Cognitive Behavioral Therapy Research Articles

The externalization of internal experiences in psychotherapy through generative artificial intelligence: a theoretical, clinical, and ethical analysis

IntroductionExternalization techniques are well established in psychotherapy approaches, including narrative therapy and cognitive behavioral therapy. These methods elicit internal experiences such as emotions and make them tangible through external representations. Recent advances in generative artificial intelligence (GenAI), specifically large language models (LLMs), present new possibilities for therapeutic interventions; however, their integration into core psychotherapy practices remains largely unexplored. This study aimed to examine the clinical, ethical, and theoretical implications of integrating GenAI into the therapeutic space through a proof-of-concept (POC) of AI-driven externalization techniques, while emphasizing the essential role of the human therapist.MethodsTo this end, we developed two customized GPTs agents: VIVI (visual externalization), which uses DALL-E 3 to create images reflecting patients' internal experiences (e.g., depression or hope), and DIVI (dialogic role-play-based externalization), which simulates conversations with aspects of patients' internal content. These tools were implemented and evaluated through a clinical case study under professional psychological guidance.ResultsThe integration of VIVI and DIVI demonstrated that GenAI can serve as an “artificial third”, creating a Winnicottian playful space that enhances, rather than supplants, the dyadic therapist-patient relationship. The tools successfully externalized complex internal dynamics, offering new therapeutic avenues, while also revealing challenges such as empathic failures and cultural biases.DiscussionThese findings highlight both the promise and the ethical complexities of AI-enhanced therapy, including concerns about data security, representation accuracy, and the balance of clinical authority. To address these challenges, we propose the SAFE-AI protocol, offering clinicians structured guidelines for responsible AI integration in therapy. Future research should systematically evaluate the generalizability, efficacy, and ethical implications of these tools across diverse populations and therapeutic contexts.

Cognitive behavior therapy for academic burnout, procrastination, self-handicapping behavior, and test anxiety among adolescents: a randomized control trial

ObjectiveAcademic stressors among adolescents, strongly associated with emotional disturbance, increase the chance of psychiatric problems, and their severity increases over time when emotional and educational issues remain unresolved. The present study is designed to investigate the impact of cognitive behavioural therapy (CBT) on procrastination, burnout, self-handicapping behaviour, test anxiety, and school functioning among adolescents facing academic problems.Materials and methodsA total of 200 adolescents were enrolled for eligibility assessment; 129 participants met the eligibility criteria, and they were allocated to the experimental and waitlist control conditions. After the baseline assessment, participants were involved in the treatment condition, and after 6–8 follow-up sessions, they were referred for the post-assessment. We used different assessment measures to assess the outcome, i.e. General Procrastination Scale (GPS), Maslach Burnout Inventory-Student Survey (MBI-SS), Self-handicapping Scale (SHS), Test Anxiety Inventory (TAI), and Living up to Parental Expectation Scale (LPES). Repeated measures ANOVA was used to analyze the results.ResultsThe current RCT findings suggest that CBT was found an effective treatment condition to address the emotional problems among adolescents. CBT significantly reduced the degree of procrastination {F (1, 63) = 25.01, p < .000, η2 = 0.29} academic burnout {F (1, 63) = 11.08, p < .000, η2 = 0.16}, test anxiety {F(1, 63) = 88.17, p < .000, η2 = 0.59}, and self-handicapping {F (3, 56) = 10.17, p < .000, η2 = 0.16} among adolescents. CBT also significantly helped the students to manage parental unrealistic expectations through providing relationship skills and training {F (3,56) = 546.46, p < .001, η2 = 0.89). Further analysis reveals that counseling sessions substantially improved students’ academic performance and students functioning at school in term of attendance and punctuality.ConclusionIt is concluded that CBT efficiently addressed emotional and academic problems (i.e. procrastination, burnout, test anxiety, and self-handicapping behavior), improved students’ functioning at school (i.e. attendance & and academic grades), and guided the students to manage unrealistic parental expectations.

Pilot Trial of a Transdiagnostic Cognitive Behavioral Therapy (CBT)-Based Group Intervention to Reduce Psychological Distress, Facilitate Positive Behavior Change, and Mitigate Inflammation in Older People with HIV.

