Cognitive Behavioral Therapy Techniques Research Articles

Applied muscle tension and exposure during the cognitive behavioral therapy of a adolescent with blood- injection -injury phobia: a case report

Blood-injection-injury phobia (BII) is a specific type of phobia that includes anxiety and avoidance behaviors against blood, injection, injuries or medical practices. Children and adolescents are seen with a frequency of 0.8% to 1.5% and the median age of onset is 5.5. It has been shown to have some unique factors (fainting, disgust, physiological symptoms, and pain) compared to other phobia subspecies. The increase in heart rate and blood pressure follows a sudden decrease, and this condition is called vasovagal syncope. Cognitive Behavioral Therapy (CBT) is one of the most effective treatment methods in BII. CBT can be applied for one session or 8-12 sessions. CBT includes psychoeducation, automatical thoughts detection and restructuring, prevention of exposure and avoidance. Blood pressure increasing techniques, especially applied muscle tension technique, to prevent syncope during exposure, increase the effectiveness of therapy. In this case report, the treatment process of adolescent patient admitted with blood-injection-injury phobia successfully completed using CBT techniques will be discussed. After ten sessions of cognitive behavioral therapy, the patient's blood concerns and avoidance behaviors were completely gone. He managed to give blood, which he stated the highest degree of discomfort in the hierarchy of fear, without experiencing syncope. It has been demonstrated with the fact that CBT, which involves exposure, especially in combination with blood pressure raising techniques, is effective in the treatment of BII in children and adolescents, as in adults.

Симптомы психологических травм у детей 5 – 11 лет

In this work, the authors studied the symptoms of various children psychological traumas in the age of 5-11 years The study involved group of parents of 25 children and children of a specified age. The work was based on individual form of work using techniques of cognitive-behavioral therapy. After stage of survey of parents and children, an individual therapy plan was developed for each child, consisting of separate classes.The amount of work with the child was not exceeding 8 consultations, usually 2 sessions with parents was required in some cases mutual psychotherapeutic work of the child and the parents. The duration of psychotherapeutic sessions with a child ranged from 30 minutes to 1 hour, with a parentsessions ranged up to 1, 5 hour.The breaks between sessions was 7-10 days. The work is cross-sectional: authors studied the distribution of certain symptoms of psychological trauma in children in the age of 5-11 years and describe the features of parental roles during periods of formation of the personality of the child.

Adaptation of cognitive behaviour therapy in childhood obsessive-compulsive disorder: a case study

Cognitive behaviour therapy (CBT) has been proved to be one of the most well-researched and effective therapy. It has been found effective in many clinical conditions in children and adolescents as well. Application of therapeutic processes gets complicated by the facts that childhood and adolescent problems do not come in neat packages and tend to overlap and/or coexist. For instance, there is much overlap among clinical problems like anxiety, depression, behavioural problems, and between reading and writing difficulties, and attention and hyperactivity. Many behavioural and emotional disturbances in children are also associated with specific medical conditions. The relationship between physical and/or medical conditions and emotional and behavioural disorders in children and adolescent has been documented in various studies. This demands attention to the therapeutic intervention to the childhood problems with greater monitoring and modulation. Use of CBT in childhood and adolescent problems for efficiency and convenience may be grouped into externalising and internalising disorders, and the management techniques may be formulated and tailored to meet the two opposing dimensions. In this case study, index client was an eight years old girl who presented with compulsive behaviour along with anxiety and fear, and the application of CBT techniques, its adaptability and efficacy in this case of obsessive-compulsive disorder (OCD), with specific phobia would be discussed.

Death anxiety in the time of COVID-19: theoretical explanations and clinical implications

(1)To understand terror management theory and its theoretical explanation of death anxiety in the context of COVID-19.(2)To understand the transdiagnostic role of death anxiety in mental health disorders.(3)To understand current treatment approaches for directly targeting death anxiety, and the importance of doing so to improve long-term treatment outcomes.

