Group Cognitive Behavioral Therapy Research Articles

Managing emotional and physical stress in sickle cell anemia: a review of effective strategies and approaches

Sickle cell anemia (SCA) is a genetic blood disorder characterized by recurrent pain episodes, chronic complications, and significant emotional and physical stress. This review article explores effective strategies for managing both the emotional and physical aspects of stress in SCA patients. A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Google Scholar, using keywords such as “sickle cell anemia,” “stress management,” “psychological support,” and “pain management.” Emotional stress in SCA arises from chronic pain, frequent hospitalizations, and disease uncertainty, leading to conditions such as anxiety and depression. Effective management of emotional stress involves a combination of psychological counseling, cognitive-behavioral therapy (CBT), and support groups, which help patients develop coping strategies and address the mental health challenges of living with a chronic illness. This review evaluates various psychological interventions and their impact on patient outcomes, emphasizing the need for integrated mental health support in the management of SCA. Physical stress in SCA is primarily due to acute vaso-occlusive crises and chronic pain, which require effective pain management and preventive measures. The review explores pharmacological treatments, such as opioids and hydroxyurea, as well as non-pharmacological approaches, including physical therapy and lifestyle modifications. Additionally, the article discusses innovative therapies like gene therapy and stem cell transplantation, which hold promise for long-term disease management.

Neuropsychological Functions in Obsessive-compulsive Disorder Patients and the Impact of Cognitive Behavioral Group Therapy

Neuropsychological Functions in Obsessive-compulsive Disorder Patients and the Impact of Cognitive Behavioral Group Therapy

Treating the Psychological Distress in Children with Adventitious Blindness

Less than half of those who need mental health counseling receive it globally, underscoring the urgent need for psychology-focused intervention. According to data, 30.9% of Nigerians experience psychological anguish. This study investigated the efficacy and moderators of group cognitive behaviour therapy in psychologically distressed schoolchildren with adventitious blindness in Nigeria. A total of 98 students with adventitious blindness were recruited and participated in this study. The participants were assessed at three points using Perceived Emotional Distress Inventory. A mixed model ANCOVA with repeated measures shows that the CBT treatment had a dependable significant effect in decreasing psychological distress. The results showed that sociodemographic factors do not significantly moderate the efficacy of CBT treatment on the reduction of psychological distress in schoolchildren with adventitious blindness. In conclusion, the effect of a group cognitive behavioural therapy had a consistent significant reduction in psychological distress and none of their sociodemographic characteristics moderated the effects. Therefore, cognitive-behavioural practitioners should collaborate with special schools to diagnose and provide CBT treatment to schoolchildren living with adventitious blindness.

Comparative effectiveness of cognitive behavioural therapy, modafinil, and their combination for treating fatigue in multiple sclerosis (COMBO-MS): a randomised, statistician-blinded, parallel-arm trial

Fatigue is one of the most disabling symptoms reported by people with multiple sclerosis. Although behavioural and pharmacological interventions might be partly beneficial, their combined effects have not been evaluated for multiple sclerosis fatigue, or examined with sufficient consideration of characteristics that might affect treatment response. In this comparative effectiveness research trial, we compared the effectiveness of cognitive behavioural therapy (CBT), modafinil, and their combination for treating multiple sclerosis fatigue. This randomised, analyst-blinded, parallel-arm, comparative effectiveness trial was done at two universities in the USA. Adults (aged ≥18 years) with multiple sclerosis and problematic fatigue (Fatigue Severity Scale [FSS] score ≥4) were randomly assigned (1:1:1), using a web-based treatment assignment system with minimisation, to receive CBT, modafinil, or both for 12 weeks. Statisticians were masked to group assignment, but participants, study neurologists, CBT interventionalists, and coordinators were not masked to treatment assignment. The primary outcome was the change in Modified Fatigue Impact Scale (MFIS) from baseline to 12 weeks, assessed using multiple linear regression, adjusted for age, sex, study site, anxiety, pain, baselines MFIS score, and physical activity. Analyses were done by intent to treat. The trial was registered with clinicaltrials.gov, NCT03621761, and is completed. Between Nov 15, 2018, and June 2, 2021, 336 participants were randomly assigned treatment (114 assigned to CBT, 114 assigned to modafinil, and 108 assigned to combination therapy). At 12 weeks, CBT (n=103), modafinil (n=107), and combination therapy (n=102) were associated with clinically meaningful within-group MFIS reductions of 15·20 (SD 11·90), 16·90 (15·90), and 17·30 (16·20) points, respectively. Change in MFIS scores from baseline to 12 weeks did not differ between groups: relative to combination therapy, the adjusted total mean difference in MFIS change score was 1·88 (95% CI -2·21 to 5·96) for CBT and 1·20 (-2·83 to 5·23) for modafinil. Most common adverse events for modafinil-containing treatment groups included insomnia (eight [7%] for modafinil and eight [7%] for combination therapy) and anxiety (three [3%] for modafinil and nine [8%] for combination therapy). Modafinil, CBT, and combination therapy were associated with similar reductions in the effects of multiple sclerosis fatigue at 12 weeks. Combination therapy was not associated with augmented improvement compared with the individual interventions. Further research is needed to determine whether effects of these interventions on multiple sclerosis-related fatigue is influenced by sleep hygiene and sleepiness. No serious adverse events related to the study drug were encountered. Patient-Centered Outcomes Research Institute and National Multiple Sclerosis Society.