More than half of adults with HIV in the United States are aged 50 or older. Older people with HIV (OPWH) are disproportionately affected by age-related health disparities and non-communicable diseases associated with inflammation. The current pilot randomized controlled trial (RCT) evaluated the feasibility and acceptability, while exploring signals of effects of a transdiagnostic cognitive behavioral therapy (CBT) modular group teaching skills to cope with distress, make positive health behavior changes, and ultimately reduce inflammation. Participants were 31 virally undetectable, and psychiatrically stable OPWH (age [Formula: see text]50 years). Participants were randomized 1:1 to enhanced usual care or CBT for HIV and Symptom Management (CHAMP). CHAMP consists of 12-weekly virtual group sessions led by two interventionists. Self-report questionnaires and intravenous blood draws were collected at baseline and follow-up. Intervention participants completed an exit interview. Of those screened eligible, 96.8% (30/31) were randomized (n = 15 per group), 86.7% (13/15) completed the intervention, and 87% (26/30) completed the follow-up. On acceptability questionnaires scaled 0-3, participants reported high satisfaction and the intervention to be of high quality (M(SD)=3.00(0.0) for both). They also indicated their needs were met (2.67(0.50)) and coping improved (2.60(0.52)). Intervention participants showed a mean decrease in anxiety (-1.07(6.08)) and depressive (-1.71(5.37)) symptoms on clinical screeners, and mean increase in quality of life (2.86(3.59)). CHAMP is both feasible and acceptable for OPWH. Exploratory analyses indicate favorable outcomes for improving psychological distress and health-related quality of life.

Ketamine Treatment for Pediatric Refractory Obsessive: Five Open Label Cases.

Importance: Selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy are the first-line treatments for pediatric obsessive-compulsive disorder (OCD) populations. Due to their limited effectiveness, additional treatment options are needed. A new potential pharmacological medication treatment avenue for OCD is intravenous (IV) ketamine. Objective: This study aimed to establish the feasibility, acceptability, and preliminary efficacy of an IV ketamine infusion for the treatment of refractory OCD in adolescents. Design: In this clinical pilot trial, every participant received IV ketamine infusion. Symptom severity and side effects were assessed daily for 2 weeks following the infusion. Setting: Study procedures were conducted at the New York State Psychiatric Institute, including a combination of in-person visits and phone calls. Participants: Five adolescents with OCD (age M, SD: 16.6 ± 1.5), who had previously failed trials of first-line treatments were enrolled. Intervention: All participants received an IV infusion of 0.5 mg/kg ketamine hydrochloride. Main Outcomes and Measures: A multimethod approach was applied, including physiological, self-report, and clinician-rated measures. To assess feasibility and acceptability, vital signs, electrocardiogram suicidality, self-reported adverse events, and dissociative symptoms were obtained. Obsessive-compulsive (OC) (Yale-Brown Obsessive Compulsive Challenge Scale, CY-BOCS) and depressive symptom severity, as well as global clinical impression, were assessed to investigate preliminary efficacy. Results: The mean (SD) pre- and 14-day posttreatment CY-BOCS were 29 (5.5) and 26.2 (5.6). There were no incidents of abnormal vital signs, mortality, or suicidal ideation in the 2 weeks following the infusion. All participants experienced mild dissociative symptoms in the 40 minutes after the IV ketamine infusion. Descriptively, OC symptom severity decreased immediately after the infusion but was not maintained over the course of the study. Conclusions and Clinical Significance: Ketamine is well-tolerated in adolescents with OCD and therefore appropriate for further efficacy testing. Trial Registration: ClinicalTrials.gov Identifier: NCT02422290.

Effectiveness of Cognitive Behavioral Therapy Provided Through a Web Application for Subthreshold Depression, Subthreshold Insomnia, and Subthreshold Panic: Open-Labeled 6-Arm Randomized Clinical Trial Pilot Study.