Internet-Based Cognitive-Behavioral Therapy for Employees With Anxiety, Depression, Social Phobia, or Insomnia: Clinical and Work Outcomes

This applied study profiled four self-directed behavioral health support tools from Learn to Live, Inc., when offered as an employee benefit. Each of these automated online programs featured eight structured lessons that emphasized cognitive-behavioral therapy techniques. Archival operational information collected across multiple employers in the United States was analyzed for 1,297 unique participants with longitudinal program use data. Significant reductions were found on validated measures of clinical symptoms specific to each program: Depression ( d = 0.93, n = 268; Patient Health Questionnaire–nine-item scale [PHQ-9]), Insomnia ( d = 0.69, n = 295; Medical Outcomes Study [MOS] Sleep), Social Anxiety ( d = 0.53, n = 170; Social Phobia Inventory [SPIN]), and Stress, Anxiety, & Worry ( d = 0.50, n = 633; Generalized Anxiety Disorders–seven-item scale [GAD-7]). Moderators of improvement included greater initial clinical severity and greater engagement in the programs (more lessons used and use of optional live support from a coach or friend/family). Follow-up survey results ( n = 290) revealed high satisfaction and improved work absenteeism and job performance. Financial return to the employer from improved work productivity was estimated at US$2,431 per employee user.

Supportive Psychotherapy: Giving Cinderella Her Due

Supportive Psychotherapy: Giving Cinderella Her Due

Integrating Evidenced-Based Counseling Interventions into Employee Development and Training: A Narrative Discussion on Counseling Professionals and Business Owners Working Together to Better Serve the Employee and Workplace Environment

This conceptual article outlines a framework and proposes theorical evidence for integrating evidenced-based counseling interventions into employee training and development. An introduction to Cognitive Behavior Therapy (CBT) techniques and tools will be presented and proposed as an enhancement to current employee training and development in support of an employers’ efforts to promote positive job behavior outcomes and overall job satisfaction. The conceptual article will advocate for counseling professionals and business owners to collaborate to not only better serve the employee and workplace environment, but to bridge the gap between research and practice.

Psychosocial interventions for preventing and treating depression in dialysis patients.

Psychosocial interventions for preventing and treating depression in dialysis patients.

Combining physical therapy and cognitive behavioral therapy techniques to improve balance confidence and community participation in people with unilateral transtibial amputation who use lower limb prostheses: a study protocol for a randomized sham-control clinical trial

BackgroundLow balance confidence is a prevalent yet overlooked issue among people who use lower limb prostheses (LLP) that can diminish community integration and quality of life. There is a critical need to develop rehabilitation programs that specifically target balance confidence in people who use LLP. Previous research has shown that multicomponent interventions including cognitive-behavioral therapy (CBT) techniques and exercise are feasible and effective for improving balance confidence in older adults.Therefore, a cognitive behavioral–physical therapy (CBPT) intervention was developed to target balance confidence and increase community integration in people who use LLP.Methods/designThis randomized control trial will recruit 60 people who use LLP with low balance confidence. Participants will be randomized to the CBPT intervention condition or control condition.DiscussionThe trial is designed to test the effects of the CBPT intervention on balance confidence and functional mobility in lower limb prosthesis users by examining self-reported and objective measures of community integration and quality of life. The trial will also examine the relationship between changes in balance confidence and changes in community integration following participation in CBPT intervention. Additionally, through participant feedback, researchers will identify opportunities to improve intervention efficacy.Trial registrationClinicalTrials.gov, NCT03411148. Registration date: January 26, 2018.

Nurse-led video-coaching interventions in childhood, adolescent and young adult cancer survivors (REVIVER): a protocol for mixed methods feasibility research

