Cognitive Behavioral Therapy of Depression

Initial evidence suggests Socratic questioning predicts session-to-session symptom change in cognitive behavioral therapy (CBT) for depression, but little is known about which clients are most likely to benefit from this approach. We examined pretreatment client characteristics as potential moderators of the relation between Socratic questioning and symptom improvement. Participants were 55 adults who met criteria for major depressive disorder and participated in CBT. Clients on antidepressant medication were required to be on a stable dose during the study. Therapist use of Socratic questioning was rated by trained observers at sessions 1–3 and depressive symptoms were assessed at each session. We examined four potential pre-treatment moderators of the relation of within-client Socratic questioning and session-to-session symptom change: cognitive bias, medication use, presence of a personality disorder, and dysfunctional attitudes. Pessimistic bias in predicting future life events and concurrent use of antidepressant medication emerged as significant moderators with small effects. Among clients with a greater pessimistic bias and those not on antidepressant medication, Socratic questioning more strongly predicted symptom improvement. Findings are consistent with the view that Socratic questioning promotes session-to-session symptom improvements for some clients but plays a less important role for others.

Reevaluating the Alliance-Outcome Relationship in the Early Sessions of Cognitive Behavioral Therapy of Depression.

The therapeutic alliance has been reliably associated with outcome across psychotherapies. We investigated the alliance-outcome relationship in the early sessions of cognitive behavioral therapy of depression using a model that disaggregates within- and between-person variance while estimating the reciprocal relation between variables. We utilized this model in a combined dataset from two studies totaling 191 patients. In our primary model, we found evidence for a predictive within-patient relationship between alliance and symptoms such that symptoms predicted regressed change in alliance and alliance predicted regressed change in symptoms. In a more conservative detrended model, these relationships were not significant. Given that a) most of the variability in alliance scores is between-patient; b) the size of the alliance-outcome relationship is modest; and c) the alliance-outcome relationship is not robust to detrending, our findings suggest the alliance plays at most a small role in improving patient outcomes in cognitive behavioral therapy of depression.

What Do People Really Think of Me? Evaluating Bias in Interpersonal Predictions Over the Course of Cognitive-Behavioral Therapy of Depression

Cognitive behavioral therapy (CBT) of depression is hypothesized to achieve its effects by correcting negative biases. However, little research has tested how biases change over the course of CBT. We focus on biases in interpersonal judgments and examine whether changes in biases occur in CBT and are associated with symptom improvements. A sample of 126 adults (60% women, mean age 31.7, 83% White) participated in CBT of depression. Observers provided ratings of patients participating in two interpersonal tasks on three occasions. Patients were asked to predict observers’ ratings. In a thin slice (TS) task, observers evaluated how patients came across in a brief segment in which patients talked about themselves. In a Standard Interaction Task (SIT), observers rated the social skills patients displayed in challenging role plays. The difference between patient predictions and observer ratings provided measures of bias in these interpersonal judgments. TS and SIT bias became significantly less pessimistic and more realistic over the course of CBT. Improvements in TS bias were associated with a faster reduction in symptoms, whereas there was a non-significant trend for improvement in SIT bias being associated with faster symptom reduction. Consistent with the CBT model, negative interpersonal biases became more realistic throughout a course of CBT for depression and at least some of the changes in bias were related to therapeutic outcomes. We encourage future researchers to continue examining for whom and under which conditions correcting such biases produces the greatest benefits.

Editors' Note: Telephone-Based Cognitive Behavioral Therapy for Depression in Parkinson Disease: A Randomized Controlled Trial.

In “Telephone-Based Cognitive Behavioral Therapy for Depression in Parkinson Disease: A Randomized Controlled Trial,” Dobkin et al. reported that depressive symptoms (measured using the Hamilton Depression Rating Scale) improved significantly in patients with Parkinson disease who had weekly telephone-based cognitive behavioral therapy compared with those who had their usual treatment. Braillon commended the authors for independently designing a study that led to both significant and meaningful patient-centered results but lamented the fact that our healthcare systems are not able to facilitate routine care for psychosocial issues in a multidisciplinary manner outside of the clinical environment. Dobkin agreed that there are a number of reasons why patients with Parkinson disease need access to telephone-based cognitive behavioral therapy, many of which apply to patients with other neurologic diseases, too. Dobkin also reinforces the need to expand telehealth, with a particular emphasis on provision of mental health care to patients who do not have access to clinicians with the relevant expertise or prefer to be evaluated and treated while at home. In “Telephone-Based Cognitive Behavioral Therapy for Depression in Parkinson Disease: A Randomized Controlled Trial,” Dobkin et al. reported that depressive symptoms (measured using the Hamilton Depression Rating Scale) improved significantly in patients with Parkinson disease who had weekly telephone-based cognitive behavioral therapy compared with those who had their usual treatment. Braillon commended the authors for independently designing a study that led to both significant and meaningful patient-centered results but lamented the fact that our healthcare systems are not able to facilitate routine care for psychosocial issues in a multidisciplinary manner outside of the clinical environment. Dobkin agreed that there are a number of reasons why patients with Parkinson disease need access to telephone-based cognitive behavioral therapy, many of which apply to patients with other neurologic diseases, too. Dobkin also reinforces the need to expand telehealth, with a particular emphasis on provision of mental health care to patients who do not have access to clinicians with the relevant expertise or prefer to be evaluated and treated while at home.