A common definition of "subthreshold" is that the diagnostic threshold is not met but the individuals are not asymptomatic. Some symptoms are present, causing significant difficulty in functioning and negatively impacting quality of life. Despite the attention given to subthreshold symptoms and the interventions for subthreshold symptoms being efficient in preventing the transition to psychiatric disease in primary care, reports on specific interventions are insufficient. This study aimed to verify the effectiveness of internet-delivered cognitive behavioral therapy (ICBT) for subthreshold depression (SD), subthreshold insomnia (SI), and subthreshold panic (SP). Additionally, this study aimed to explore the minimally important change (MIC) of each subthreshold group's effectiveness outcome. Participants aged 18-70 years from internet research monitors were categorized into SD, SI, and SP groups based on screening assessment. They were randomly assigned to intervention or control groups within each subthreshold symptom. The intervention groups worked on 4 weeks of nonguided ICBT ("Mentre"), while the control groups worked on a sham app. The primary outcome was the score change from screening (T1) to 4-week follow-up (T4) using the Center for Epidemiologic Studies Depression Scale (CESD) in the SD group, the Pittsburgh Sleep Quality Index (PSQI) in the SI group, and the Panic and Agoraphobia Scale (PAS) in the SP group. Secondary outcomes were score changes in the Generalized Anxiety Disorder-7 (GAD-7) scale, the Patient Health Questionnaire 9 (PHQ-9), the CESD, the PSQI, and the PAS, except the primary outcome in each group. Secondary outcomes were analyzed using complete-case analysis and repeated-measures ANOVA. Additionally, the MIC in the primary endpoint for each group was also calculated as an exploratory outcome. The SD, SP, and SI groups contained 846, 597, and 1106 participants, respectively. In the SD group, the difference in the CESD score change from baseline to follow-up between the intervention and control groups was significant (difference=0.52, 95% CI 1.29-4.66, P<.001). In the SI group, the difference in the PSQI score change was also significant (difference=0.53, 95% CI 0.11-0.94, P=.01). However, in the SP group, the difference in the PAS score change was not significant (difference=0.07, 95% CI -2.00 to 2.15, P=.94). Our ICBT program Mentre contributes to the improvement of SI and SD. This suggests that nonguided ICBT may be effective in preventing SI and SD from progressing to the full threshold. However, appropriate definitions of subthreshold symptoms are necessary. In particular, it is difficult to define SP, and further research that considers the specific factors of each subthreshold symptom is necessary to accumulate evidence. University Hospital Medical Information Network (UMIN) UMIN000051280; https://tinyurl.com/2wyahhe3.

Instatherapy: A Content Analysis of Psychotherapists' Instagram Posts and User Engagement

ABSTRACTBackgroundSocial media is increasingly a source of mental health information and support. Online mental health content accessibility has allowed providers to access large audiences and client bases.AimsOur aim was to understand information audiences are encountering from psychotherapists on social media.Materials and MethodsSummative content analysis was completed on 10,395 posts from 294 psychotherapist influencers on Instagram. Analysis focussed on two domains: mental health concerns and psychotherapy‐related topics.ResultsInterpersonal concerns were the most frequently discussed mental health concern followed by anxiety, trauma/PTSD, depression and stress. The most frequently discussed psychotherapy‐related topics included holistic approaches, nervous system, cognitive behavioural therapy and internal family systems. Certain codes were associated with more user engagement than posts without those codes. Regarding mental health concerns, posts mentioning substance use garnered more likes and comments, posts mentioning dissociation/dissociative identity disorder garnered more comments, and posts mentioning perinatal issues received fewer likes. Regarding psychotherapy‐related topics, holistic approaches garnered more likes and comments, and crisis and couples/divorce garnered fewer likes.DiscussionFindings elucidate content that psychotherapist influencers discuss as well as how users engage with content.ConclusionThis study has implications for ethical guideline development for social media use among psychotherapists.

Estimating the Efficacy of CBT for Children on the Autism Spectrum Using a Home-Based Video Assessment of Autism-Related Solitary Behavior.