BackgroundSuccessful cancer treatment can lead to cancer survivors being predisposed to an increased lifelong risk of adverse late health effects. Therefore, high-quality cancer survivorship care to earlier detect and treat late effects or to preserve survivor’s health is essential. Nevertheless, this care needs to be sustainable and cost-effective as well. We developed three different screen-to-screen nurse-led eHealth interventions for survivors of childhood, adolescent and young adult-onset cancer, collectively called the REVIVER interventions. Elaborating on person-centred care principles with content based on cognitive behavioural therapy modules and/or motivational interviewing techniques, these interventions aim to empower and coach survivors to improve (1) symptoms of cancer-related fatigue, (2) self-efficacy and self-management or (3) lifestyle. With the REVIVER study, we aim to evaluate the interventions’ feasibility and gain insights into the potential effectiveness.MethodsThe REVIVER study involves a mixed methods design, including (1) interviews till data saturation with cancer survivors who completed the interventions as well as with all involved medical professionals, (2) reviews of nurses reports and (3) a single-group, pre-post evaluation among cancer survivors. Eligible survivors are survivors of childhood, adolescent and young adult-onset cancer who are referred to one of the interventions, in complete remission of cancer, 16–44 years old at enrolment, completed treatment at least 5 years ago and have access to a device with Internet options. We will assess feasibility in terms of demand, adherence, acceptability, practicality and integration/implementation. Health-related quality of life, as primary outcome of the potential effectiveness evaluation, will be assessed at three different time points: prior to the intervention; immediately following the intervention and 6 months post-intervention. Secondary outcome measures include changes in level of fatigue, self-efficacy, self-management and lifestyle.DiscussionThis is the first study to evaluate the feasibility and potential effectiveness of eHealth nurse-led interventions elaborating on person-centred care, using cognitive behavioural therapy and/or motivational interviewing techniques as an innovative and promising approach for providing CAYA cancer survivorship care. If the interventions prove to be feasible and potential effective, a randomized controlled trial will be conducted to test the (cost)-effectiveness.

Measurement training and feedback system for implementation of evidence-based treatment for adolescent externalizing problems: protocol for a randomized trial of pragmatic clinician training

BackgroundInnovations in clinical training and support that enhance fidelity to evidence-based treatment (EBT) for adolescent behavior problems are sorely needed. This study will develop an online training system to address this gap: Measurement Training and Feedback System for Implementation (MTFS-I). Using procedures intended to be practical and sustainable, MTFS-I is designed to increase two aspects of therapist behavior that are fundamental to boosting EBT fidelity: therapist self-monitoring of EBT delivery, and therapist utilization of core techniques of EBTs in treatment sessions. This version of MTFS-I focuses on two empirically supported treatment approaches for adolescent conduct and substance use problems: family therapy and cognitive behavioral therapy (CBT).Methods/designMTFS-I expands on conventional measurement feedback systems for client outcomes by adding training in observational coding to promote EBT self-monitoring and focusing on implementation of EBT treatment techniques. It has two primary components. (1) The training component, delivered weekly in two connected parts, involves self-monitored learning modules containing brief clinical descriptions of core EBT techniques and mock session coding exercises based on 5–8 min video segments that illustrate delivery of core techniques. (2) The feedback component summarizes aggregated therapist-reported data on EBT techniques used with their active caseloads. MTFS-I is hosted online and requires approximately 20 min per week to complete for each treatment approach. This randomized trial will first collect data on existing delivery of family therapy and CBT techniques for youth in outpatient behavioral health sites (Baseline phase). It will then randomize site clinicians to two study conditions (Implementation phase): Training Only versus Training + Feedback + Consultation. Therapists will choose whether to train in family therapy, CBT, or both. Study aims will compare clinician performance across study phase and between study conditions on MTFS-I uptake, reliability and accuracy in EBT self-monitoring, and utilization of EBT techniques in treatment sessions (based on observer coding of audiotapes).DiscussionStudy contributions to implementation science and considerations of MTFS-I sustainability are discussed.Trial registrationClinicalTrials.gov, NCT03722654. Registered on 29 October 2018.

Approaching Cognitive Behavior Therapy For Generalized Anxiety Disorder From A Cognitive Process Perspective.

