Cognitive-behavioral Techniques Research Articles

Career Aspirations for People With Serious Mental Disorders.

Career Aspirations for People With Serious Mental Disorders.

A case of outpatient treatment in a 58-year-old woman with hoarding disorder and hallucinations.

IntroductionIn hoarding disorder the patient has a strong tendency to collect and accumulate objects with or without value and great difficulty in destroying them.In this case, a 58-year-old woman diagnosed with a hoarding disorder 5 years ago, came to a psychiatry clinic due to frequent auditory hallucinations related to episodes of acute stress. She received treatment in an outpatient mental health unit which consisted of psychopharmaceuticals and cognitive behavioural therapy. The patient achieved a partial remission of the hallucinations and a clinical improvement of the accumulation symptoms.ObjectivesThe main objective of this study is to describe the psychiatric and psychological treatment of this patient. We also performed a review of the available literature on comorbidity of the symptoms of Diogenes syndrome and psychotic symptoms.MethodsA close follow-up of the psychopathology of this patient was carried out and we did a database search in PubMed to document the case, with the keywords: “hoarding disorder”, “psychotic disorder”, “comorbidity”, “hallucination”, with the inclusion criteria: In the last ten years, Spanish and English language.ResultsThe patient, who was being treated with sertraline 100 mg, started treatment with olanzapine 10 mg and with a psychotherapeutic plan with different objectives: stabilization of symptoms, reduction of hoarding behaviours, letting go of objects, as well as coping with stressful situations. Cognitive behavioural techniques such as psychoeducation, exposure with response prevention and cognitive therapy were included in the psychological treatment. After one year of treatment the hallucinatory symptoms have remitted and the patient’s daily functioning has improved. The most resistant symptoms are those of accumulation that are slowly decreasing but the patient has stopped collecting objects from the street.ConclusionsMore studies of the treatment of hoarding disorder and more investigation of its possible comorbidities are needed.Disclosure of InterestNone Declared

The Effectiveness of Family-Centered Problem-Solving Training on Marital Satisfaction among Couples

Aim and Background: Improving the level of marital satisfaction can strengthen family ties and promote a long-lasting marriage. Cognitive-behavioral techniques, such as problem-solving, have proven to be efficacious in mitigating conflicts and augmenting marital satisfaction. Therefore, the current study was undertaken to scrutinize the effectiveness of family-oriented problem-solving training in couples’ marital satisfaction.

Penerapan Teknik Kognitif Behavioral Untuk Mengurangi Kecanduan Gadget Pada Siswa Kelas IX di MTs Negeri 1 Sumenep

Gadget is another term for mobile phones or smartphones. Nowadays, almost everyone uses gadgets in their daily life. However, the use of gadgets has many impacts on users, both negative and positive impacts. This study aims to analyze the causes of gadget addiction in students and to help students to be able to overcome the problems they experience and problems that will come. The population of this study were all students of class IX MTsN 1 Sumenep, while the sample was students of class IX who were taken randomly using the Proportional Random Sampling Technique with a total of 10 students. The results showed that gadget addiction in students can be caused by many factors, for example students think too much about gadgets, students cannot control themselves when using gadgets, students often feel anxious when not using gadgets, and many other influences. The application of cognitive behavioral techniques is very appropriate for students who are addicted to gadgets.
 

Feasibility of a video-delivered mental health course for primary care patients: a single-group prospective cohort study

BackgroundIn many health care systems, primary care is tasked with offering psychological treatment for common mental disorders. Resources are often limited, which complicates widespread dissemination of traditional psychological treatments. Stepped care models where the less resource-intensive interventions are delivered first, can be employed, but often do not eliminate the need for a thorough diagnostic assessment, which can be time-consuming, has the potential to bottleneck patient intake, and can add to waiting times. Novel low-threshold formats are needed to improve access to mental health care in the primary care setting.MethodsThis was a single-group prospective cohort study (N = 91). We assessed the feasibility of a video-delivered course as a first-line intervention for patients seeking help for mental health problems at a primary care center. The course had a transdiagnostic approach, suitable for both depression and anxiety disorders, and was based on cognitive behavioral techniques. Patients in need of psychosocial assessment, which usually entailed a four- to six-week wait, were referred by physicians or triage nurses. Study participants could start within a week, without the need for conventional diagnostic assessment, and were informed that they would be offered assessment after the course if needed. Key feasibility outcomes included participant satisfaction, attendance rates, the proportion of participants in need of additional clinical intervention after the course, and the rate of clinically significant improvement in anxiety and depression symptoms.ResultsParticipants scored a mean of 21.8 (SD = 4.0, 9–32, n = 86) on the Client Satisfaction Questionnaire-8; just below our target of 22. The mean attendance rate was 5.0/6 lectures (SD = 1.6, range: 0–6, n = 91). Forty-six percent (37/81) reported experiencing no need of further clinical intervention after the course. The rate of clinically significant improvement was 59% (27/46) for anxiety and 48% (22/46) for depression. No serious adverse event was reported.ConclusionsDelivering a low-threshold online video-delivered mental health course in primary care appears to be feasible. Adjustments to further improve patient satisfaction are warranted, such as offering the choice of participating online or face-to-face.Trial Registration(ClinicalTrials.gov NCT04522713) August 21, 2020.