While laboratory and school playground-based independent evaluator (IE) rated measures of intervention outcome have been used in some clinical trials for autistic individuals (Dawson Pediatrics 125:e17-e23, 2010), IE ratings of children's behavior in their home environments are virtually nonexistent in published clinical trials in autism. In the present study, IE-rated measure of children's social isolation in the home setting pre and post intervention is utilized to evaluate treatment effects from a cognitive behavioral therapy (CBT) treatment for school-aged children on the autism spectrum (Wood et al. J Consult Clin Psychol 89:110-125, 2021). Twenty-nine of the 68 families of participants from a CBT intervention for autistic youth (Wood et al. J Consult Clin Psychol 89:110-125, 2021) who recorded home-based videos at pre-treatment also did so at post-treatment. Two measures were used by IEs to rate pre- and post-treatment home video recordings on children's social isolation (Children's Household-Environment Engagement Rating Scale; CHEERS, (Wood et al. Br J Clin Psychol, 2024) and Social Interaction Rating Scale (SIRS; Ruble et al. Topics Early Childhood Special Educ). Children in the CBT condition had a statistically significantly greater decline in CHEERS Solitary scores than did children in the Enhanced Standard Community Treatment (ESCT) condition. An increase in SIRS Responsive Parenting scores from pre- to post-treatment was statistically significantly linked with a decrease in Solitary scores. This study suggests that CBT-based interventions may be able to facilitate a positive impact on children's social engagement in their home environment. This study provides an informative lens for considering the contextual validity of interventions for autistic children with IE-rated measures.

Developmental Differences in Cognitive Restructuring Skill Acquisition across the Lifespan: Age Differences between Children, Adults and Older Adults, and the Role of Cognitive Flexibility

Abstract Purpose Replacing irrational or unhelpful thoughts with more rationale and helpful ones is a core skill in Cognitive Behavioural Therapy, but there is limited research examining the neuropsychological mechanisms underpinning this process. This study examined age-differences in cognitive restructuring skill acquisition between children, younger adults and older adults; whether individual differences in cognitive flexibility influences the ability to learn cognitive restructuring across the lifespan; and whether cognitive flexibility explains age-differences in cognitive restructuring ability. Method Participants were 114 individuals with anxiety disorders, including 35 children (aged 7–12, M = 9.14, SD = 1.44), 32 younger adults (aged 18–53, M = 23, SD = 7.84) and 47 older adults (aged 61–78, M = 66.81, SD = 4.43). Participants completed neuropsychological measures of cognitive flexibility and learned cognitive restructuring, which was coded for quality and efficacy. Results More than half the participants of all ages showed good quality cognitive restructuring skill acquisition with only brief instruction. Older adults showed comparable cognitive restructuring skills to children, with slightly better skills among younger adults. However, after accounting for individual differences in cognitive flexibility, there were no age-differences in cognitive restructuring quality. Greater perseveration was associated with poorer cognitive restructuring skill acquisition in younger and older adults, and mediated age-differences in cognitive restructuring skill acquisition. Conclusions Among younger and older adults, individual differences in perseveration, rather than chronological age, underpins the ability to learn cognitive restructuring. There is little evidence that cognitive flexibility plays a role in cognitive restructuring skill acquisition among children.

Efficacy of internet-based cognitive behavioral therapy for medicated adults with attention-deficit/hyperactivity disorder (ADHD): A randomized controlled trial.

Cognitive behavioral therapy (CBT) is an effective treatment for adults with attention-deficit/hyperactivity disorder (ADHD), but its use is limited by poor accessibility and time constraints-barriers that internet-based CBT (iCBT) may help overcome. This trial aimed to explore the short- and long-term efficacy of iCBT in medicated adults with ADHD. Eighty-six adults with ADHD were randomized into two groups: the iCBT combined with medication group (iCBT+M, n = 43) and the medication-only group (n = 43). The iCBT+M group received 12 weeks of iCBT with ongoing medication, while the medication-only group continued with medication alone. The primary outcome was the change in ADHD symptoms. Secondary outcomes included emotional symptoms, executive function, quality of life, and global functioning. Outcomes were assessed at baseline, post-treatment (T1), 6-month (T2), and 12-month follow-up (T3). Mixed linear models were used to assess the differences in outcomes between the two groups at each follow-up point. Compared to the medication-only group, the iCBT+M group showed greater improvements in ADHD symptoms (d = 0.50 at T1/T2, 0.59 at T3), executive function (d = 0.87 at T1, 0.49 at T2, 0.25 at T3), quality of life (d = -0.74 at T1, -0.59 at T2, -0.28 at T3), global functioning (d = 0.66 at T1, 0.85 at T2, 0.42 at T3), and anxiety (d = 0.43 at T1). iCBT interventions may benefit medicated adults with ADHD by improving core symptoms, executive function, quality of life, and overall functioning, with effects sustained for 12 months.

