Group Cognitive Behavioral Therapy Research Articles

Qualitative findings from a randomized trial of mindfulness-based and cognitive-behavioral group therapy for opioid-treated chronic low back pain.

This article reports qualitative outcomes from a randomized controlled trial comparing eight weeks of cognitive-behavioral group therapy for chronic pain (CBT-CP) and mindfulness-based group therapy (MBT) in individuals with chronic low back pain (CLBP). Approximately 10 months post-treatment, 108 participants completed structured qualitative interviews to express how the study treatment affected their life or health. Responses were qualitatively analyzed to generate a set of themes and subthemes, with between-groups comparisons to evaluate differences (if any) in treatment-response between MBT and CBT-CP. A majority of participants (n = 88, 81.5%) across both groups reflected positively on the study intervention and outcomes, identifying benefits in pain management (31.5%), meditation and mindfulness skills (25.9%), and relaxation skills (22.2%). Perceived benefits varied widely, suggesting no one intervention may be ideal for CLBP. Future research should examine tailoring interventions to target diverse clinical presentations to achieve optimal outcomes.

Behavioral activation for depression in groups embedded in psychosomatic rehabilitation inpatient treatment: a quasi-randomized controlled study.

Behavioral activation (BA) and cognitive-behavioral therapy (CBT) have shown to be efficacious treatment methods for depression. Previous studies focused mostly on the outpatient treatment either in group or individual setting. The present study aimed at comparing the efficacy of group treatment BA vs. CBT, when embedded in inpatient psychosomatic rehabilitation treatment. 375 inpatients were randomly assigned to either BA (N = 174) or CBT (N = 201). We used established scales for depression such as the Beck Depression Inventory II (BDI-II, self-rating), the Quick Inventory of Depressive Symptomatology (QIDS; expert rating) and the Behavioral Activation for Depression Scale (BADS) to assess changes over the course of the treatment and at follow-up (4 to 6 months). In addition, we measured disability-related functioning with the Mini-ICF-APP, a rating scale built in reference to the International Classification of Functioning, Disability and Health (ICF). Multilevel models with repeated measures were conducted to examine the differences between groups in relation to change over time with patients' random effects. Both group formats showed substantial reduction in depressive symptoms at the end of treatment (d= 0.83 BA vs. d= 1.08 CBT; BDI-II) and at follow-up after 4 to 6 months (d = 0.97 BA vs. d = 1.33 CBT, BDI-II; and d = 1.17 BA vs. d = 1.09 CBT, QIDS). There were no significant differences between treatment approaches. At least 50% symptom reduction was achieved by 53.7% and 54.2% in BA vs. CBT respectively. Reported activation levels increased from pre- to posttreatment (d = 0.76 BA vs. d = 0.70CBT), while showing loss of increment between the end of the treatment until follow up in both formats (d = 0.28 BA vs. d = 0.29 CBT). Both modalities led to significant improvement of symptomatology and functioning at the end of the treatment and at follow-up, thus for the first time demonstrating the practicability of BA in rehabilitation clinics. Considering its lower requirements regarding cognitive abilities and its easier implementation, BA proved to be a good alternative to other psychotherapeutic treatments.

Cognitive Behavior Therapy vs Mindfulness in Treatment of Prolonged Grief Disorder