Reader Response: Telephone-Based Cognitive Behavioral Therapy for Depression in Parkinson Disease: A Randomized Controlled Trial.

Dobkin et al.1 deserve commendations for their well-designed trial in patients with depression and Parkinson disease showing telephone-based cognitive behavioral treatment improved by 7 points using the Hamilton Depression Rating Scale, over a 6-month follow-up.

Author Response: Telephone-based Cognitive Behavioral Therapy for Depression in Parkinson Disease: A Randomized Controlled Trial.

We thank Dr. Braillon for commenting on our article1 and for highlighting several advantages of increasing Parkinson disease (PD) patients' access to nonpharmacologic depression treatments. We share his interest in multidisciplinary PD care and his concern about the scarcity of such resources. Evidence-based, PD-informed depression treatment is critical to this approach, yet it remains largely inaccessible for several reasons, beyond considerable underdiagnosis of PD depression.2 People with PD (PWP) face a dearth of PD-informed mental health clinicians, often live far from specialized care centers, and contend with disability and transportation barriers to attending appointments.3,4 In studying PWPs' mental health care preferences (N = 769), we found that these factors contribute to strong interest in telehealth: 85% reported a preference for telehealth-to-home over clinic-based care, given the choice.4 We likewise view telehealth treatment not as a resource-poor alternative, but as a set of flexible, scalable, patient-centered modalities for extending the reach of specialized mental health care5 as it is in medicine.6 The large effects of telephone-based cognitive behavioral therapy—comparable with in-clinic treatment—suggest an exciting, near-term means of helping more patients alleviate depressive symptoms and improve PD self-management. We believe mental telehealth shows potential to begin countering inequities in community-based, interdisciplinary PD resources and thereby to advance personalized care by increasing patients' choice.

Getting down to business: an examination of occupational outcomes in cognitive behavioral therapy for depression

ABSTRACT Depression is associated with unemployment and poor occupational functioning. Although cognitive behavioral therapy (CBT) has been shown to reduce depressive symptoms, the degree to which it improves occupational outcomes has received little attention. We investigated change in job status and presenteeism (i.e., the inability to focus on and accomplish work) over the course of CBT. We assessed employment status, presenteeism, depressive symptoms, cognitive style, and CBT skills at intake and posttreatment in a sample of 126 participants enrolled in a 16-week course of CBT for depression. Employment status significantly improved from pre to posttreatment, with 11 of the 27 patients (41%) seeking to improve their employment status achieving this goal. Among the 59 consistently employed patients, presenteeism decreased significantly over the course of treatment (dz = 1.13). We also found, even after controlling for changes in symptoms, reductions in negative cognitive style (but not changes in CBT skills) were associated with reductions in presenteeism. Our findings suggest CBT patients experience positive changes in occupational outcomes, both in finding work and being more focused and productive at work. Changes in negative cognitive styles appeared to partly explain this latter change. We encourage future work examining CBT’s impact on occupational outcomes.

Personality Disorders and Their Relation to Treatment Outcomes in Cognitive Behavioural Therapy for Depression: A Systematic Review and Meta-analysis

BackgroundPrevious reviews indicate that depressed patients with a comorbid personality disorder (PD) tend to benefit less from psychotherapies for depression and thus personality pathology needs to be the primary focus of treatment. This review specifically focused on studies of Cognitive Behavioural Therapy (CBT) for depression examining the influence of comorbid PD on post-treatment depression outcomes.MethodsThis was a systematic review and meta-analysis of studies identified through PubMed, PsychINFO, Web of Science, and Scopus. A review protocol was pre-registered in the PROSPERO database (CRD42019128590).ResultsEleven eligible studies (N = 769) were included in a narrative synthesis, and ten (N = 690) provided sufficient data for inclusion in random effects meta-analysis. All studies were rated as having “low” or “moderate” risk of bias and there was no significant evidence of publication bias. A small pooled effect size indicated that patients with PD had marginally higher depression severity after CBT compared to patients without PD (g = 0.26, [95% CI: 0.10, 0.43], p = .002), but the effect was not significant in controlled trials (p = .075), studies with low risk of bias (p = .107) and studies that adjusted for intake severity (p = .827). Furthermore, PD cases showed symptomatic improvements across studies, particularly those with longer treatment durations (16–20 sessions).ConclusionsThe apparent effect of PD on depression outcomes is likely explained by higher intake severity rather than treatment resistance. Excluding these patients from evidence-based care for depression is unjustified, and adequately lengthy CBT should be routinely offered.