The effect of caregiver opinion leaders to increase demand for evidence-based practices for youth anxiety: A cluster randomized controlled trial.

Dissemination initiatives have the potential to increase consumer knowledge of and engagement with evidence-based treatments (e.g., cognitive behavioral therapy [CBT]). Opinion leaders (OLs) have been used in public health campaigns, but have not been examined for the dissemination of mental health treatments. This study uses the Theory of Planned Behavior to test the dissemination strategy of involving an OL in an educational presentation to increase caregiver demand for CBT for youth anxiety. Participants (N = 262; 92% female; 69% White, 82% non-Hispanic) were caregivers who registered for a virtual presentation on youth anxiety treatment through their child's school. Schools within 1.5-hr drive of Philadelphia, PA were cluster-randomized (k = 25; two-arm prospective randomization) to the OL condition (presented by a clinical researcher and local caregiver OL; n = 119 participants) or the researcher-only condition (n = 143 participants). Presentations occurred from May 2021 to May 2022. Measures were completed pre- and post-presentation and at 3-month follow-up. Relative to the researcher co-presenter, participants rated the OL as significantly more relatable, familiar, similar, and understanding of their community, but less credible than the researcher co-presenter. In both conditions, there was a significant pre-post increase in participants' knowledge of, attitudes about, subjective norms related to, and intention of seeking CBT for youth anxiety, but not stigma. Presentation conditions did not differ in change on these measures, or on rates of seeking youth anxiety CBT at follow-up. Although involvement of a caregiver OL did not increase caregiver demand for evidence-based treatment for youth anxiety, the outreach presentation was associated with increases in knowledge of, attitudes about, subjective norms related to, and intention to seek CBT for youth anxiety. Involving OLs in researcher-delivered dissemination efforts may not be necessary for all consumer audiences, but may be beneficial for engendering a sense of relatability, similarity, and connection with disseminators.

Comprehensive Review and Meta-Analysis of Psychological and Pharmacological Treatment for Intermittent Explosive Disorder: Insights From Both Case Studies and Randomized Controlled Trials.

Intermittent explosive disorder (IED) is characterized by sudden, disproportionate outbursts of anger that can severely impact individuals' quality of life, causing difficulties in maintaining relationships, issues at work or school and potential legal troubles. This study aimed to systematically review and meta-analyse the effectiveness of psychological and pharmacological treatments for IED, drawing insights from both case studies and randomized controlled trials (RCTs). A total of 12 RCTs and 14 case studies were included in this comprehensive analysis. The meta-analysis revealed that psychological treatments, particularly cognitive behavioural therapy (CBT), showed significant effectiveness in reducing aggression and achieving full remission compared to pharmacological treatments. However, the latter, notably fluoxetine, demonstrated notable efficacy in managing irritability and achieving treatment response. Subgroup analysis identified follow-up time and intervention type as significant moderators of treatment outcomes. The systematic review of case studies highlighted the successful application of deep brain stimulation (DBS) and various off-label medications, including SSRIs and mood stabilizers, in managing IED symptoms. Despite these insights, the study emphasizes the need for more robust evidence-based treatment protocols and further research into the underlying mechanisms of IED to develop targeted treatments.