Although grief-focused cognitive behavior therapies are the most empirically supported treatment for prolonged grief disorder, many people find this treatment difficult. A viable alternative for treatment is mindfulness-based cognitive therapy. To examine the relative efficacies of grief-focused cognitive behavior therapy and mindfulness-based cognitive therapy to reduce prolonged grief disorder severity. A single-blind, parallel, randomized clinical trial was conducted among adults aged 18 to 70 years with prolonged grief disorder, as defined in the International Classification of Diseases, 11th Revision, and assessed by clinical interview based on the Prolonged Grief-13 (PG-13) scale. Those with severe suicidal risk, presence of psychosis, or substance dependence were excluded. Between November 2012 and November 2022, eligible participants were randomized 1:1 to eleven 90-minute sessions of grief-focused cognitive behavior therapy or mindfulness-based cognitive therapy at a traumatic stress clinic in Sydney, Australia, with follow-up through 6 months. Both groups received once-weekly 90-minute individual sessions for 11 weeks. Grief-focused cognitive behavior therapy comprised 5 sessions of recalling memories of the deceased, plus cognitive restructuring and planning future social and positive activities. Mindfulness-based cognitive therapy comprised mindfulness exercises adapted to tolerate grief-related distress. The primary outcome was change in prolonged grief disorder severity measured by the PG-13 scale assessed at baseline, 1 week posttreatment, and 6 months after treatment (primary outcome time point), as well as secondary outcome measures of depression, anxiety, grief-related cognition, and quality of life. The trial included 100 participants (mean [SD] age, 47.3 [13.4] years; 87 [87.0%] female), 50 in the grief-focused cognitive behavior therapy condition and 50 in the mindfulness-based cognitive therapy condition. Linear mixed models indicated that at the 6-month assessment, participants in the grief-focused cognitive behavior therapy group showed greater reduction in PG-13 scale score relative to those in the mindfulness-based cognitive therapy group (mean difference, 7.1; 95% CI, 1.6-12.5; P = .01), with a large between-group effect size (0.8; 95% CI, 0.2-1.3). Participants in the grief-focused cognitive behavior therapy group also demonstrated greater reductions in depression as measured on the Beck Depression Inventory than those in the mindfulness-based cognitive therapy group (mean difference, 6.6; 95% CI, 0.5-12.9; P = .04) and grief-related cognition (mean difference, 14.4; 95% CI, 2.8-25.9; P = .02). There were no other significant differences between treatment groups and no reported adverse events. In this study, grief-focused cognitive behavior therapy conferred more benefit for core prolonged grief disorder symptoms and associated problems 6 months after treatment than mindfulness-based cognitive therapy. Although both treatments may be considered for prolonged grief disorder, grief-focused cognitive behavior therapy might be the more effective choice, taking all factors into consideration. anzctr.org.au Identifier: ACTRN12612000307808.

Comparison of changes in stress coping strategies between cognitive behavioral therapy and pharmacotherapy.

Coping refers to conscious responses to negative circumstances, with the intention of ameliorating these situations. Few studies have compared the differences between psychotherapy and medication treatment for coping strategies for depression. In this study, we investigated the differences in coping strategies between cognitive behavioral therapy (CBT) combined with medication (CBT group) and medication alone (pharmacotherapy group) among outpatients with depression. A prospective observational study was conducted among 50 patients with major depression (24 and 26 in the CBT and pharmacotherapy groups, respectively). Stress coping strategies (Coping Inventory for Stressful Situations [CISS]) and depression severity (Beck Depression Inventory-Second Edition [BDI-II]) were assessed at baseline and 16 weeks later. Changes in the CISS and BDI-II scores in both groups were tested using repeated analysis of variance. Inverse probability weighting with propensity score analysis was applied to address potential selection bias. At 16 weeks, the CBT group exhibited increased CISS task-oriented coping, distraction, and social diversion scores, which differed from those of the pharmacotherapy group. The CBT group exhibited a significantly greater reduction in depressive symptoms than the pharmacotherapy group. This study was not a randomized controlled trial and thus may have selection bias. Gaining adaptive coping skills, including task-oriented coping, distraction, and social diversion skills, by combining CBT with medication may lead to greater improvement in depression symptoms. These findings suggest that clinicians should evaluate coping strategies and facilitate the acquisition of adaptive coping strategies in patients with depression to reduce their symptoms.

Effect of cognitive behavioral therapy on pain, knee function, and psychological status in patients after primary total knee arthroplasty: a systematic review and meta-analysis

ObjectiveThe clinical efficacy of cognitive behavioral therapy (CBT) after Total knee arthroplasty (TKA) is still controversial, and the purpose of this meta-analysis was to evaluate the effect of CBT on pain, knee function, and psychological status of patients after TKA.MethodsWe systematically searched electronic databases such as CNKI, CBM, VIP, PubMed, Cochrane Library, and EMBASE for randomized controlled studies up to February 30, 2023. Screening against inclusion criteria to select valid studies and extract data. The quality of included studies was evaluated by the Cochrane Collaboration risk-of-bias 2 (RoB 2) tool for randomized trials. Statistical analysis of the data from this study was carried out using Stata 15.1 software.ResultsFinally, our meta-analysis incorporated seven randomized controlled studies of high quality, including 608 patients. The findings of the meta-analysis demonstrated a noteworthy decrease in kinesiophobia levels during the early postoperative phase in the CBT group as compared to the usual care group (WMD = -6.35, 95% CI: -7.98 to -4.72, Z = 7.64, P < 0.001). However, no statistically significant difference between the CBT and usual care groups in terms of postoperative pain as well as knee function.ConclusionCBT may effectively reduce the level of kinesiophobia in the short term after TKA, but did not significantly relieve knee pain or improve knee function.

