Cognitive-behavioral Therapists Research Articles

Report of a small feasibility study involving group analysts and groupwork practitioners in facilitating self-practice/self-reflection groups in the training of cognitive behaviour therapists

This article provides a narrative account of a small research study run with a grant from the Institute of Group Analysis (IGA) Legacy Fund. It discusses the challenges and opportunities of engaging in research involving interdisciplinary collaboration between trainee cognitive behaviour therapists working in the NHS and group analysts/groupwork practitioners. It makes the case for building on the results of this study by developing a protocol for a pre-post pilot study using a mixed methods approach to explore whether IGA-led groupwork in CBT training has any effect on patient outcomes and service key performance indicators.

Side Effects in Psychodynamic and Cognitive Behavior Therapy

AbstractTherapists and the public are becoming increasingly aware that psychotherapy can have side effects. The prevalence varies depending on the patients, treatments, settings, assessment methods and the researched type of side effect. Objective of this study is to assess side effects of routine outpatient psychodynamic and cognitive behaviour therapy. In a cross-sectional study cognitive behaviour therapist (n = 73) and psychodynamic psychotherapists (n = 57) were asked in a semi-structured interview about unwanted events and side effects in reference to their most recent patients (N = 276) using a domain inspection method. Their reports were cross-checked by an expert assessor. Multiple random-intercept models were conducted to investigate the influence of various variables. Therapists reported in 170 patients (61.4%) a total of 468 unwanted events. There was at least one side effect in 33.2% of the cases. Most frequent side effects were “strains in family relations” and “deterioration of symptoms”. Illness severity has a significant influence on the amount of side effects reported. The data confirm that side effects of psychotherapy are frequent. The difference between side effects and unwanted events shows the importance of such a distinction. The reporting of side effects for one in three patients may indicate an under recognition of side effects or reporting of only relevant or disturbing side effects.

REBT with Members of the Church of Jesus Christ of Latter-day Saints

Rational Emotive Behavior Therapy’s (REBT’s) ABC model proposes that it is B, Beliefs about A, Activating events, not A, Activating events themselves, that create and control C, emotional Consequences. Codified beliefs such as scriptures and creeds are prominent in most religions. Integrating codified religious beliefs with REBT to help D, Dispute irrational beliefs has been studied in REBT for more than 50 years. Broad knowledge of religious cultures, scriptures, creeds, and wisdom literature is likely to help REBTers and other cognitive behavior therapists (CBTers) more effectively treat religious clients. We give a brief overview of the history, culture, doctrine, and scriptures of the Church of Jesus Christ of Latter-day Saints, then give examples of REBT Disputations excerpted from religion integrative sessions with practicing Latter-day Saint clients. We present practice-based evidence for the effectiveness of this approach and offer suggestions for future study and research in integrating religion with REBT and CBT.

Beliefs and therapeutic practices related to traumatic memories among Italian cognitive behavioral therapists and trainees

PurposeThe purpose of this study was to investigate cognitive behavior therapists and trainees’s beliefs about various aspects of traumatic memory and to investigate cognitive behavior therapists’ practices in relation to alleged traumatic experiences and whether they are linked with their beliefs about various aspects of traumatic memory.Design/methodology/approachIn the current study, the authors surveyed, by a questionnaire (in Italian), certified Italian cognitive behavioral (CB) therapists and trainees with respect to their beliefs in traumatic memories and whether they discussed about the possibility of repressed memory with their patients.FindingsThe majority of participants held strong beliefs about many controversial aspects related to traumatic memory, such as the mind being able to block out of consciousness memories of traumatic experiences. Also, more than half of CB therapists stated that they sometimes discussed about the importance of traumatic events in the genesis of their patient’s disorder and half of them sometimes talked with patients about memories for traumatic events of which they may be unaware. Such practices could lead to false memories of abuseOriginality/valueOne particularly novel finding relates to the evidence that therapists reported that they had discussed with patients the importance of traumatic events in the genesis of their illness and frequently noted that they talked about the possibility of repressed memories with them. In turn, patients may be induced to recall traumatic experiences from their lives, thereby producing false memories which may tear families apart and could even lead to wrongful convictions.