Effectiveness of intervention programs aimed at improving the nursing work environment: A systematic review.

The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment. To determine whether measures designed to improve the work environment for nursing professionals are effective. Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre-/post-measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool. A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive-behavioral techniques, stress management, channeling anxiety and physical well-being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement. Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy. This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.

Journal Digest: IRT; Motivational Therapy; Mental Health Apps; and More

Journal Digest: IRT; Motivational Therapy; Mental Health Apps; and More

Emergency Reflex Action Drills and the Problem with Stress.

Clinicians involved in the care of critically ill patients are often exposed to demanding and stressful situations that require immediate action. Evidence suggests that human performance can be significantly diminished when multiple stressors and stimuli are present. Humans have developed conscious and unconscious methods of dealing with this type of cognitive overload in various high-risk occupations, but these coping methods have not necessarily been structured and adapted to the provision of emergency medical care. Emergency reflex action drills (ERADs) are derived from available evidence in specific domains (e.g., airway management) and develop automaticity of critical skills which engender quick, effective, and reproducible performance with minimal cognitive load. These are pre-planned, practiced responses to specific, high-demand and time-sensitive situations. This article outlines the psychological, cognitive, and behavioral effects of stress that affect performance and necessitate development of ERADs. It also reviews the scientific underpinnings behind how humans have adapted cognitive behavioral techniques to manage under high-stress situations. Finally, this article recommends the adoption of these cognitive tactics via ERADs to enhance clinical practice and provides an example in the context of airway management.

Supplemental Material for Effects of Cognitive Behavioral Techniques for Gambling on Recovery Defined by Gambling, Psychological Functioning, and Quality of Life: A Systematic Review and Meta-Analysis

Supplemental Material for Effects of Cognitive Behavioral Techniques for Gambling on Recovery Defined by Gambling, Psychological Functioning, and Quality of Life: A Systematic Review and Meta-Analysis

Intervention strategy for children victims of bullying and school violence

The present work "Intervention strategy in children victims of bullying and school violence", was designed to evaluate and intervene, based on the scales of psychological damage found, with cognitive behavioral therapy techniques, exposure therapy, cognitive processing, physical care, self-knowledge, self-acceptance and learning to see memories as a tool. Objective: To develop and apply an intervention strategy in children victims of violence and bullying. Methodology: This research was experimental and mixed, combining qualitative and quantitative approaches. Both approaches were used in this work because when evaluating the children with the AVE test it was done by means of percentiles, when describing the concepts of the scales it was done in a qualitative way, as well as when registering the progress of the patients in the Anecdotal Record. The program provides a series of techniques for dealing with bullying and school violence.

Schema therapy for personality disorders in autistic adults: Results of a multiple case series study.

To our knowledge, treatment of personality disorder (PD) comorbidity in autistic adults is understudied and is still in its infancy. We investigated the effectiveness of schema therapy (ST) for autistic adults with PD. A multiple case series design with 12 adults (aged 19-62 years) was used with baseline, exploration, ST (with cognitive behavioural and experiential techniques) and follow-up conditions. Participants rated dysfunctional core beliefs (primary outcome) weekly during baseline and treatment and monthly during follow-up. Schema modes, general mental health symptoms, social responsiveness, PD traits and common Axis-I mental disorders were assessed. Mixed model analyses indicated significant effects of ST with medium to large effect sizes for dysfunctional core beliefs, functional schema modes, PD traits, general mental health symptoms and social responsiveness. Results remained stable during follow-up. The results of this study indicate that ST might be effective in decreasing dysfunctional core beliefs, PD traits and general mental health symptoms and in increasing functional schema modes and social responsiveness. Improvements persisted over time. ST seems effective in treating PD in autistic individuals.