Group schema therapy versus group cognitive behavioral therapy for patients with social anxiety disorder and comorbid avoidant personality disorder: A randomized controlled trial

BackgroundPatients with social anxiety (SAD) and comorbid avoidant personality disorder (AVPD) are severely impaired. Group cognitive behavioral therapy (GCBT) is considered an effective treatment for SAD. More knowledge on treatment of SAD with comorbid AVPD is needed. Schema therapy, developed for personality and chronic mental disorders, may be a promising treatment. MethodsWe conducted a randomized controlled trial in an outpatient population (n = 154) with both SAD and AVPD. Group Schema Therapy (GST) and GCBT were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and manifestations of AVPD (Avoidant Personality Disorder Severity Index). ResultsIntention-to-treat analysis showed no significant differences between treatments at 3 months post-treatment and one-year follow-up. Both modalities led to significant and substantial improvements. No significant between-differences were found in depressive symptoms (Inventory of Depressive Symptoms) and quality of life (World Health Organization Quality of Life-BREF). Per-protocol analysis showed similar outcomes and no significant differences in recovery from SAD and AVPD. Significantly more patients completed GST. ConclusionGST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment retention in ST indicates ST is more acceptable than GCBT. Future studies should focus on enhancing treatment effects and improving retention to GCBT.

Comparing psychological versus pharmacological treatment in emotional disorders: A network analysis.

Transdiagnostic group cognitive behavioural therapy (TD-GCBT) is more effective in improving symptoms and severity of emotional disorders (EDs) than treatment as usual (TAU; usually pharmacological treatment). However, there is little research that has examined the effects of these treatments on specific symptoms. This study used Network Intervention Analysis (NIA) to investigate the direct and differential effects of TD-GCBT + TAU and TAU on specific symptoms of anxiety and depression. Data are from a multicentre randomised clinical trial (N = 1061) comparing TD-GCBT + TAU versus TAU alone for EDs. The networks included items from the PHQ-9 (depression) and GAD-7 (anxiety) questionnaire and mixed graphical models were estimated at pre-treatment, post-treatment and 3-, 6- and 12-month follow-up. Results revealed that TD-GCBT + TAU was associated with direct effects, mainly on several anxiety symptoms and depressed mood after treatment. New direct effects on other depressive symptoms emerged during the follow-up period promoted by TD-GCBT compared to TAU. Our results suggest that the improvement of anxiety symptoms after treatment might precipitate a wave of changes that favour a decrease in depressive symptomatology. NIA is a methodology that can provide fine-grained insight into the likely pathways through which treatments exert their effects.

Grading of Recommendations of psychological interventions in the rehabilitation of patients with schizophrenia

IntroductionAs part of the intervention, patients with severe schizophrenia who are cared for in psychiatric rehabilitation units need psychological treatments. However, there is great variability within the psychotherapy alternatives that are proposed for rehabilitation in schizophrenia, and it is necessary to know which are the most efficient interventions in order to prioritize their inclusion in intervention programs.Objectives To know the level of evidence of the existing psychotherapy alternatives for the rehabilitation treatment in schizophrenia through the systematic review of recently published studies.Methods Consecutive systematic searches in the scientific literature were used in a sensitive and specific way, aimed at identifying the existence of documents in databases and clinical practice guidelines based on evidence of psychological treatment in schizophrenia. Psychosocial and social approaches and family members interventions were excluded, and the search was limited to the last 5 years. The PICO format has been used, and a subsequent critical reading using the AGREE II tool, considering the inclusion criteria of presenting a score &gt;60% in 4 domains.ResultsThe following interventions have been found to be therapeutically effective: Level 1B (Early intervention in Psychosis; Patient and Family psychoeducational intervention; Basic ando social skills training; Social cognition and Metakognition training; Cognitive Remediation; Cognitive Behavioral Individual Therapy; Assertive Community treatment; Supported employment). Level 2B (Family Problem Solving Therapy, Dynamic Psychotherapy; Cognitive Behavioral Group Therapy); Level 2C (Horticultural, Art, Music, Animals Therapies).ConclusionsSeveral psychotherapy alternatives are proposed for rehabilitation in schizophrenia, with known level of evidenca in order to prioritize their inclusion in intervention programs.Disclosure of InterestNone Declared

Therapy program assisted with therapy dogs for children with Autism Spectrum Disorder (ASD)