Changes in Hoarding-Related Beliefs and Associated Neural Changes during a Simulated Discarding Task after Cognitive-Behavioral Treatment for Hoarding Disorder

Hoarding disorder (HD) is maintained by maladaptive beliefs about possessions, and recent research has demonstrated that changes in these beliefs partially mediate improvement in cognitive-behavioral therapy (CBT) for hoarding. It is not yet known whether changes in neural activity, particularly when discarding possessions, are associated with cognitive change during CBT for HD. Adults who completed group CBT for HD (N = 58) participated in a simulated discarding task before and after CBT. Neural activity was measured using functional magnetic resonance imaging (fMRI) as participants made simulated discarding decisions. At baseline, activity in the left middle insula and left anterior cingulate cortex was significantly associated with hoarding-related beliefs. After receiving CBT for HD, decreases in maladaptive hoarding-related beliefs were significantly associated with increased activity compared to baseline in the right anterior ventral insula, along the left middle frontal gyrus and bilateral inferior temporal lobe, and in visuospatial areas. These results demonstrate that maladaptive beliefs in HD are associated with activation of specific neural regions during discarding decisions and that reduction in beliefs over a course of CBT for HD is associated with specific changes in neural activity.

An Equine-Assisted Intervention Versus Non-Manualized Psychotherapy for Youth in a Residential Childcare Facility

AbstractCharacteristics of individuals with disruptive behavior disorders often include elevated externalizing behaviors such as impulsivity, defiance of authority and antagonism of social norms. Evidence shows that adolescents diagnosed with these types of disorders are particularly challenging to treat; however, therapies incorporating horses have shown some success. We examined the impact of an equine-assisted intervention compared to a non-manualized cognitive behavioral therapy in youth between 12- and 18-years old living in a residential childcare facility. Upon admittance, youth were administered three assessments: the Youth Self-Report, Adolescent Psychopathology Scale, and Basic Empathy Scale. Youth scoring in the clinical range for at least one externalizing subscale of the Youth Self-Report were assigned to equine-assisted intervention (EQI; N = 23) or non-manualized cognitive behavioral therapy (NM-CBT; N = 20) groups. Each group received a total of 7 h of treatment per week (three 2-hr group sessions and one 1-hr individual session) for 24 weeks. After 24 weeks of treatment, the same three assessments were administered a second time. There were no significant differences between the NM-CBT and EQI groups in the amount of change between assessments. A significant time effect was found for total externalizing behaviors in the Adolescent Psychopathology Scale and Youth Self-Report such that these measures were within the normal range after 24 weeks of treatment for participants in both groups.