Generalized anxiety disorder (GAD), with uncontrollable worry at its core, is a common psychological disorder with considerable individual and societal costs. Cognitive behavior therapy (CBT) is recommended as the first-line treatment for GAD; however, further investigation into its effectiveness in routine clinical care is indicated and improvement is required in treatment outcomes for worry. Improvements to CBT need to be guided by experimental research that identifies key mechanisms maintaining core aspects of the disorder. This paper summarizes how theory-driven experimental research guided selection and refinements of CBT techniques originally developed by Borkovec and Costello, to target key cognitive processes that maintain worry in GAD. Hirsch and Mathews’ model specifies three key research-supported processes that maintain uncontrollable worry in GAD: implicit cognitive biases such as negative interpretation bias and attention bias, generalized verbal thinking style, and impaired ability to re-direct attentional control away from worry. Specific CBT techniques outlined in this paper aim to target these key processes. Clinical data from clients treated using our refined CBT protocol for GAD in a routine clinical care service with a special interest in anxiety disorders were collected as part of service procedures. Large pre-to-posttreatment effect sizes were obtained for anxiety (GAD-7), depression (PHQ-9), and worry (PSWQ) (d=.90–2.54), and a moderate effect size was obtained for quality of life (WASA; d=.74). Recovery was indicated for 74% of cases for anxiety, 78% for depression, and 53% for worry. These findings exceeded most previous effectiveness studies in routine care and were in-line with GAD efficacy trials. This paper also outlines the application of specific clinical techniques selected, adapted or developed to target key cognitive mechanisms which maintain worry in GAD.

Development and Preliminary Evaluation of a 3-Week Inpatient Energy Management Education Program for People with Multiple Sclerosis-Related Fatigue.

Energy conservation strategies and cognitive behavioral therapy techniques are valid parts of outpatient fatigue management education in people with multiple sclerosis (MS). In many European countries, multidisciplinary rehabilitation for people with MS is chiefly delivered in specialized rehabilitation centers, where they benefit from short intensive inpatient rehabilitation annually. However, no evidence-based and standardized fatigue management education program compatible with the inpatient setting is available. Based on a literature search and the expertise of occupational therapists (OTs), a manualized group-based Inpatient Energy Management Education (IEME) program for use during 3-week inpatient rehabilitation that incorporates energy conservation and cognitive behavioral management approaches was developed. An IEME pilot program operated by trained OTs included 13 people with MS-related fatigue. The experiences of the IEME users and OTs were collected during focus groups to refine the program's materials and verify its feasibility in the inpatient setting. The program was feasible in an inpatient setting and met the needs of the people with MS. Targeted behaviors were taught to all participants in a clinical context. In-charge OTs were able to effect behavioral change through IEME. Users evaluated the evidence-based IEME program positively. The topics, supporting materials, and self-training tasks are useful for the promotion and facilitation of behavioral change. The next step is a clinical trial to investigate the efficacy of IEME and to evaluate relevant changes in self-efficacy, fatigue impact, and quality of life after patients return home.

Comparing Treatment Modalities For Juvenile Delinquency

Juvenile delinquency has improved by 65 percent from 1980 through 2016. The criminal justice system has explored various means of treating juvenile delinquents over the years to improve recidivism rates and to give youth a rewarding adult life. Most juvenile delinquency programs use a Usual Community Service (UCS) treatment method while the youth are incarcerated or immediately after release. UCS uses cognitive behavioral therapy (CBT) techniques to help the juvenile link their thoughts and behaviors. While Short-term Behavioral Therapy did not take off with the public or juvenile justice system, Multisystemic Therapy (MST) has showed progress in reducing recidivism of juvenile offenders. Studies have found that engaging the family in the treatment process has contributed to the reduced recidivism rates. For example, participants that enrolled in the UCS treatment modality had an increased recidivism rate of 75 percent while 29.2 percent of the group members from the MST recidivated within a year. At the end of a longitudinal study (8.9 years), researchers found that juveniles who received UCS treatment re-offended with a sex crime 45.8 percent and 58.3 percent re-offended for non-sexual crimes. After incarceration, 24 families participated in the MST treatment model. After a year, 8.3 percent re-offended for a sex crime and 29.2 percent re-offended with a non-sexual crime. Therefore, a family-based therapy model is salient to reduce recidivism compared to CBT based. This paper employs a meta-analysis and statistical analysis of seminal knowledge and law enforcement reports to construct the importance of effective therapeutic treatments by comparing treatment modalities for juvenile delinquents. Keywords: Juvenile Delinquency, Youth, Usual Community Service, Short-term Behavioral, Therapy, Systems Theory, Multisystemic Therapy, Recidivism, Antisocial Behavior