IntroductionAutism spectrum disorders (ASD) is a neurodevelopmental disorder with an estimated lifetime prevalence of at least 1%. Some studies suggest that approximately 60% of children with ASD show emotional dysregulation and 44-86% sleeping disorders.Studies suggest that cognitive behavioral therapy and animal-assisted therapy AAT can be an intervention strategy to promote emotional and behavioral dysregulation and sleep disturbances.ObjectivesThe purpose of this study was to investigate the effect of a therapy program assisted with dogs (AAT) together with cognitive behavioral therapy (CBT) on behavioral and emotional regulation and sleep disorders in children diagnosed with ASD.MethodsThe sample was composed of 24 children between 7 and 10 years old diagnosed with ASD randomized into two groups (CGT group (control group) and AAT + CBT group (experimental group). Inclusion criteria: communication level of simple sentences, mild-moderate difficulties in behavioral and emotional regulation and sleep disturbances. Exclusion criteria: intellectual disability, children with specific dogs phobia. Assessment included ADOS-2, WISC-V, CGAS. dysregulation profile of Achenbach scale and Sleep Disturbance Scale for Children-Bruni. A program of 12 sessions (weekly one-hour sessions) focusing emotional and behavioral regulation and sleep disturbance was designed (Behavior Emotional Sleep Treatment Program. A pre-post evaluation was performed.ResultsParticipants were 20 boys and 2 girls (2 participants dropped out), with a mean age of 9. Regarding the socio-demographic and clinical characteristics, no significant differences has been observed between both groups in the global functioning measured with the Children’s Global Assessment scale (CGAS) (p=0.832), nor in the cognitive capacity (QI ) neither in reference to the associated comorbidities (p=0.103) nor in the variable prescription pharmacological treatment (p= 0.142). In emotional self-regulation, a significant improvement in emotional regulation difficulties was observed after treatment in both groups (experimental group: p=0.014; control group: p=0.012). However, the comparison between the pre-post intervention results between groups, regarding the emotional regulation variable, a greater improvement is observed in the experimental group (p=0.013). Significant improvements were also observed in sleep disorders (Bruni scale total score and in the sleep conciliation and maintenance difficulties scale) in both groups.ConclusionsTo conclude, although this is a pilot study with a small sample size and further research is needed, results suggest that a therapy program assisted with therapy dogs and CBT have positive effects on emotional dysregulation and sleep disturbances in children with ASD and offers a possible intervention strategy.Disclosure of InterestNone Declared

The acceptability, feasibility, and preliminary effectiveness of group cognitive behavioral therapy for Chinese children with posttraumatic stress disorder: A pilot randomized controlled trial.

The psychological need for traumatized children is huge in China. However, evidence-based treatments designed for Chinese children are scarce. This study aimed to test the feasibility and preliminary effectiveness of a cognitive-behavioral program (Power up Children's Psychological Immunity; PCPI) in Chinese children. A total of 87 children with posttraumatic stress disorder (PTSD) symptoms in grades 3 to 5 were randomly allocated (1:1) to the PCPI group or the treatment as usual (TAU) group. The feasibility was assessed by participant adherence, satisfaction, and acceptability. The severity of PTSD, depression and anxiety were assessed at pre- and posttreatment and the 3-month follow-up. A high level of satisfaction (81.82%) and retention rate of each session (more than 93.33%) were found. Qualitative feedback reported a high level of acceptance. At posttreatment, the PCPI group had lower mean scores than the TAU group for PTSD (adjusted mean difference [AMD], -6.18; 95% CI, -12.21 to -.14; p = .048), and anxiety (AMD, -2.05; 95% CI, -3.81 to -.28; p = .026). However, little change was found from posttreatment to 3-month follow-up. The findings indicated that the school-based group PCPI intervention was feasible and acceptable. Further evaluation is needed to examine its effectiveness in a larger sample size. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Changes in Resting-State Brain Activity After Cognitive Behavioral Therapy for Chronic Pain: A Magnetoencephalography Study