Comparing the Effectiveness of In-person and Telehealth Cognitive-Behavioral Therapy on Psychological Distress and Resilience in People Recovered from COVID-19: A Randomized Control Study

Background: In addition to the physical effects caused by coronavirus disease 2019 (COVID-19), the disease is also associated with various psychological problems that have required research and clinical attention. Objectives: The purpose of this study was to compare the effectiveness of in-person and telehealth cognitive-behavioral therapy (CBT) in people who have recovered from COVID-19. Methods: This study was a randomized controlled trial with a pre-post design, a control group, and a three-month follow-up. The statistical population consisted of patients who had recovered from COVID-19 in Tehran between 2022 and 2023. From this population, 45 patients were selected using a convenience sampling method and randomly divided into three groups: An in-person CBT group, a telehealth CBT group (15 patients in each), and a control group (15 patients). The in-person CBT group received 11 sessions, while the telehealth CBT group received 12 sessions. Research instruments included the Depression, Anxiety, and Stress Scale (DASS-21) and the Resilience Scale (RS). The data were analyzed using repeated measures analysis of variance. Results: The results showed that although both treatments led to improvements in psychological distress (P < 0.01) and resilience (P < 0.01), the effectiveness of in-person CBT was greater and statistically significant. The effect sizes for depression, anxiety, stress, and resilience were 0.37, 0.38, 0.44, and 0.64, respectively. Conclusions: The results indicate that both in-person and virtual CBT lead to improvements in psychological distress and resilience in patients with a history of COVID-19, compared to the control group. However, the improvement rate was higher for in-person CBT compared to the virtual group. In-person CBT led to significant improvements in both psychological distress and resilience.

Bridging the gap of Inequity in Implementation Science: Adaptations of Group EBPs for those with Serious Mental Illness in the Public Sector.

There are many group EBPs that are now listed as effective treatments for those with serious mental illness (SMI). Despite this, there are few of these group EBPs that are being delivered consistently in the public sector, causing disparity. This article reviews the challenges that relate to implementation science and those with SMI receiving group EBPs to help them live a life of meaning as they define. The article discusses the need for adaptations of EBPs as individuals with complex concerns need different approaches to implementation science. Next, the article conveys what core constructs of group EBPs have to be maintained as they are and what elements of EBPs need adapting to empower those with SMI in engagement. This article provides knowledge of practical application of implementation science approaches while providing dialectical behavior group therapy and cognitive behavior group therapy for psychosis adaptations for those with SMI in a public sector inpatient setting.

Inference-Based Cognitive Behavioral Therapy versus Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: A Multisite Randomized Controlled Non-Inferiority Trial

Introduction: Although cognitive behavioral therapy (CBT) effectively treats obsessive-compulsive disorder (OCD), many patients refuse CBT or drop out prematurely, partly because of anxiety regarding exposure and response prevention (ERP) exercises. Inference-based cognitive behavioral therapy (I-CBT) focuses on correcting distorted inferential thinking patterns, enhancing reality-based reasoning, and addressing obsessional doubt by targeting underlying dysfunctional reasoning, without incorporating an ERP component. We hypothesized that I-CBT would be non-inferior to CBT. Additionally, we hypothesized that I-CBT would be more tolerable than CBT. Methods: 197 participants were randomly assigned to 20 sessions CBT or I-CBT and assessed at baseline, posttreatment, and 6 and 12 months’ follow-up. The primary outcome was OCD symptom severity measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; non-inferiority margin: 2 points). The secondary outcome, treatment tolerability, was assessed using the Treatment Acceptability/Adherence Scale (TAAS). A linear mixed-effects model was used to assess the non-inferiority of the primary outcome and superiority of secondary outcomes. Results: Statistically significant within-group improvements in the primary and secondary outcomes were observed in both treatments. No statistically significant between-group differences in Y-BOCS were found at any assessment point, but the confidence intervals exceeded the non-inferiority threshold, making the results inconclusive. The estimated mean posttreatment TAAS score was significantly higher in the I-CBT group than in the CBT group. Conclusion: While both CBT and I-CBT are effective for OCD, whether I-CBT is non-inferior to CBT in terms of OCD symptom severity remains inconclusive. Nevertheless, I-CBT offers better tolerability and warrants consideration as an alternative treatment for OCD.

Sertraline medications plus dialectical behavior therapy for depressed adolescents with nonsuicidal self-injury behaviors.