Associations between the personal style of the therapist, empathy and theory of mind among Argentine psychotherapists

The personal style of the therapist refers to the dispositions, traits and attitudes that the therapists display in their professional practice. The associations between personal style of the therapist, empathy and theory of mind, have yet to be examined. This study analyzed the associations between personal style of the therapist, empathy and theory of mind among therapists, while considering the effect of their theoretical background and other contextual and individual variables. The study sample consisted of 152 Argentine therapists. Personal style and empathy were assessed through self-report questionnaires (Personal Style of the Therapist Questionnaire and Interpersonal Reactivity index, respectively), while theory of mind was evaluated with the Reading the Mind in the Eyes test. Cognitive empathy was associated with a broader attentional focus and higher emotional expressiveness, while affective empathy led to stronger commitment and a higher emotional impact of therapy on the therapist. In addition, psychoanalysts and cognitive behavioral therapists exhibited personal style of therapist differences in their spontaneity and emotional distance, and cognitive behavioral therapists showed higher levels of engagement. Keywords: Personal style of the therapist; empathy; theory of mind; clinical psychology.

474 Potential contribution of community pharmacists in suicide prevention in Nigeria: key informants’ perspective

Abstract Introduction Globally, over 700,000 people die by suicide yearly, and 77% of the suicide global burden is reported in Low middle-income countries, including Nigeria (1). Community pharmacists are often the most visited healthcare providers for locals in Nigeria. However, there is sparse knowledge about their contributory role in suicide prevention (2). Aim To explore key informants’ perspectives on the potential contribution of community pharmacists in Nigeria to suicide prevention and gain insight into the potential barriers and facilitators in incorporating a suicide prevention programme within community pharmacies. Method Online semi-structured interviews were conducted with global key informants. The key informants were recruited based on their expertise in suicide prevention, public health, mental health, and pharmacy practice from low- and high-income countries. In addition, key informants were either author from literature reviews or referred by the informants. All key informants were contacted through emails, agreed informants gave both verbal and written consent. The topic guide questions were modified according to each key informant’;s professional role and country. The recruitment and interviews were done from March 2022 to September 2022. The interviews were audio, and video recorded, transcribed verbatim and thematically analysed using NVivo software.Codes were generated by the lead researcher and reviewed by the study team. Results A total of 22 key informants consisting of 6 pharmacists, 5 researchers, 4 mental health consultants, 2 policy makers, 2 cognitive behavioural therapists, 2 psychiatrists and 1 suicide and self-harm analyst with different geographical background participated in this study. Each key informant presented perspective on how suicide prevention effort is being handled in their country and how the potential community pharmacist’s role in Nigeria could work. The major themes identified are :(i) The need for a suicide prevention programme in community pharmacies, and this includes (ii) Restricting access to means. This could be achieved by (iii) Education and Training, (iv) Pharmacy service reimbursement and (v) a referral system with other health professionals. (vi) stigma and (vii) pharmacy environment were highlighted as barriers. Conclusion Global Key informants were open to the community pharmacist’;s role in suicide prevention, expecting it would help fill the psychiatric professional gap in Nigeria’;s mental health system. However, some expressed concerns about community pharmacists’ lack of knowledge and awareness in this area and where they could distinctively fit in suicide prevention strategies. Perceptions of stigma underpinned much of key informants’ discussion. All key informants indicated the high existence of cultural and professional stigma and its impact on suicide prevention. This is the first study to explore a broad global perspective on community pharmacists’ role in suicide prevention. However, some key informants are registered pharmacists, and others have a particular interest in suicide prevention and training, thus may be biased towards community pharmacists’ role in suicide prevention. To further explore the practical implication of any recommendations about this role, our identified themes will help to develop our Delphi study to determine consensus on the scope of the future contribution of community pharmacists to suicide prevention efforts in Nigeria.