Cognitive behavioral therapy (CBT) is believed to be an effective treatment for chronic pain due to its association with cognitive and emotional factors. Nevertheless, there is a paucity of magnetoencephalography (MEG) investigations elucidating its underlying mechanisms. This study investigated the neurophysiological effects of CBT employing MEG and analytical techniques. We administered resting-state MEG scans to 30 patients with chronic pain and 31 age-matched healthy controls. Patients engaged in a 12-session group CBT program. We conducted pretreatment (T1) and post-treatment (T2) MEG and clinical assessments. MEG data were examined within predefined regions of interest, guided by the authors’ and others’ prior magnetic resonance imaging studies. Initially, we selected regions displaying significant changes in power spectral density and multiscale entropy between patients at T1 and healthy controls. Then, we examined the changes within these regions after conducting CBT. Furthermore, we applied support vector machine analysis to MEG data to assess the potential for classifying treatment effects. We observed normalization of power in the gamma2 band (61–90 Hz) within the right inferior frontal gyrus (IFG) and multiscale entropy within the right dorsolateral prefrontal cortex (DLPFC) of patients with chronic pain after CBT. Notably, changes in pain intensity before and after CBT positively correlated with the alterations of multiscale entropy. Importantly, responders predicted by the support vector machine classifier had significantly higher treatment improvement rates than nonresponders. These findings underscore the pivotal role of the right IFG and DLPFC in ameliorating pain intensity through CBT. Further accumulation of evidence is essential for future applications. PerspectiveWe conducted MEG scans on 30 patients with chronic pain before and after a CBT program, comparing results with 31 healthy individuals. There were CBT-related changes in the right IFG and DLPFC. These results highlight the importance of specific brain regions in pain reduction through CBT.

Changes in Parental Reflective Functioning before and after a postpartum depression group therapy

IntroductionParental Reflective Functioning (PRF) refers to parents’ ability to view their children’s and their own behavior by considering internal mental states, such as thoughts, desires, and intentions. Depression has been described as compromising reflective functioning in female samples, whereas other studies have not detected differences in RF between depressed and non-depressed mothers.ObjectivesWe aim to study whether a group intervention focused on postpartum depression, which we have already observed to cause significant changes in the mother-child bond and the severity of depressive, also improves parental reflective functioning.MethodsTo that end, we analyzed pre-post data from two different groups (N=12), composed of mothers who had been clinically diagnosed with postpartum depression. They received the 6-week Mothers &amp; Babies Program© and completed the Parental Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) and the Parental Reflective Functioning Questionnaire (PRFQ) before and after group therapy. Pre-post data from the PRFQ were analyzed using the repeated measures t-test. The correlation between changes in the three questionnaires was also analyzed using Pearson’s correlation test.ResultsSignificant changes were observed in the Pre-Mentalization Modes (pre=2.37±.457, post=2.03±.520, t=2.0206, p=0.027) and Certainty About Mental States (pre=2.87±1.141, post=3.68±.908, t=-2.814, p=0.010) subscales of the PRFQ, with no significant changes in the Interest and Curiosity subscale (t=-.516, p=0.309). A significant correlation was also observed between pre-post change in EPDS scores and pre-post change in the Certainty About Mental States subscale of the PRFQ (r=-.640, p&lt;.05), while no significant correlations were observed with the rest of the PRFQ subscales, nor with the PBQ.ConclusionsA brief cognitive-behavioral group therapy developed specifically to treat postpartum depression improves pre-post scores on the Pre-Mentalization (lower post- than pre- score) and Certainty About Mental States (higher post- than pre- score) subscales of the PRFQ. Although a control group is needed to determine the actual effect of the intervention, as time could also play a role in the observed changes, this is an encouraging result. Moreover, the improvement obtained in Certainty About Mental States is inversely correlated with the pre-post changes observed in the EPDS, meaning that the greater the improvement in depression, the greater the improvement in the aforementioned subscale of the PRFQ. A larger sample is needed to assess a hypothetical mediating effect of depression in the observed change.Disclosure of InterestNone Declared

Comparative study of the effectiveness of EMDR G-TEP and CBT group protocols for the treatment of trauma in children exposed to a conflict context

Introduction357 million children live in conflict zones. Children’s mental health is a major but complex issue as needs and interventions depend on the age of the child, caregivers, daily safety and protection, etc. EMDR and CBT are the recommended therapies to treat PTSD according to the WHO, but there is not enough standardized evidence-based protocol for children. Testing and evaluating trauma management systems for children is essential for trauma treatment interventions to be implemented in emergency contexts, such as war and conflict situations.Objectives This research compares two intervention protocols for children aged 6 to 17 years suffering from Post Traumatic Stress Disorder after exposure to conflict traumatic events in the Central African Republic: the protocol “Kôno” developed by Action contre la Faim, based on a CBT and narrative approaches and the EMDR/G-TEP (Group Traumatic Events Protocol). After a psychoeducation session, the children were assigned to the ACF-KONO or EMDR/G-TEP groups for 5 sessions. The Child Psychosocial Distress Screener (CPDS) to measure general well-being and functioning and the Child Revised Impact of Events Scale (CRIES) to assess trauma, were administered before and after treatment.Methods 793 children participated in the research, 391 were included in the ACF-KONO protocol and 402 in the EMDR/G-TEP protocol. Both protocols have been shown to be equally effective in improving well-being and reducing traumatic symptoms. 185 children (90 ACF-KONO and 95 EMDR/G-TEP) were also re-evaluated after 5 months. The CPDS and CRIES-8 measurements reveal that the results are stable over time, with the use of both protocols. Detailed results will be presented.Results This research contributes to the discussion on a framework for group protocols for children in mental health and psychosocial support interventions in humanitarian programs. The two protocols tested showed very good results in reducing symptoms of PTSD in children. How to choose between EMDR/G-TEP and CBT? What contextual and cultural adaptations are to be expected? Are there differences in children’s appreciation? And in that of mental health practitioners? Ideas for reflection will be shared.ConclusionsIt is possible to widen access to therapeutic treatment of PTSD for children in emergency situations such as war and conflict. Further research in other contexts is needed. These studies should explore qualitative elements, such as children’s appreciations, but also the impact of these different protocols on the vicarious trauma of professionals involved in the treatment of children’s trauma.Disclosure of InterestNone Declared