The study aims to investigate the efficacy of sertraline medication plus dialectical behavior therapy (DBT) in reducing nonsuicidal self-injury (NSSI) behavior and depression among adolescents. Participants were 100 adolescents with depression and NSSI behaviors, 50 of whom received sertraline medication plus DBT and 50 of whom received sertraline medication plus cognitive behavioral therapy (CBT) for 12 weeks. During 6 months post intervention, 26 (57.8%) participants did not report having engaged in any form of NSSI in the sertraline + DBT group and 15 (32.6%) in the sertraline + CBT group, showing significant difference. The sertraline + DBT group and the sertraline + CBT group exhibited significant difference regarding the proportions of cutting skin and biting self. The scores of anxiety, depression, aggression against self in four modified overt aggression scale categories, and Personal and Social Performance were notably lower in the sertraline + DBT group than those in the sertraline + CBT group at 6 months post intervention. Sertraline medication plus DBT could decrease NSSI episodes and improve symptoms of anxiety and depression for adolescents, and these changes were comparable to those of CBT. More importantly, DBT was demonstrated better clinical improvements at 6-month follow-up.

Finite element analysis of biomechanical investigation on diverse internal fixation techniques in oblique lumbar interbody fusion

BackgroundTo establish a three-dimensional finite element model of the lumbar spine and investigate the impact of different fixation techniques on the biomechanical characteristics of oblique lumbar interbody fusion (OLIF).MethodsThe study aimed to establish and validate a comprehensive three-dimensional model of the lower lumbar spine (L3-S1) using the finite element method. L4-L5 was selected as the surgical segment, and four distinct OLIF surgical models were constructed: Stand-alone (SA), unilateral cortical bone trajectory screw (UCBT), bilateral cortical bone trajectory screw (BCBT), and bilateral pedicle screw (BPS). The models were underwent a pure moment of 10N·m to simulate lumbar extension, flexion, left bending, right bending, left and right rotation movements. Subsequently, the range of motion (ROM), cage stress, and fixation stress were calculated.ResultsIn the L3-L5 segment, the BCBT group showed the most limited range of motion (ROM) under exercise load, indicating superior stability within this group. The ROM and cage stress values were found to be highest in the SA group. In contrast, the cage and internal fixation stress in the BPS group were observed to be lowest (9.91 ~ 53.83MPa, 44.93 ~ 84.85 MPa). With the exception of right bending and right rotation, the UCBT group demonstrated higher levels of internal fixation stress (102.20 ~ 164.62 MPa).ConclusionsThe study found that OLIF-assisted internal fixation improved segmental stability and reduced cage stress. The BPS group had advantages over the CBT group in preventing endplate damage and reducing the risk of cage subsidence. However, BCBT group has distinct merits in maintaining surgical segment stability, distributing stress load on the spinal motor unit, and reducing the likelihood of adjacent segment degeneration (ASD).

A Short-Term Group Telehealth Cognitive Behavioral Therapy Intervention for Youth with Autism and Anxiety: A Pilot Study.

Background: Children with autism often present with comorbid anxiety disorders. Cognitive behavioral therapy (CBT) is an effective, evidence-based approach to treating anxiety, but information on youth with autism and anxiety is limited. Coping Cat is a 16-week CBT intervention for children with anxiety but its use in a group telehealth format in an urban, predominantly Hispanic population is limited. Objectives: (a) To examine the feasibility and preliminary effectiveness of a short-term CBT telehealth group for youth with autism and anxiety disorders in an urban, predominantly Hispanic population and (b) to examine satisfaction with the intervention. Methods: Single-arm pilot study that consisted of a 16-week telehealth CBT group therapy was based on a modified Coping Cat curriculum. Youth with autism and anxiety disorders who were on a waitlist for psychotherapy at an urban developmental center were invited to participate. Anxiety was assessed pre- and posttreatment using the Screen for Child Anxiety Related Emotional Disorders, parent and self-report. Results: Eighteen children were enrolled; 16 children completed the program. Mean age was 11 ± 2.5 years (8-15 years); 89% males, 61% Hispanic. There was a significant reduction in pre-post intervention in symptoms of overall anxiety (parent: 41.0 ± 18.5 to 31.0 ± 16.3 p ≤ 0.003, self: 25.9 ± 12.8 to 14.1 ± 7.8 p ≤ 0.001), panic disorder (parent: 8.1 ± 7.0 to 4.1 ± 4.2 p = 0.013, self: 5.1 ± 4.8 to 0.8 ± 0.9 p = 0.004), and separation anxiety disorder (parent: 7.5 ± 4.8 to 5.7 ± 4.4 p = 0.041, self: 5.8 ± 3.3 to 3.8 ± 2.4 p = 0.018) as per parent and self-reports. Self-report data also revealed a significant reduction in symptoms of social anxiety disorder (6.5 ± 3.5 to 3.9 ± 2.7 p ≤ 0.001). Parents and children reported satisfaction with the group. Conclusion: In this small, predominantly Hispanic population of youth with autism and anxiety disorder, 89% of families were compliant with a group telehealth CBT intervention. Parents and youth reported a significant reduction in anxiety symptoms and program satisfaction. A modified group CBT program via telehealth represents a feasible intervention for youth with autism and anxiety disorders.