A qualitative exploration of SMART Recovery meetings in Australia and the role of a digital platform to support routine outcome monitoring

Previous research has reported on the benefits of mutual support groups. However, such groups do not routinely collect data on participant outcomes. Moreover, the effect of collecting outcomes measures on these groups is unknown. The objective of this mixed methods study was to elicit participant views on using a novel, purpose built digital platform for routine outcome monitoring (ROM) as a standard component of a mutual support group. SMART Recovery, or the Self-Management and Recovery Training program, is group-based and uses professional clinicians to facilitate discussion and foster mutual support for a range of addictive behaviours, alongside Cognitive Behavioural Therapy and Motivational Interviewing techniques. This paper reports on the qualitative component of this study and how participants perceive ROMs, and the potential shift to technological resources. Twenty semi-structured telephone interviews were conducted with participants from SMART Recovery groups across New South Wales, Australia. Participants discussed their use of mutual support within group meetings to manage their recovery, including: naming their goals in front of peers; learning from clinicians and group discussion; and developing reciprocal and caring relationships. They also described any previous experience with routine outcomes measures and how digital technologies might enhance or hinder group function. Participants valued mutual support groups and reported that digital technologies could be complementary to physical, weekly group meetings. They were also concerned that the introduction of technological resources might pose a threat to physical meetings, thereby risking their access to mutual support. Findings have implications for the implementation of ROM when delivered via digital mechanisms, and indicate threats and opportunities that warrant consideration for future initiatives.

Using cognitive behaviour therapy techniques with people who hold delusional beliefs

Using cognitive behaviour therapy techniques with people who hold delusional beliefs

Three-week inpatient energy management education (IEME) for persons with multiple sclerosis-related fatigue: Feasibility of a randomized clinical trial

BackgroundMultiple sclerosis (MS)-related fatigue limits participation in everyday activities and has a considerable impact on quality of life (QoL), thereby affecting productivity and employment. Outpatient education interventions involving energy conservation strategies and cognitive behavioral therapy techniques are helpful. However, no inpatient program is currently available. The inpatient energy management education (IEME) program is a novel group-based intervention that lasts for 6.5 h and is conducted by a trained occupational therapist (OT) during a 3-week period of inpatient rehabilitation. Persons with MS (pwMS) and OTs previously evaluated the IEME positively in a pilot study test run. The aim of this study was to evaluate the feasibility of a research protocol and collect preliminary data on the IEME effect size. MethodsTo assess the feasibility of conducting a randomized clinical trial, pwMS-related fatigue were recruited during a 3-week inpatient rehabilitation. Six IEME (experimental) group sessions or progressive muscle relaxation (PMR, control) group sessions comprised part of a personalized rehabilitation program. The recruitment and assessment procedures, dropout and follow-up assessment rates and the treatment fidelity were evaluated, and six telephone interviews were conducted with IEME participants after they returned home. Outcomes were fatigue impact, occupational performance, self-efficacy regarding energy conservation strategies, and QoL at baseline, discharge, and 4 months. Paired-sample and independent-samples t-tests were used to assess within- and between-group effects. Effect sizes were estimated using Cohen's d. ResultsBetween August and November 2017, 47 pwMS were included and randomized. The dropout rate (4.2%) was low and the sample was balanced. The PMR was a well-accepted control intervention. The OTs reported no problems in conducting the IEME, and treatment fidelity was high. IEME participants confirmed the adequacy of the IEME. Within-group differences in fatigue impact and some QoL dimensions at discharge were significant (p < 0.05) in both groups. The IEME alone resulted in significant improvements in self-efficacy regarding energy conservation strategies, with a large effect size (Cohen's d: 1.32; 95% CI: 0.54–2.1), and in the QoL physical functioning dimension at T2 (Cohen's d: 1.32; 95% CI: 2.11–0.53). IEME participants spent significantly less time in individual OT sessions. A sample size of 192 participants in a randomized controlled trial would be sufficient to detect clinically relevant between-group differences. ConclusionThis feasibility study has provided promising preliminary data about the effect of the IEME. The research protocol was confirmed to be feasible and a future study is justified. This study was registered in the German Clinical Trials Register (no. DRKS00011634).