Conceptualization of Stress-Related Disorders and PTSD by Cognitive Behavior Therapists

Background: Many people experience stressful life events like social conflicts, accidents, or physical violence. Some develop post-traumatic stress disorders (PTSD) thereafter. A diagnostic problem is the differentiation between causal stressful events, occasional causes, pseudo-causes or retrospective reinterpretations. This study investigates how often the diagnosis PTSD is mentioned in outpatient behavioral therapy patients, and which causes, findings, and therapeutic measures are reported. Patients and Method: In 1,480 behavioral therapy case reports the assignment of the diagnosis PTSD was explored. Cases with PTSD (N = 106) were compared with other cases without PTSD (N = 95). Results: In 7.16% the diagnosis PTSD was given. In both groups 90% reported earlier stressful experiences. In only 17% of the PTSD cases an “extraordinary threat of catastrophic proportions” was reported. In a quarter, the trauma assumption was based only on therapist or patient suggestions. Dissociative symptoms or intrusion were described only in the PTSD cases. Discussion: The data suggest that (a) almost all patients report stressful experiences, (b) the diagnosis of PTSD is given only in a limited number of patients, (c) in PTSD cases, intrusion and dissociation are reported only in a minority of cases, and (d) in PTSD cases, the full spectrum of exposure techniques is mentioned. Conclusion: Stress-associated disorders need precise description and differentiation.

Judging others makes me forget: Assessing the cognitive, behavioural, and emotional consequences of other-evaluations on self-evaluations for social anxiety

Background and objectivesPeople with Social Anxiety Disorder (SAD) evaluate themselves negatively before, during, and after anxiety-provoking social situations, which leads to negative consequences (e.g., performance deficits, memory impairments, and post-event processing). Despite decades of research, little is known regarding whether these evaluations generalize to how they view others. Social projection theory—the belief that others are similar to oneself—might further extend the basic Cognitive Behavioural Therapy (CBT) model. Our aim was to understand whether the degree to which people negatively evaluate a visibly anxious person causes them to negatively evaluate themselves. Methods172 unselected participants completed several baseline questionnaires. We then randomly assigned participants to provide high-, medium-, or no-evaluation of a videotaped anxious person (i.e., other-evaluations) while we assessed their state anxiety. After, they evaluated the anxious person on multiple criteria. Participants then participated in an impromptu conversation task and subsequently evaluated their own performance. ResultsAlthough our manipulation was effective, we found no emotional or behavioural differences between conditions. However, people in the high-evaluation condition recalled significantly fewer facts about their conversation partner than did people in the medium- and no-evaluation conditions. LimitationsAfter data cleaning, the sample size was slightly smaller than planned; most analyses were nonetheless appropriately powered. Our findings may not generalize beyond unselected undergraduate students; replication in a clinical sample is warranted. ConclusionsThese findings highlight the cognitive consequences (i.e., memory impairments) of other-evaluations, which cognitive behavioural therapists should consider when treating individuals with SAD.

“Sharing in people's pain is not an easy thing to do”: Cognitive Behavioural Therapists' understandings of compassion in the workplace

AbstractObjectivesCompassion is central to the aim of improving patient care and staff well‐being within healthcare systems. To inform service development, explorations of experiences and meanings of compassion are needed. This study explored cognitive behavioural therapists' understandings of compassion within their work environment.DesignA qualitative study was conducted using semistructured interviews and interpretative phenomenological analysis (IPA).MethodsData were obtained from five practicing cognitive behavioural therapists.ResultsTwo superordinate themes were developed, each with two subordinate themes. CBT therapists reported entering the profession with intrinsic motivation to care for others. They further developed an interest in compassion with exposure to clients and ongoing professional development in compassion‐focused therapy (CFT). Compassionate work environments helped to facilitate compassionate practice; however, for many, workplaces were perceived to lack compassion. Challenges were encountered when negative workplace interactions left therapists feeling fatigued, distressed and demoralised. There was a desire for recognition and to be seen as more than a “work machine,” the experience of which was a threat to retaining therapists within the profession.ConclusionsCurrent recruitment and training processes are producing staff with skills and motivation to deliver compassionate care. However, lack of compassion within workplaces can be a barrier to actioning these skills and motivations. Research needs to focus on how to effectively implement and run systems that are compassionate for both staff and clients. To provide compassionate care, staff need work environments that show compassion to them. These findings provide some insights into and practical suggestions regarding how this can be achieved.