A prediction analysis testing if internet-delivered cognitive-behaviour therapy is most suitable for the milder cases of pediatric obsessive-compulsive disorder

BackgroundCommon clinical sense would suggest that individuals with milder obsessive-compulsive disorder (OCD) symptoms should be the most suitable for guided internet-delivered cognitive behaviour therapy (CBT), with more intensive forms of treatment reserved for more severe or complex cases.ResultsIn this secondary data analysis of a non-inferiority clinical trial comparing internet-delivered CBT with in-person CBT for young people with OCD (N = 152), we found that higher baseline symptom severity predicted worse treatment outcomes in the in-person group but not the internet-delivered CBT group. Additional analyses showed that among individuals with milder symptoms, internet-delivered CBT was associated with worse outcomes than in-person CBT.ConclusionsIf replicated, these results would question the axiom that internet-delivered CBT is most suitable for milder cases.Trial registrationThe original trial was registered at ClinicalTrials.gov ID NCT03263546. Date of registration 2017–08–28.

Digital cognitive behavioral therapy vs education for pain in adults with sickle cell disease

AbstractDespite the significant burden of chronic pain in sickle cell disease (SCD), nonpharmacological approaches to manage pain in SCD are lacking. Behavioral interventions incorporating digital cognitive behavioral therapy (CBT) for pain should be compared with available education efforts. This multisite randomized comparative effectiveness trial aimed to compare a CBT intervention tailored for adults with SCD with a digital pain/SCD educational intervention (“Education”) in terms of improving pain and associated symptoms. Participants were recruited virtually from 7 comprehensive SCD centers and community organizations in the United States. Adults (aged ≥18 years) with SCD-related chronic pain and/or daily opioid use were randomly assigned to CBT or Education. Over 12 weeks, the CBT arm received an app-based intervention for pain management; the Education arm received digital pain/SCD education. Both groups received interactive chatbot lessons plus personalized health coach support. Changes in the pain interference scale (primary outcome) and other patient-reported secondary outcomes, including pain intensity, depression, anxiety, quality of life, and self-efficacy, were assessed over 6 months. Of the 453 participants who completed screening, 359 (79%) were randomly assigned to CBT (n = 181) or Education (n = 178), 332 (92%) were Black African American, and 238 were (66.3%) female. At 6 months, 250 (70%) participants (n = 125 per arm) completed follow-up assessments, 93 (26%) missed their follow-up window, and 16 (4%) withdrew. Engagement with the chatbot content was variable (76% connected, 48% completed ≥1 lesson). However, 80% of participants completed ≥1 session with a health coach via phone, video, or text. The 6-month change in pain interference in the CBT (−2.13; 95% confidence interval [CI], −3.42 to −0.84) and Education (−2.66; 95% CI, −3.97 to −1.36) groups was not significantly different (mean difference, 0.54; 95% CI, −1.30 to 2.37; ∗P = ∗.57). Daily pain intensity ratings did not change for either group. There were no between-arm differences in depression, anxiety, quality of life, or the effect of the intervention on pain and mental health in SCD when combined with health coaching. Variable engagement with digital components and high engagement with health coaching may explain the lack of between-group differences, but these findings also provide insights into delivering digital interventions in racial minority and difficult-to-reach populations. This trial was registered at www.clinicaltrials.gov as #NCT04419168.