Trichotillomania in an Autistic Spectum Disroder: Single Case Intervention

The following work addresses trichotillomania and dermatillomania, both symptoms of the impulses control, in a 11 years old girl, who courses the sixth grade in a private elementary school and with a diagnose of first degree autism spectrum disorder and Attention Deficit Hyperactivity Disorder (ADHD) as a comorbidity. The objective was to reduce the frequency of tearing her hair and the skin imperfections in the school context throughout an intervention based on cognitive behavioral techniques. Within the used methodology to analyze the case an exhaustive evaluation of the patient has been performed using grade observation records, before and during the intervention period in order to systematize the whole process. The intervention techniques used where Token Economy and self-instruction. The results show a progressive improvement of the symptoms, reflected in the diminish of frequency of the behaviors registered that were conducted. In spite of the limited time for the intervention for these kinds of behaviors and the base line phase, it was possible to get to know the girl well and establish bonds with her, in spite of her condition, which can be noted in a better adaptation on her school context. This work seeks to favor the increase of research on this disorder since there is information related on the etiological factors, but it still is not enough, likewise, the related information on these disorders and its possible comorbidities is useful to continue with the advance on the treatments in this area.

Use of an app-based exercise therapy program including cognitive-behavioral techniques for the management of intermittent claudication: Presented at the Vascular Annual Meeting of the Society for Vascular Surgery, Boston, Massachusetts, June 17, 2022.

Use of an app-based exercise therapy program including cognitive-behavioral techniques for the management of intermittent claudication: Presented at the Vascular Annual Meeting of the Society for Vascular Surgery, Boston, Massachusetts, June 17, 2022.

Use of an app-based exercise therapy program including cognitive-behavioral techniques for the management of intermittent claudication.

Clinical practice guidelines recommend supervised exercise therapy (SET) as first-line therapy for patients with peripheral artery disease (PAD) and intermittent claudication (IC). The Society for Vascular Surgery Appropriate Use Criteria for IC deems excercise therapy (ET) as appropriate for all patients with IC. However, compliance with recommendations for the use of ET is often poor owing to the lack of availability, patient travel requirements, and cost. Results of home-based ET programs have been mixed with a trend toward improved results with more frequent patient engagement. The feasibility, use, and effectiveness of a 12-week app-based structured ET program using cognitive-behavioral therapy (CBT) techniques for IC was evaluated. Patients with PAD confirmed by an abnormal ankle-brachial index or toe-brachial index and IC were recruited prospectively to participate in Society for Vascular Surgery SET, a 12-week app-based ET program. Participants performed home 6-minute walk tests, completed quality-of-life surveys, received education options via micro learning courses (eg, What is PAD?, Exercise, and Nutrition), and ongoing health coaching using CBT techniques. They were instructed to record at least three 30-minute ET walks a week using their personal mobile phones. Programming also included daily doses of health education, coaching, and reminders sent via text message. One hundred thirty-nine patients (37% women; mean age, 65years) were enrolled across 20 institutions (44% offered in-person ET programs). One hundred twenty patients (86%) completed the program. Participants recorded 201,163minutes of walking 8,013,520 steps with the ET program, completing a total of 5049 SET walks. Nineteen enrolled participants (14%) became inactive because they either paused (14 participants: medical reasons, travel, or other) or withdrew (5 participants: security concerns, lack of motivation). Ninety-two percent of patients met their stated CBT specific, measurable, achievable, relevant, and time-bound goals. Freedom from intervention at 6months was 92% and 69% at 12months. Deployment of a 12-week app-based ET program for PAD incorporating CBT was feasible in achieving 86% program completion and effective at meeting guideline recommended activity goals. Ninety-two percent of participants achieved their CBT specific, measurable, achievable, relevant, and time-bound goals. The use of ET was increased by virtue of offering this program at institutions that did not offer ET.

Exploring the black box of French community supervision

This article explores how probation officers (POs) in France employ evidence-based practice in the real world. Using 78 audio tapes of 11 POs and 33 offenders in 2 probations services, we assessed PO skills with an adapted version of the Jersey Checklist. Our results suggest that French probation officers generally possess good communication skills, and use – to a certain extent – core correctional practices. They do, however, underperform with regard to cognitive behavioural techniques.

Development of the First Episode Digital Monitoring mHealth Intervention for People With Early Psychosis: Qualitative Interview Study With Clinicians.