A qualitative exploration of black psychotherapists’ personal experience of racism and the challenges that exist for black therapists who work with clients in therapy who have also experienced racism. A pilot study using interpretive phenomenological analysis

Abstract The impact of racism to the individual is arguably immeasurable; however, the impact on psychotherapists who themselves have personally had either one or multiple experiences of racism and work with clients in therapy who have also experienced racism is an area with very little research. Semi-structured interviews were conducted with black cognitive behavioural therapists who have personally experienced racism and have also worked with clients who have experienced racism; data were analysed using interpretive phenomenological analysis. As this was a pilot study, only two participants were recruited to the study. Superordinate and subordinate themes were identified from the data and explored. The study highlighted that the impact of racism, racist experiences and microaggressions can lead to mental health problems, and there is need for further support for therapists, especially within the contexts of clinical supervision and from their organisation leadership. In addition, the need for further research was also identified, as well as improved training in working with disclosures of racism, and racial trauma within a therapeutic context was considered as important to the therapists of this pilot study. Key learning aims (1) To explore and understand the personal experiences of black therapists who have personally experienced racism. (2) To identify some of the challenges that exist for black therapists who work with clients who have experienced racism and to explore possible solutions to overcome such challenges.

The relationship between therapist experiential avoidance and observed CBT competence during training: a preliminary investigation

Abstract The psychological literature highlights experiential avoidance as a transdiagnostic maintenance factor for a number of psychopathologies. Some attention has been given to therapist experiential avoidance, with the suggestion that this interferes with the acquisition and execution of CBT skills; there is, however, a paucity of research directly examining this relationship. This study aimed to measure experiential avoidance in trainee cognitive behavioural therapists, and establish any relationships with observed clinical competence. Twenty-nine trainee therapists took part in the study; levels of experiential avoidance were measured using the Multidimensional Experiential Avoidance Questionnaire and were analysed in relation to observed CBT skills assessed using the Cognitive Therapy Scale (Revised). No overall relationship between therapist experiential avoidance and clinical competency was observed. However, a number of significant associations were observed between individual dimensions of therapist experiential avoidance and CBT skills in collaboration, guided discovery, conceptual integration and homework setting. Aspects of therapist experiential avoidance during training may therefore be associated with the acquisition of key CBT skills. Tentative interpretations and recommendations for CBT training and supervision have been made, although further investigation is required. Key learning aims (1) To understand the role of experiential avoidance in psychopathology. (2) To understand the relevance of client experiential avoidance as part of CBT treatment. (3) To examine the potential impact of therapist experiential avoidance on the development and execution of key CBT skills. (4) To consider implications for CBT training, supervision and clinical practice.

‘It’s been quite a poor show’ – exploring whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of Black, Asian and Minority Ethnic (BAME) communities