The effectiveness of cognitive-behavioral group therapy on foreign language learning anxiety among university students

For many students, foreign language anxiety can be a paralyzing condition that prevents learners from fully learning and slows the use of their second language in communication. Past studies have confirmed the effectiveness of psychological therapies in alleviating anxiety-based disorders. At the same time, there is a lack of studies, particularly in cognitive-behavioral group therapy (CBT) on foreign language learning anxiety. The study aimed to explore the efficiency of cognitive-behavioral group therapy in reducing foreign language learning anxiety among young adults. This pretest–posttest with a control group study was conducted with sixty eligible English-preparatory university students with noticeable foreign language learning anxiety selected as a sample by purposive sampling and randomized to an intervention and a control group into equal numbers. The Bangla version of the Foreign Language Classroom Anxiety Questionnaire (FLCAS) was used to measure foreign language learning anxiety at baseline and post-intervention. The obtained data were subsequently analyzed by t-test, ANOVA, and repeated measures with between-groups multivariate variance analysis (MANOVA) with effect size. The results revealed that over time, in the intervention group, communication nervousness, fear of negative appraisal, test anxiety, and overall foreign language learning anxiety considerably dropped. In contrast, these issues remained steady in the control group. The findings reflected the benefits of CBT in groups by considering its limitations which might be regarded as a practical treatment option for alleviating foreign language learning anxiety in clinical settings among youth in developing countries. Therapeutic ramifications for reducing anxiety-based issues in both research and practice are explained.

The Effectiveness of Cognitive Behavioral Therapy on Depression and Anxiety Symptoms in Breast Cancer Patients and Survivors: A Systematic Review of Interventional Studies.

Breast cancer (BC) is the most common type of cancer and the second cause of cancer-related death among women. Psychological treatments such as cognitive behavioral therapy (CBT) have been used as an effective method in the treatment of depression and anxiety in BC patients, and their effectiveness has been approved in various studies. The present study aimed to systematically investigate the effectiveness of CBT on depression and anxiety symptoms in BC patients and survivors. Electronic databases such as PubMed, Scopus, Web of Science [WOS], ScienceDirect, Cochrane Library, and Google Scholar were systematically searched from "October 2023" to "February 2024." The quality of the included studies was evaluated using the Critical Appraisal Skills Programme (CASP). In this study, the randomized controlled trials and quasi-experimental studies that assessed the effectiveness of CBT, cognitive behavioral group therapy (CBGT), and the combination of CBT with other psychological studies on depression and anxiety of BC patients and survivors were reviewed. Out of the 16 included studies, six used CBT, and six used CBGT. In the other four studies, a combination of CBT with other psychological interventions was implemented as an interventional program. Among 16 included studies, 14 studies showed that CBT, CBGT, and a combination of CBT with other psychological interventions significantly decreased the anxiety and depression scores among BC patients and survivors (p < 0.05), and only in two studies, no significant effect was observed. As most included studies showed the effectiveness of CBT in decreasing the depression and anxiety scores among BC patients and survivors, this study strongly suggests CBT as an effective non-pharmacological method for the treatment of psychiatric disorders of BC patients during cancer treatments and also for BC survivors.

A Comparative Study on the Efficacy of Group Positive Psychotherapy and Group Cognitive Behavioral Therapy on Flourishing, Happiness and Satisfaction with Life: A Randomized Controlled Trial

The present study examines the efficacy of Positive Psychotherapy (PPT) on psychological well-being, happiness, and satisfaction with life. We investigated people suffering from different kinds of depressive disorders, comparing it to Cognitive Behavioral Therapy (CBT). PPT is an empirically validated intervention targeting positive resources and personal strengths. It aims at amplifying well-being while also ameliorating the impact of symptoms. In a controlled two-center-study, we randomly assigned 92 out-patient participants with a DSM-IV diagnosis of major depressive disorder and/or Dysthymia to 14 sessions of manualized PPT or CBT group therapy. We assessed outcomes related to well-being using the Flourishing Scale, the Satisfaction with Life Scale, and the Positive Psychotherapy Inventory (PPTI). The PPTI represents the five components of Seligman’s PERMA-model of flourishing, encompassing positive emotions, engagement, positive relationships, meaning, and accomplishment. We took measurements before and after the intervention, and at a 6-months follow-up. Moreover, we considered a list of moderators that may impact the efficacy of PPT. PPT resulted in significant improvements in all measures, and these improvements remained stable for up to 6 months. Using 2 × 2 mixed-effects models (T1 vs. T2), we found significant interactions for all three main scales and two out of the five PPTI subscales. These interactions depicted significantly better outcomes for PPT at post-treatment. Regarding the follow-up (T1 vs. T3), we did not find significant interactions, and thus, there were no differences between the two therapies. No demographics or characteristics of the treatments were significant moderators. Summarized, these findings provide support for the effectiveness of PPT in increasing happiness, well-being, and quality of life. We can confirm that PPT is an additional tool for the enhancement of positive mental health.