Mobile health (mHealth) technologies have been used extensively in psychosis research. In contrast, their integration into real-world clinical care has been limited despite the broad availability of smartphone-based apps targeting mental health care. Most apps developed for treatment of individuals with psychosis have focused primarily on encouraging self-management skills of patients via practicing cognitive behavioral techniques learned during face-to-face clinical sessions (eg, challenging dysfunctional thoughts and relaxation exercises), reminders to engage in health-promoting activities (eg, exercising, sleeping, and socializing), or symptom monitoring. In contrast, few apps have sought to enhance the clinical encounter itself to improve shared decision-making (SDM) and therapeutic relationships with clinicians, which have been linked to positive clinical outcomes. This qualitative study sought clinicians' input to develop First Episode Digital Monitoring (FREEDoM), an app-based mHealth intervention. FREEDoM was designed to improve the quality, quantity, and timeliness of clinical and functional data available to clinicians treating patients experiencing first-episode psychosis (FEP) to enhance their therapeutic relationship and increase SDM. Following the app's initial development, semistructured qualitative interviews were conducted with 11 FEP treatment providers at 3 coordinated specialty care clinics to elicit input on the app's design, the data report for clinicians, and planned usage procedures. We then generated a summary template and conducted matrix analysis to systematically categorize suggested adaptations to the evidence-based intervention using dimensions of the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) and documented the rationale for adopting or rejecting suggestions. The clinicians provided 31 suggestions (18 adopted and 13 rejected). Suggestions to add or refine the content were most common (eg, adding questions in the app). Adaptations to context were most often related to plans for implementing the intervention, how the reported data were displayed to clinicians, and with whom the reports were shared. Reasons for suggestions primarily included factors related to health narratives and priorities of the patients (eg, focus on the functional impact of symptoms vs their severity), providers' clinical judgment (eg, need for clinically relevant information), and organizations' mission and culture. Reasons for rejecting suggestions included requests for data and procedures beyond the intervention's scope, concerns regarding dilution of the intervention's core components, and concerns about increasing patient burden while using the app. FREEDoM focuses on a novel target for the deployment of mHealth technologies in the treatment of FEP patients-the enhancement of SDM and improvement of therapeutic relationships. This study illustrates the use of the FRAME, along with methods and tools for rapid qualitative analysis, to systematically track adaptations to the app as part of its development process. Such adaptations may contribute to enhanced acceptance of the intervention by clinicians and a higher likelihood of integration into clinical care. ClinicalTrials.gov NCT04248517; https://tinyurl.com/tjuyxvv6.

Cognitive Behavioral Psychotherapy after COVID-19: Opportunities and Prospects

This article reviews domestic and foreign studies on cognitive behavioral therapy techniques in treating cognitive disorders in former COVID-19 patients. Coronavirus-induced cognitive disorders include damage to the nervous system as a result of respiratory distress syndrome, cytokine storm, cerebral vascular thrombosis, direct exposure to SARS-Cov2, and inadequate immune response. Concomitant mental illnesses include autistic disorders, dementia, cognitive decline, eating disorders, suicidal behavior, anxiety, depression, post-traumatic stress, insomnia, etc. Diagnostic methods usually take into account a complex violation of mental activities, e.g., short memory span, attention deficiency, slow thinking, and various affective disorders. As a result, diagnostic methods can be divided into several areas: neuropsychological diagnostics of cognitive functions (MMSE, MOCA, FAB), identification of inadequate attitudes and behavior (WCQ, SPB, DAS), identification of violations of daily activity (The Barthel Scale), identification of psychological and psychiatric issues (Hospital Anxiety and Depression Scale, State-Trait Anxiety Inventory, Hamilton Rating Scale for Depression). Psychological care for former COVID-19 patients relies on some basic principles. Cognitive behavioral psychotherapy techniques aim at correcting cognitive distortions, teaching relaxation and self-regulation, improving problem-solving skills, and restoring cognitive functions.

Introducing a Physical Therapist-Led Acceptance and Commitment Therapy Training for Pain: A Clinical Perspective