Structural Brain Changes Associated With Cognitive Behavioral Therapy in Cocaine Use Disorder Treatment

Structural Brain Changes Associated With Cognitive Behavioral Therapy in Cocaine Use Disorder Treatment

Emotion dysregulation in youths with obsessive-compulsive disorder and its implication for treatment - an exploratory study from the TECTO trial: A protocol and statistical analysis plan

BackgroundResearch on improving psychotherapy for youths with obsessive-compulsive disorder (OCD), including cognitive behavioral therapy (CBT), should explore what works for whom and how by examining baseline moderators and potential mechanisms of change. Emotion dysregulation is proposed as an intermediate therapy factor in a transdiagnostic framework. This study investigates emotion dysregulation as an outcome, mechanism, and moderator of psychotherapy in youths aged 8-17 years with OCD. MethodsData are from a randomized clinical trial and a parallel prospective study of healthy controls. Participants with OCD (n=130; 121 in this study) were randomized to 14 sessions of either family-based CBT with exposure and response prevention versus family-based psychoeducation and relaxation training. We will; 1) assess if emotion dysregulation, measured by the Difficulties in Emotion Regulation Scale (DERS), decreases from baseline to end-of-treatment; 2) compare the proportion of participants with normative emotion regulation to a 90% reference interval from healthy controls (n=90); 3) use linear regression to examine if baseline emotion dysregulation moderates treatment effects measured by the Children’s Yale-Brown Obsessive-Compulsive Scale; 4) investigate if changes in emotion dysregulation mediate treatment effects; and 5) investigate the stability of emotion regulation over time in the healthy controls. Analyses 1-4 will be conducted for all OCD participants and separately for the two treatment groups. Two independent investigators will perform the analyses. ConclusionThis protocol and statistical analysis plan are presented to enhance analytical transparency and limit bias.

The efficacy of cognitive behavioral therapy (CBT) in managing depression among nurses: A systematic review

The efficacy of cognitive behavioral therapy (CBT) in managing depression among nurses: A systematic review

The relationship between cognitive and affective control and symptoms of depression and anxiety across the lifespan: A 3-wave longitudinal study

IntroductionThe association between cognitive functioning and mental health symptoms across the lifespan remains poorly understood. Understanding the directional associations between mental health and cognition is important as most gold-standard psychological therapies, such as cognitive-behaviour therapy, are cognitively demanding. Here, we examined the directionality of the association between cognitive and affective control with symptoms of depression and anxiety across the lifespan. Methods1002 participants (87.2 % female, age range: 11–89 years) completed self-report measures of depressive and anxiety symptoms and an affective backward digit span task thrice at 3-month intervals. Cross-lagged panel models (CLPMs) were used to model the longitudinal relationships between affective and cognitive control with depressive and anxiety symptoms. Multiple-group CLPMs were applied to test the model invariance between adolescents and adults. ResultsThe results supported a unidirectional relationship, where symptoms of depression and anxiety predicted impaired affective control across time points, over and above cognitive control. There was no evidence for affective or cognitive control capacity predicting emotional disorder symptomatology. In addition, multiple-group analysis revealed that depressive symptoms also predicted impaired cognitive control among adolescents only. There were no age-related differences in the associations between cognitive and affective control with anxiety symptoms. ConclusionsOur findings support depression and anxiety as antecedents, but not consequences, of impaired affective control, suggesting that timely management of emotional disorders, in particular for adolescents, is essential to prevent deterioration in cognitive functioning. The results further signal that practitioners should consider impaired affective control capacity in therapeutic contexts.

Evaluating Response to a Cognitive Behavioural Therapy for Psychosis-Informed Family Intervention at Variable Duration of a Psychotic Illness.

Early intervention in psychosis is associated with favourable outcomes. We investigated whether loved ones' illness duration moderated caregiver outcomes following a Cognitive Behavioural Therapy-informed Family Intervention for psychosis (FIp). We conducted a secondary analysis of measures of FIp participants' depression and anxiety symptoms, caregiver appraisals, expressed emotion and foundational psychotherapeutic competencies at pre-, post- and 4-month follow-up. Our primary aim was to evaluate whether duration of illness moderated participant outcomes. Relative to pre-intervention, all caregivers reported lower depression, anxiety and expressed emotion, as well as higher positive attitudes and mastery of cognitive behavioural skills, at post-intervention and 4-month follow-up. Outcomes were not moderated by their loved one's illness duration. Families may benefit equally from FIp regardless of illness duration. Although we recommend that FIp are offered as early as possible, modifications for families with lengthier illness courses are not implicated by our findings.

Augmenting trauma-focused cognitive behavior therapy for post-traumatic stress disorder with memory specificity training: a randomized controlled trial.