臨床心理士養成大学院におけるCBTトレーニングの基本構成要素と教育方法—日本のトレーニング・ガイドラインの策定に向けた実態調査—

The purpose of this study was to investigate the current status of the basic components and training methods of cognitive behavioral therapy (CBT) in Japan. The participants in this study were 74 university faculty specializing in CBT and affiliated with certified master's degree courses in clinical psychology graduate program training institutions in Japan. They were asked to complete a questionnaire regarding the components and methods of CBT training, and to provide a free description of educational components. The results indicated that the basic constituent elements of CBT were generally insufficiently covered. In particular, while basic education on CBT theory and techniques is relatively thorough, practical education and training seems to be lacking. In addition, the amount of instruction on these components varies widely among faculty members, showing a tendency for education to depend on the discretion of each faculty member. Finally, since it is thought that a number of constituent elements have become newly necessary for CBT training in the Japanese context, it is necessary to develop CBT training guidelines specific to Japan.

Human givens rewind trauma treatment: description and conceptualisation

PurposeHuman Givens (HG) Rewind technique is a graded trauma-focused exposure treatment for post-traumatic stress disorder and trauma. The purpose of this paper is threefold: first, to describe the technique; second, to provide an outline of its potential benefits; and third, to present some preliminary evidence.Design/methodology/approachThis paper provides an overview of HG therapy and describes the stages of HG Rewind trauma treatment and its potential benefits. Similarities and differences between Rewind and other Cognitive Behavioural Therapy techniques are explored. Possible underlying mechanisms are discussed.FindingsPreliminary evidence suggests that Rewind could be a promising trauma treatment technique and that HG therapy might be cost effective. The findings highlight the need for further research and a randomised controlled trial (RCT) on Rewind is warranted.Practical implicationsDuring the rewind technique, the trauma does not need to be discussed in detail, making treatment potentially more accessible for shame-based traumas. Multiple traumas may be treated in one session, making it possible for treatment to potentially be completed in fewer sessions.Social implicationsThis UK-based treatment may be cost effective and make treatment more accessible for people who do not want to discuss details of their trauma.Originality/valueThis is the first description of HG Rewind in the peer-reviewed literature. Alternative explanations for mechanisms underlying this trauma treatment are also presented.

The effectiveness of workplace health promotion interventions on physical and mental health outcomes - a systematic review of reviews.

Objective This systematic review aimed to provide an overview of the effectiveness of health promotion interventions at the workplace on physical and mental health outcomes related to chronic diseases. Methods A search for reviews published between 2009 and 2018 was performed in electronic databases. References of the included reviews were checked for additional reviews. Workplace health promotion interventions were included if they studied metabolic risk factors as important predictors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) or if they studied mental or musculoskeletal health outcomes. Review quality was assessed using the AMSTAR checklist. Results Of the 23 reviews included, 9 were of high quality. For weight-related outcomes, there was strong evidence for favorable effects of workplace interventions, especially for interventions targeting physical activity and/or diet. For the remaining metabolic risk factors, there was no evidence for a positive effect of workplace health promotion interventions due to the absence of high quality reviews and mixed conclusions between the reviews. There was also strong evidence for a positive, small effect on the prevention of mental health disorders of workplace psychological interventions, especially those that use e- health and cognitive behavioral therapy techniques. Furthermore, strong evidence was found for the prevention of musculoskeletal disorders through workplace interventions, especially resistance exercise training. Conclusions This review found evidence for the effectiveness of workplace interventions on the prevention of weight-related outcomes as well as mental health and musculoskeletal disorders. Future research is however needed on the factors that contribute to the successful implementation of an intervention.