Abstract Cultural competency is a core clinical skill. Yet, psychological therapists may be inadequately trained to deal with the needs of service users from Black, Asian and Minority Ethnic (BAME) backgrounds. This can lead to dissatisfaction with mental health services, disengagement from therapy, and poorer treatment outcomes when compared to the White British population. The aim of this study was to explore whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of diverse communities. Semi-structured interviews were carried out with a range of practitioners, from early career psychological wellbeing practitioners (PWPs) to senior cognitive behavioural therapists (n=16). Reflexive thematic analysis (RTA) was used to analyse the data, guided by a six-phase process to produce a robust pattern-based analysis. Overall, three themes were generated: (1) encountering cultural dissonance within therapy; (2) challenges in making cultural adaptations to therapy; and (3) identifying cultural competency needs. Out of sixteen participants, only nine therapists received one-day formal training throughout their therapeutic career, whilst seven reported receiving no cultural competence training at all. Overall, it appears that there is an urgent need and desire for therapists to be offered cultural competency training so that they can better serve BAME communities. Clinical implications and future recommendations are made. Key learning aims (1) To briefly introduce cross-cultural theoretical models that may assist mental health professionals to think critically about Western notions of therapy and whether they are suited to the needs of ethnic minority communities. (2) To consider challenges IAPT practitioners encounter during therapy and identify examples of good practice. (3) To explore to what extent IAPT practitioners feel culturally competent to deal with the needs of BAME communities. (4) To encourage IAPT services and decision makers (e.g. training bodies and commissioners) to enhance cultural competence training so that practitioners can better serve ethnic minority communities.

The Perception of Therapists on the Effectiveness of CBT in Altering Mental Well-Being

Cognitive behavioral therapy (CBT) has gained support over the past few years due to the more popularized perception of researchers and therapists for its ability to help patients suffering from mood disorders. Moreover, it is currently being used alongside a variety of techniques and other treatments. In the past, research has focused on the ability of CBT to mitigate physical symptoms, including fatigue and high heart rate, that emerge from mood disorders. In an attempt to fill in the gap by focusing on mental well-being as opposed to physical symptoms, this study aimed to establish how the perceptions of therapists showcase the effectiveness of CBT in altering the mental well-being of patients with mood disorders. In order to gain an in-depth understanding towards this concept, interviews were conducted with cognitive behavioral therapists in Indiana. Ultimately, this research led to 2 main conclusions: CBT and mental well-being are connected, and the extent to the effectiveness of CBT depends on the specific tools that are utilized. Specifically, when utilizing the CBT tools of testing logic and homework, mental well-being was seen to improve, while when utilizing the tools of confronting fears and enneagram tests, no effect was seen on mental well-being. Future research, however, must be conducted in order to further the idea of altering a patient’s mental well-being as it relates to different population samples and other forms of therapy.

PSAT185 Pseudohypoparathyroidism Type 1B: A Medication Compliance Challenge

Abstract Introduction Pseudohypoparathyroidism (PHP) encompasses five metabolic disorders characterized by target organ PTH resistance. The focus of this paper is PHP Type 1B (PHP1B), a disease that typically presents in children with symptomatic hypocalcemia. Only 15-20% of cases are genetic, making our case of Familial PHP1B even rarer. Case Presentation A 23-year-old African-American female with hypothyroidism and PHP1B diagnosed in 2005 presented to the emergency department with symptomatic hypocalcemia. As a child, she was evaluated for progressive femur, tibia, radius, and ulna bowing in the setting of short stature without phenotypic features of Albright's Hereditary Osteodystrophy. Her biochemical profile was consistent with pseudohypoparathyroidism and imaging showed costochondral junction enlargement. Genetic testing revealed STX mutation confirming PHP1B diagnosis. Extensive studies of her family revealed several affected members, including one of her two children.Patient has history of multiple hospitalizations for symptomatic hypocalcemia. During this admission, her laboratories demonstrated: calcium 4.4 mg/dL (8.6-10.3 mg/dL), phosphorus 7.3 mg/dL (2.5-4.5 mg/dL), PTH 574 pg/mL (16-65 pg/mL), 1,25-dihyroxyvitamin D < 8 ng/mL (18-78 ng/mL), and 25-hydroxyvitamin D 7.6 ng/mL (30-100 ng/mL).She has an extensive history of non-compliance with medications and endocrinology appointments. During the last visit, she complained of ostealgia, particularly in long bones. While discussing the importance of maintaining adequate calcium levels, the patient expressed feeling overwhelmed by her regimen (calcitriol 1 mcg QAM and 0.5 mcg QHS, calcium carbonate 1,200 mg TID). After a lengthy conversation regarding the need for long-term medical therapy, she became increasingly distraught. Conclusion When normocalcemia is achieved with high doses of calcium and calcitriol, patients with PHP1B have an average life expectancy. Given that patients are typically diagnosed in childhood, taking several medications multiple times a day can be challenging and lead to poor compliance. When this occurs, PHP1B becomes a life-altering disease with a significant decrease in quality of life.In 2018 Wierenga et al. reported that being emotionally overwhelmed by chronic disease prevents a patient from appropriately caring for themselves. Their research shows that older males with higher levels of education have better emotional regulation than young females with low educational levels. Providing patients at high risk of psychological stress with a multidisciplinary team including cognitive-behavioral therapists can improve their quality of life and compliance while decreasing the healthcare costs associated with poorly controlled chronic diseases. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Quality of the therapeutic working alliance as a factor in intensive residential treatment of obsessive-compulsive disorder