The Effectiveness of Cognitive Behavioral Therapy versus Notched Sound Therapy in Adults with Chronic Subjective Tinnitus and Normal Hearing.

Introduction Tinnitus can be distressing, and it affects the quality of life (QoL) through psychological and cognitive impairments. Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are tinnitus management approaches aiming to reduce symptoms and improve QoL via two different mechanisms. The CBT attains the cognitive principle, whereas the NST initiates tinnitus habituation. Objective To evaluate the effect of CBT and NST and compare their results in the management of chronic subjective tinnitus. Methods The present prospective study involved 64 adults with normal hearing and chronic subjective tinnitus. They were subjected to history taking, basic audiological evaluation, and extended high-frequency audiometry at 10 and 12.5 kHz. The participants were divided into two equal groups, the first treated with CBT and the second treated with NST. The psychoacoustic measures of tinnitus and the Arabic Questionnaire for Tinnitus Reaction (Arabic-QTR) were used to monitor the outcomes of both therapies. Results Both groups showed significant reduction in tinnitus severity according to the Arabic-QTR and tinnitus loudness matching. Improvement in the Arabic-QTR was better in the CBT group, while tinnitus loudness improvement was better in the NST group. Conclusion Both CBT and NST are effective in the management of chronic subjective tinnitus. In a comparison of the effect of the two therapies, CBT was found to be more effective in decreasing tinnitus-related distress, whereas SNT was found to be more helpful in reducing tinnitus loudness.

Intensive Group Behavioral Treatment for Older Youth With Selective Mutism: An Open Trial

Selective mutism (SM) is an anxiety disorder characterized by an inability to speak in social situations, despite comfortably speaking in familiar situations (American Psychiatric Association, 2022). To date, research has demonstrated the effectiveness of cognitive-behavioral therapy (CBT) models, including both weekly CBT and intensive group behavioral treatment for younger children with SM (Cohan et al., 2006; Cornacchio et al., 2019; Haggerty et al., 2022; Oerbeck et al., 2018). However, no research has examined treatment options for older youth with SM. The present study sought to examine effectiveness of an intensive group behavioral treatment (IGBT) for older youth with SM by examining pretreatment to follow-up differences on primary (SM symptoms) and secondary outcomes (self-efficacy and social skills). Sixteen youth, ages 10–17, with a primary diagnosis of SM engaged in a 5-day IGBT. Results indicated statistically significant reductions in parent- and self-reported SM symptoms from pretreatment to follow-up (2 months and 5 months into the following school year), as well as statistically significant improvements in self-reported self-efficacy and social skills from pretreatment to follow-up. These findings provide empirical support for the preliminary effectiveness of IGBT for older youth with SM and reveal information about the unique clinical profile of this subset of the population.

Acceptability, engagement, and efficacy of cognitive remediation for cognitive outcomes in young adults with first-episode psychosis and social anxiety: A randomized-controlled trial

Social anxiety disorder (SAD) is a frequent comorbidity in first-episode psychosis (FEP) and may increase cognitive impairments. Cognitive remediation (CR) is an effective treatment for cognition, particularly in a group format. This study aims to assess the efficacy, acceptability and engagement of group CR on cognitive outcomes in FEP+SAD compared to group cognitive-behavioral therapy (CBT). Participants with FEP+SAD were randomized to group CR (n = 45) or CBT-SAD (n = 51). They were assessed for cognition at baseline, post-therapy and 3- and 6-month follow-up. The CR group additionally completed scale to assess perceived competency and enjoyment in CR. Linear mixed models for repeated measures were used for cognitive scores. Descriptive statistics and t-tests were used to summarize acceptability, perceived competency, and enjoyment, for CR completers and non-completers. The CR group performed significantly better than CBT on executive functions and visual memory at post-therapy compared to baseline. Twenty participants completed CR (44 %; mean 5.5 sessions). At week 1, CR non-completers presented higher levels of perceived competency. Completers reported higher enjoyment scores at the last session compared to the first session. Group CR is effective for cognitive outcomes in FEP+SAD, but acceptability and engagement present a challenge. Future studies are necessary to explore approaches promoting engagement.