Does nature-based social prescription improve mental health outcomes? A systematic review and meta-analysis.

A nature-based social prescription (NBSP) is an approach to improving mental health outcomes that involves prescribing nature-based interventions as complementary or alternative therapy to traditional ones. A variety of advantages are available from NBSP for people looking to enhance their mental well-being. The effect size of the nature-based social prescriptions (NBSPs) has not been thoroughly evaluated by systematic reviews and meta-analyses. The current study aimed to analyze existing studies and conduct a meta-analysis to determine the overall effect size of the nature-based social prescriptions (NBSP's) outcomes on mental health. By choosing the relevant papers from among those that were available, a meta-analysis was carried out in the current study. A systematic search of electronic databases (Pub Med, Web of Science, Scopus, Cochrane Library, Embase, CINAHL, and PsychINFO) was conducted to identify relevant studies. Studies were included if they evaluated the effects of NBSP on mental health outcomes. Effect sizes were calculated using the random effects model. Meta-analysis of interventions statistics shows that CBT (SMD -0.0035; 95% CI: [-0.5090; 0.5020]; Tau^2: 0.1011; Tau: 0.318), digital intervention (SMD -0.3654; 95% CI: [-0.5258; 1.2566]; Tau^2: 0.2976, Tau: 0.5455), music intervention (SMD -2.1281; 95% CI: [-0.4659; 4.7221]; Tau^2: 3.4046; Tau:1.8452), and psychological interventions (SMD -0.8529; 95% CI: [0.3051; 1.4007]; Tau^2: 0.1224; Tau: 0.3499) do not significantly impact. The other interventions [social belongingness, communication training, blue intervention, nature-based education, cognitive behavior group therapy (CBGT), social prescribing coordinator, self-help intervention, participatory, organizational intervention, inpatient services, brief diet, internet-based intervention, prenatal intervention, yoga and meditation, ergonomics training program, yoga nidra intervention, and storytelling] highlighted above are significant. The conclusion of the meta-analysis supports the idea that incorporating nature-based social prescription interventions into mental healthcare plans can effectively complement traditional therapies and improve mental health outcomes. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023412458, CRD42023412458.

Using Restricted Interests in Cognitive Behavioral Therapy for Children With Autism Spectrum Disorder: Results From a Preliminary Randomized Controlled Trial.

Children with autism spectrum disorder (ASD) exhibit significant deficits in social communication and emotion regulation skills. While cognitive behavioral therapy (CBT) applications appear promising, trials to date have largely excluded social communication skill development and have not been designed to include a wider range of emotional challenges. To our knowledge, the present study is the first to pilot a uniquely modified CBT program targeting emotion regulation, including social communication training, and explicitly focusing on the child's areas of circumscribed interest in order to teach skills and promote generalization. Forty participants were randomly assigned to either the CBT group or a waitlist control (WLC) group, resulting in 20 school-aged children in each group. The treatment approach was determined to be feasible and acceptable, and therapy engagement and attendance were reasonably high. Caregivers expressed high satisfaction with the program, qualitatively citing gains in skills such as social problem-solving, emotion identification, and identifying and processing cognitive distortions. The primary outcome of postintervention changes was not significantly different between the groups (CBT vs. WLC). The mean Social Skills Improvement System score decreased by 0.44 points (95% confidence interval [CI]: -5.04, 4.15) in the CBT group and increased by 0.41 points (95% CI: -4.23, 5.04) in the WLC group, and the postintervention changes were not significantly different between the groups (difference: -0.85; 95% CI: -7.29, 5.60; p = .79). The estimated rate of emotional dysregulation episodes decreased by a factor of 0.94 (95% CI: 0.57, 1.56) in the CBT group and increased by a factor of 1.07 (95% CI: 0.51, 2.24) for WLC (p = .74). Among those who reported emotional dysregulation episodes, the mean duration decreased by 1.39 minutes (95% CI: -3.90, 6.67) less for CBT than waitlist (p = .60). Although satisfaction, acceptability, and emotional dysregulation outcome results from this preliminary CBT treatment for ASD are promising, sample size and measurement limitations will be important considerations to inform future trials.