Objective: Intensive residential treatment (IRT) for obsessive-compulsive disorder (OCD) includes frequent meetings with a cognitive–behavioral therapist. We examined whether this therapeutic working alliance relates to IRT outcomes. Method: Data came from a naturalistic sample of patients with OCD (n = 124) who received IRT at a specialty OCD clinic. Patients completed measures of OCD severity and well-being at admission and discharge. Both the patient and treating psychologist completed the Working Alliance Inventory-Short Form (WAI-SF). Alliance ratings were tested as predictors in models predicting outcomes (discharge scores adjusting for baseline and treatment duration) as well as logistic regression predicting treatment response (≥35% symptom reduction in OCD symptoms). Results: Patient and clinician ratings of the quality of the alliance were weakly yet significantly correlated. Patient ratings of the alliance predicted outcomes, while therapist ratings did not. Moreover, greater discrepancy between patient and client ratings predicted worse outcomes. Patient ratings of the task dimension of the alliance uniquely related to responder status. Conclusions: Patient perceptions of the working alliance, particularly as pertaining to agreement on therapeutic tasks, related to success with IRT for OCD. Further study is needed test interventions to improve task alliance as a strategy to enhance treatment.

Rational emotive intervention for work-family conflict and female primary school teachers' well-being.

Globally, work and family conflict has been investigated by many researchers. Yet there is an increased prevalence of work-family conflict and its influence on the well-being of the female teaching population, especially Nigerian primary school teachers. This incidence has kept a good proportion of schoolteachers vulnerable to health problems as well as affected their wellbeing. This study evaluates the effect of rational emotive behaviour therapy on improving the well-being of female teachers with irrational behaviours arising from the work-family conflict. This is a randomized study. A total of 69 female primary school teachers in Enugu state Nigeria who met the criteria for inclusion were used as the study participants. Three self-report measures (Work-Family Conflict questionnaire, Multidimensional Health States Scale-Short Form, and Teacher Irrational Belief Scale) were used to collect data. Repeated measures with analysis of variance (ANOVA) were used to determine the effects of the intervention. The findings of the study revealed that REBT had a significant effect on the well-being scores of Nigerian female primary school teachers with work-family conflict when compared to their counterparts in the no-intervention group at Time 2. In addition, the effect of REBT on improving well-being in female teachers with work-family conflict was significantly maintained at the follow-up measurements (Time 3). In conclusion, it is suggested that REBT is an effective intervention for moderating the effect of work-family conflict on the well-being of career female teachers. As such, cognitive behavioural therapists can further examine the effectiveness of REBT using other constructs and cultures.

Treating common mental disorder including psychotic experiences in the primary care improving access to psychological therapies programme (the TYPPEX study): protocol for a stepped wedge cluster randomised controlled trial with nested economic and process evaluation of a training package for therapists

IntroductionAt least one in four people treated by the primary care improving access to psychological therapies (IAPT) programme in England experiences distressing psychotic experiences (PE) in addition to common mental...