Although trauma-focused cognitive behavior therapy (TF-CBT) is the recommended treatment for post-traumatic stress disorder (PTSD), up to one-half of patients do not respond to this intervention. There is an urgent need to develop new strategies to improve treatment response. Training people to recall specific positive memories may augment treatment gains in TF-CBT. We conducted a controlled trial in Australia with current or former first responders (including police, firefighters and paramedics) with PTSD, who were randomized on a 1:1 basis to 12 weekly 90-min individual sessions of either TF-CBT combined with memory specificity training (TF-CBT/MT) or TF-CBT alone. The primary outcome was change in PTSD severity independently assessed at baseline, post-treatment, and six months after treatment (primary outcome timepoint). Secondary outcomes included measures of depression, trauma-related cognitions, alcohol use, and quality of life. Between October 2021 and May 2023, fifty participants were randomized to TF-CBT/MT, and fifty to TF-CBT alone. Most participants were males (71.0%) and the mean age was 46.8±9.9 years. At the 6-month assessment, participants receiving TF-CBT/MT showed a greater reduction of PTSD severity than those randomized to TF-CBT alone (mean difference: 9.2, 95% CI: 3.2-15.1, p=0.003), indicating a large effect size (0.9, 95% CI: 0.1-1.6). Participants receiving TF-CBT/MT also had greater reductions in alcohol use (mean difference: 5.3, 95% CI: 1.5-9.2, p=0.007; effect size: 0.8, 95% CI: 0.2-1.4) and self-blame cognitions (mean difference: 0.8, 95% CI: 0.2-1.4, p=0.008; effect size: 0.5, 95% CI: 0.1-0.9). These data suggest that memory specificity training adds significantly to the effect of standard TF-CBT in reducing PTSD severity. This approach can offer a simple and easy to implement strategy to augment treatment for PTSD patients.

Changes in Risk-Taking Among People Who Received Cognitive Behavioral Therapy Versus an Other Treatment for Substance Use

Changes in Risk-Taking Among People Who Received Cognitive Behavioral Therapy Versus an Other Treatment for Substance Use

The efficacy of antenatal cognitive Behavioural therapy for antenatal and postnatal depression: A PRISMA based systematic review and meta-analysis

The efficacy of antenatal cognitive Behavioural therapy for antenatal and postnatal depression: A PRISMA based systematic review and meta-analysis

Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy.

Insomnia and sleep problems are common in pregnancy and have potentially negative impacts on both parental and infant health. This study examined the Sleeping for Two adaptation of cognitive behavioral therapy for insomnia (CBT-I) in pregnancy. A parallel (1:1) randomized controlled trial evaluated CBT-I (n = 32) compared to a treatment as usual waitlist (n = 32) among pregnant individuals from Alberta, Canada experiencing insomnia. Five weekly individual sessions of CBT-I pivoted from in-person delivery to telehealth due to the COVID-19 pandemic physical distancing regulations. Insomnia symptom severity (primary outcome), insomnia diagnosis by structured interview, self-reported sleep problems, as well as sleep parameters measured by diary and actigraphy were assessed pretreatment at 12-28 weeks gestation, 1-week posttreatment, and 6 months postpartum. Birth information (secondary outcomes) were collected via delivery record and parent report of infant sleep (exploratory outcome) was taken at 6 months postpartum. Multilevel modeling using an intention-to-treat approach showed that CBT-I was associated with a decrease in insomnia symptoms and improved sleep quality across time compared to treatment as usual. The CBT-I group had fewer diagnoses of insomnia posttreatment, but the difference did not reach statistical significance until 6 months postpartum. Participants with worse sleep quality at baseline benefitted substantially more from CBT-I vs treatment as usual waitlist. CBT-I delivered in pregnancy can reduce symptoms of insomnia and improve sleep quality, which could in turn minimize risk of negative consequences for birthing parent and infant health. Registry: ClinicalTrials.gov; Name: Sleeping for Two: RCT of CBT-Insomnia in Pregnancy; URL: https://www.clinicaltrials.gov/study/NCT03301727; Identifier: NCT03918057. MacKinnon AL, Silang K, Watts D, etal. Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy. J Clin Sleep Med. 2025;21(2):365-376.