Reducing Economics Test Anxiety among Students as Measured by a Test Anxiety Scale: A Cognitive Behavioural Therapy

Psychological problems such as anxiety have been reported to adversely affect students' learning outcomes. This study explored the effectiveness of cognitive therapy with reflective activities on reducing Economics test anxiety among secondary school students. A randomizedcontrolledtrial experimental design was used. The sample sizewas120 senior secondary school students in South East Nigeria.A questionnaire titled "test anxiety scale" was used to collect data. It contained a demographic section and 20 items.To assign subjects to treatment or control groups, a randomization process was used.Subjectsin the treatmentgroup were subjectedto a cognitivebehavioural therapy (CBT) program.A three-time point evaluation was conducted with subjects in the treatment and control groups.Repeated measures and data collected were analysed with ANOVA. In comparison with the control group, research subjects exposed to CBT reportedlower testanxiety. In addition, at the follow-upmeasure, the scoresof researchsubjectsin the CBT groups weresignificantly lowerthan those of the control group. Hence,CBT significantly reducedEconomics students’ test anxiety. Theresearchers concludedthat the CBTprogramreducesEconomics students' test anxiety.

Contingency management for smoking cessation for individuals with overweight or obesity: A randomized controlled trial

BackgroundInterventions for quitting smoking and weight control among individuals with excess weight are scarce. Our study evaluated the effectiveness of cognitive behavioral therapy (CBT) plus contingency management (CM) in this population, and examined whether CM for smoking cessation improved CBT treatment outcomes at end of treatment (EOT) and at 1-, 3-, 6-, and 12-month follow-ups (FU). MethodsIn an 8-week randomized clinical trial, 120 adults who smoke with overweight or obesity (54.16% females; MBMI = 31.75 ± 4.31) were randomly assigned to CBT for both quitting smoking and weight control (n = 60) or the same treatment plus CM for smoking cessation (n = 60). Outcome variables were compared (i.e., treatment completion, smoking abstinence, weight change and secondary outcomes). ResultsAt EOT, the CBT + CM group achieved 78.33% 7-day point-prevalence abstinence rates compared to 61.67% in the CBT group (p = .073), and rates declined over time (12-month FU: 18% vs 12%). Participants who attained abstinence weighed more compared to baseline at EOT (Mkg = 1.07; SD = 1.88) and over time (12-month FU: Mkg = 4.19; SD = 4.31). No differences were found between the two groups in outcome variables. ConclusionsBoth interventions were effective in promoting abstinence and reducing tobacco use over time. Combining CBT with CM for smoking cessation did not improve treatment outcomes in individuals with overweight or obesity compared to CBT only. Future studies should evaluate whether implementing CM for weight maintenance helps control post-cessation weight gain in this population.

The Effect of Cognitive-Behavioral Therapy on the Sexual Function of Women with Maternal Near Miss: A Randomized Controlled Trial

Background: There is evidence that maternal near miss (MNM) may adversely affect sexual function later in life. Objectives: This study aimed to evaluate the effect of cognitive-behavioral therapy (CBT) on the sexual function of women with MNM. Methods: Forty-eight women with MNM were randomly assigned to 2 groups: CBT (n = 24) and control (n = 24). Women in the CBT group received 8 counseling sessions based on CBT. Data were collected using a demographic questionnaire and the Female Sexual Function Index (FSFI). Women were requested to complete the FSFI questionnaire before and after the 8-session intervention. A total score of &gt; 26 was considered normal sexual function. The intervention started in June and was completed in October 2021. The Shapiro-Wilk test, independent t-test, Chi-square test, and Mann-Whitney test were used to analyze the data. Results: The scores of all components of sexual function improved in the CBT group compared to the control group as follows: Sexual desire (3.77 ± .64 vs. 2.25 ± .53, P &lt; 0.001), sexual arousal (3.72 ± .45 vs. 2.40 ± .48, P &lt; 0.001), lubrication (3.13 ± .35 vs. 2.60 ± .36, P &lt; 0.001), orgasm (3.11 ± .45 vs. 1.0 ± .42, P &lt; 0.001), sexual satisfaction (4.25 ± .52 vs. 2.83 ± .81, P &lt; 0.001), pain (2.36 ± .80 vs. 4.21 ± .54, P &lt; 0.001), total score of sexual function (20.37 ± 1.44 vs. 15.3 ± 1.40, P &lt; 0.001). Conclusions: While CBT significantly improved the sexual function of women with MNM, their sexual performance score still did not fall within the normal range. Our results indicate that women with a near miss may require additional counseling sessions or alternative interventions.