UM ESTUDO DE CASO DE ANOREXIA NERVOSA: desafios e possibilidades na terapia cognitivo-comportamental

The propagation of a thin body culture and an aesthetic standard to be followed by society has increased the incidence and prevalence of eating disorders. These disorders, related to body image distortion, have been growing exponentially in several countries around the world. They are increasingly characterized as an area of interest for health professionals, however, there are still few Brazilian studies on the treatment of these pathologies from the point of view of Cognitive-Behavioral Therapy. Eating disorders are conditions known for aspects such as the morbid fear of gaining weight, voluntary reduction in nutritional consumption, massive food intake followed by vomiting and abusive use of laxatives and/or diuretics. These are serious pathologies with little discussed prognosis, which, in turn, bring patients biopsychosocial damage and high levels of lethality, in addition to suffering for families. In this way, the present article brings the experience with an illustrative case of anorexia nervosa, thinking about its form of evaluation and intervention. Based on the reporting and recording models, the cognitive-behavioral therapist describes the contingencies of which a behavior is a function, its beliefs and life history. Such information can help to understand the development of anorexia, and thus teach the patient ways to manage the disorder.

How Important Is a Guide Who Has Taken Psilocybin in Psilocybin-Assisted Therapy for Depression?

ABSTRACT Promising outcomes of Psilocybin-Assisted Therapy (PAT) for depression have generated concerted efforts to replicate, extend, and refine protocols to maximize efficacy. Psychotherapy research reveals that clients benefit most when important components of treatment align with their personal preferences. One open question related to PAT concerns the importance of the psilocybin experience of the guides (trained professionals present during acute effects). We sought to assess the importance of a guide who had used psilocybin to potential clients with depressive symptoms. Over 800 MTurk respondents with depressive symptoms rated the import of a guide who had used psilocybin relative to alternative characteristics in guides and cognitive behavioral (CBT) therapists. Importance ratings for guides who had used psilocybin significantly exceeded the “somewhat important” level (50 on a 0–100 scale), other guide-related qualities, and comparable ratings for a cognitive behavioral therapist who shared demographics, had experience with depression and received cognitive therapy personally. People of color (those who are not Caucasian) and those who had previous therapy gave significantly higher importance ratings for guides who had used psilocybin. Participants who chose to list other qualities important for guides listed very similar ones for CBT therapists, often emphasizing proper training and an empathic demeanor. Guides who have used psilocybin, who inform clients of the fact, might have advantages for facilitating PAT’s antidepressant effects, as least in a subset of clients.

Cognitive Behavioural Therapy in Children and Adolescents

Cognitive behavioural therapy (CBT) is an active, problem-focused, and time-sensitive approach to treatment that aims to reduce emotional distress and increase adaptive behaviour in patients with a host of mental health and adjustment problems. Cognitive behavioural therapists deliver interventions in a strategic manner, such that interventions emerge from the customized case formulation of the patient’s clinical presentation, are delivered in a collaborative manner with the patient, are designed to move patients forward and directly towards meeting their treatment goals, It has been shown to be effective for a wide variety of mental health disorders, including anxiety disorders, Attention deficit/hyperactivity disorders (ADHD), obsessive-compulsive disorder (OCD), insomnia, avoidant/restrictive food intake disorder (ARFID), social anxiety, autism, depression in children and adolescents. CBT has also been associated with improvements in quality of life in all the mental health disorders. CBT is typically conceptualized as a short-term, skills-focused treatment aimed at altering maladaptive emotional responses by changing the patient’s thoughts, behaviours, or both. It is the combination of one’s thoughts, feelings and behaviours. Cognitive therapy focuses on changing cognitions, which is proposed to change emotions and behaviours. Subsequently, the terms cognitive therapy, behavioural therapy, and cognitive-behavioural therapy have emerged. For the purposes of parsimony and to facilitate discussion of this diverse set of treatments, in this article we group the cognitive and behavioural therapies under the umbrella term “CBT” while acknowledging that the relative emphasis of cognitive vs behavioural techniques differs across treatment programs.