The effectiveness of brief cognitive analytic therapy for anxiety and depression: A quasi-experimental case-control study.

To investigate the effectiveness of an 8-session cognitive analytic therapy (CAT) protocol for patients with anxiety and depression in the context of relational problems, personality disorder traits, or histories of adverse childhood experiences and then to compare outcomes with cognitive behavioural therapy (CBT). The study was conducted in a single Improving Access to Psychological Therapies (IAPT) service and used sessional outcome monitoring. Propensity score matching was used to derive equivalent CAT (N=76) and CBT (N=73) samples through matching intake characteristics. Longitudinal multilevel modelling (LMLM) compared patterns of symptomatic change over time between the two therapies. LMLM found no significant differences between CAT and CBT in depression, anxiety, and functional impairment outcomes and showed similar symptom change trajectories. Small between-therapy post-treatment effects and medium-to-large within-therapy effects were found. CAT patients attended significantly more sessions, and the CAT dropout rate was significantly lower. Brief CAT appears acceptable and effective for patients with anxiety and depression in the context of complex relational problems when delivered within the high intensity tier of an IAPT service. The potential added value of CAT in IAPT services is discussed. Practitioners (under appropriate supervision) could use 8-session CAT when treating patients with anxiety and depression in the context of clinical complexity. The 8-session CAT model holds organizational promise in IAPT services. Brief CAT interventions should retain theoretical integrity.

On the Road to Personalized Psychotherapy: A Research Agenda Based on Cognitive Behavior Therapy for Depression.

In this conceptual paper, we outline the many challenges on the road to personalized psychotherapy, using the example of cognitive behavior therapy (CBT) for depression. To optimize psychotherapy for the individual patient, we need to find out how therapy works (identification of mechanisms of change) and for whom it works (identification of moderators). To date, psychotherapy research has not resulted in compelling evidence for or against common or specific factors that have been proposed as mechanisms of change. Our central proposition is that we need to combine the “how does it work?”-question with the “for whom does it work?”-question in order to advance the field. We introduce the personalized causal pathway hypothesis that emphasizes the links and distinction between individual patient differences, therapeutic procedures and therapy processes as a paradigm to facilitate und understand the concept of personalized psychotherapy. We review the mechanism of change literature for CBT for depression to see what we have learned so far, and describe preliminary observational evidence supporting the personalized causal pathway hypothesis. We then propose a research agenda to push the ball forward: exploratory studies into the links between individual differences, therapeutic procedures, therapy processes and outcome that constitute a potential causal pathway, making use of experience sampling, network theory, observer ratings of therapy sessions, and moderated mediation analysis; testing and isolation of CBT procedures in experiments; and testing identified causal pathways of change as part of a personalized CBT package against regular CBT, in order to advance the application of personalized psychotherapy.

A Preliminary Study on the Effects of a Unified Protocol Group Version of Cognitive Behavioral Therapy for Anxiety and Depression and Group Cognitive Behavioral Therapy for Depression

A Preliminary Study on the Effects of a Unified Protocol Group Version of Cognitive Behavioral Therapy for Anxiety and Depression and Group Cognitive Behavioral Therapy for Depression

Psycho-Educational Affirmations from the Qur’An on Sadness to Prevent/Treat Depression for Muslim Clients of Cognitive Behavior Therapy Approach

Introduction: This study accommodates existential crisis provoked by the Covid-19 pandemic as observed in previous plagues. It is filling the gap of underrepresentation by academics of Islamic Studies in Islamicizing Psychology, in general. Furthermore, it specifically becomes a collective duty (farḍ al-kifāyah) to deliver Muslims’ spiritual existential needs during pandemic and preparing for anticipated post-pandemic breakdown. Methods: The main keyword of sadness (Ar: Al-ḥuzn) are searched throughout the Holy Qur’an as it frequently pairs with stressing life events. The compiled Qur’anic verses from Mushaf Uthmani, English translation by Dr. Mustafa Khattab - The Clear Qur’an, and exegesis for each verse from the renowned Andalusian Exegete: Al-Qurtubi’s Exegesis (Tafsīr al- Qurtubī) are thematically analyzed based on the Qur’anic Thematic Exegetical Analysis (al- Tafsīr al-Mawḍuᶜi) method. Results: The interpretation of the analysis are converted into Qur’anic culturally adapted psychoeducational affirmations on sadness as an integration into the Cognitive Behavioural Therapy for depression among Muslim clients. Conclusion: The Cognitive Behavioural Therapy is compatible with the nature of Islam according to the late Prof. Malik Badri, e.g. the idea of fixing the ‘beliefs’ (Iṣlāḥ). Thus, theoretically, this set of Qur’anic psychoeducational affirmations should offer an effective integration for either preventing or treating depression. Essentially, it is more important for all Muslims to be psycho-educated about this from their childhood to develop their existential resilience in facing the challenges of life in general, specifically during and post-pandemic.