Evaluation of effect of brief-intensive cognitive behavior therapy on symptoms severity in relation with catastrophic cognition in patients with panic disorder: a randomized controlled trial

Introduction Due to a dearth of evidence, we examined the effectiveness of brief-intensive CBT on symptom severity and catastrophic cognition in patients with panic disorder (PD). Materials and methods In this randomized controlled trial, 155 patients were assigned to either the experimental group (2 successive days of brief-intensive CBT-3 h per day) or the control group (regular pharmacotherapy only). After excluding ineligible participants, 20 patients in the brief intensive CBT group and 18 patients in the control group completed the study and were included in the final analysis. The primary outcome was symptom severity, and the secondary outcome was catastrophic cognition, assessed by the Panic Disorder Severity Scale (PDSS) for symptoms severity and the Agoraphobic Cognition Scale (ACS) for cognitive assessment, respectively. Results The study showed that after one month of treatment, the PDSS (1.70 vs. 4.78; p = 0.0172) in the brief-intensive CBT group was significantly lower compared to the control group in contrast with the ACS (5.10 vs. 5.44; p = 0.8533). The mean score of PDSS and ACS significantly decreased from 21.60 to 1.7 (p < 0.0001) and from 22.55 to 5.10 (p < 0.0001) in the brief CBT group and from 19.44 to 4.78 (p < 0.0001) and 20.00 to 5.44 (p < 0.0001) in the control group, respectively. After treatment, the mean scores of PDSS and ACS significantly decreased in the brief intensive CBT and control groups. Both higher ACS and lower education levels contributed to higher PDSS in the brief intensive CBT group. However, only the PDSS correlated to the ACS in the control group. Conclusions The study showed that brief-intensive CBT is an effective technique for reducing the severity of symptoms among PD patients. But, it was not effective to improve the cognitive level in PD patients at one month.

Prediction of the efficacy of group cognitive behavioral therapy using heart rate variability based smart wearable devices: a randomized controlled study

BackgroundDepression and anxiety are common and disabling mental health problems in children and young adults. Group cognitive behavioral therapy (GCBT) is considered that an efficient and effective treatment for these significant public health concerns, but not all participants respond equally well. The aim of this study was to examine the predictive ability of heart rate variability (HRV), based on sensor data from consumer-grade wearable devices to detect GCBT effectiveness in early intervention.MethodsIn a study of 33 college students with depression and anxiety, participants were randomly assigned to either GCBT group or a wait-list control (WLC) group. They wore smart wearable devices to measure their physiological activities and signals in daily life. The HRV parameters were calculated and compared between the groups. The study also assessed correlations between participants’ symptoms, HRV, and GCBT outcomes.ResultsThe study showed that participants in GCBT had significant improvement in depression and anxiety symptoms after four weeks. Higher HRV was associated with greater improvement in depressive and anxious symptoms following GCBT. Additionally, HRV played a noteworthy role in determining how effective GCBT was in improve anxiety(P = 0.002) and depression(P = 0.020), and its predictive power remained significant even when considering other factors.ConclusionHRV may be a useful predictor of GCBT treatment efficacy. Identifying predictors of treatment response can help personalize treatment and improve outcomes for individuals with depression and anxiety.Trial registrationThe trial has been retrospectively registered on [22/06/2023] with the registration number [NCT05913349] in the ClinicalTrials.gov.Condensed abstractVariations in heart rate variability (HRV) have been associated with depression and anxiety, but the relationship of baseline HRV to treatment outcome in depression and anxiety is unclear. This study predicted GCBT effectiveness using HRV measured by wearable devices. 33 students with depression and anxiety participated in a trial comparing GCBT and wait-list control. HRV parameters from wearables correlated with symptoms (PHQ, PSS) and GCBT effectiveness. Baseline HRV levels are strongly associated with GCBT treatment outcomes. HRV may serve as a useful predictor of efficacy of GCBT treatment,facilitating personalized treatment approaches for individuals with depression and anxiety.