Purpose: Mounting evidence supports the use of cognitive and behavioral techniques as part of physical therapist practice. These methods are used within a physical therapist’s multimodal treatment approach for the management of pain and to facilitate health behavior change. There is a multitude of evidence-based cognitive behavioral techniques to choose from including newer approaches based on Acceptance and Commitment Therapy. Yet few studies have examined physical therapists’ perceptions to learning and implementing ACT into clinical practice. The purpose of this manuscript is to present a clinical perspective of physical therapists learning about and incorporating Acceptance and Commitment Therapy in clinical practice. Methods: An 8-week online physical therapist-led ACT for chronic pain training was completed by 65 physical therapists. A post-training evaluation was developed and then scored by 46 participants. The evaluation included 15-questions with regard to the self-reported perceptions of learning foundational ACT skills necessary to implement into physical therapy practice, a deeper understanding of psychological factors involved in musculoskeletal pain, confidence in managing musculoskeletal pain, utility in physical therapist practice, and the recognition of a new or different approach to treating musculoskeletal pain. Results: Participants’ self-reported perceptions were highly positive with 73% reporting the training furthered their understanding of psychological factors in chronic musculoskeletal pain and 100% reported learning the foundational ACT skills necessary to implement it into physical therapy practice. In addition, 7 sub-themes regarding the ACT training emerged from a qualitative content analysis and included the following: 1) The training filled a knowledge gap in understanding of how to assess and treat psychological factors related to pain, 2) A mixture of prerecorded video training, reading, experiential exercises, and self-reflection via the ACTPTE were critical to reinforce learning, 3) Coaching and supervision calls were a useful part of the training and helped to translate course knowledge and implement into clinical practice, 4) Having an opportunity to practice in a group setting with like-minded peers was a critical component of confidence building, 5) Ongoing communication, networking, and mentorship via the online forum and coaching calls allowed participants to complete the course material on-time, stay connected, and share stories and experiences about implementing the material in practice, 6) The ACT stance of not changing pain or related psychological content (example: not changing thoughts, pain related beliefs, reconceptualizing pain) may run counter to other psychologically-informed approaches found in physical therapy practice and took some time for practitioners to process and integrate, 7) Some practitioners expressed that ACT helped them cope with work-related stress and burnout and to drop the struggle of fixing or curing every patient with pain. Conclusions: ACT delivered via an online training was acceptable to physical therapists and supervision calls were necessary for confidence building and implementation into practice. The ACT model was perceived as adaptable to the practice of physical therapy as well as the complex clinical and psychosocial presentation of many chronic pain conditions. Future investigations should explore brief training interventions, treatment fidelity, long-term outcomes, the development and validation of a scale to measure knowledge, concepts and skills conceptualizing psychological flexibility within physical therapist practice.

Study protocol for a randomized controlled trial evaluating the effectiveness of an internet-based self-help intervention to cope with psychological distress due to COVID-19 in the Italian general population: the RinasciMENTE project

BackgroundThis study aims to evaluate the feasibility and effectiveness of the RinasciMENTE program, an Internet-based self-help intervention based on cognitive behavioral therapy (CBT) principles and techniques in supporting individuals experiencing psychological impairments during the COVID-19 pandemic. A randomized controlled trial (RCT) design with random allocation at the level of individual will be conducted to compare the impact of the RinasciMENTE program with a waiting list control in improving the psychological functioning of the general population during the COVID-19 pandemic.MethodsA minimum sample of 128 participants experiencing mild/subthreshold levels of psychological symptoms during the COVID-19 pandemic will be recruited. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 2 months, during which participants will receive 8 weekly CBT treatment modules. The impact of the RinasciMENTE program on selected primary and secondary psychological outcomes will be tested at the end of the intervention (2 months) and 6- and 12-month follow-ups.DiscussionWe expect people to show an increased level of psychological functioning and to acquire the skills and self-confidence necessary to deal with the psychological consequences of the COVID-19 outbreak and its related social isolation during and following the pandemic.Trial registrationClinicalTrials.gov NCT0497903 Registered on 28 May 2021

Effectiveness of two video-based multicomponent treatments for fibromyalgia: The added value of cognitive restructuring and mindfulness in a three-arm randomised controlled trial

Background/objectivesThe aim of this study was to examine the effectiveness of two video-based multicomponent programs (FIBROWALK) and the Multicomponent Physiotherapy Program (MPP) for patients with fibromyalgia (FM) compared to treatment-as-usual (TAU) only. We posit that FIBROWALK, due to inclusion of specific psychological ingredients (cognitive restructuring and mindfulness), can produce additional clinical benefits when compared to TAU or MPP alone. MethodsA total of 330 patients with FM were recruited and randomly allocated (1:1:1) to TAU only, TAU + FIBROWALK, or TAU + MPP. FIBROWALK and MPP consisted of weekly videos on pain neuroscience education, therapeutic exercise and self-management patient education, but only the FIBROWALK intervention provided cognitive restructuring and mindfulness. Both programs were structurally equivalent. Between-group differences in functional impairment, pain, kinesiophobia, anxious-depressive symptoms and physical functioning were evaluated at post-treatment following Intention-To-Treat and complete-case approaches. ResultsCompared to TAU only, individuals in the FIBROWALK arm showed larger improvements in all clinical outcomes; similarly, participants in the MPP program also showed greater improvements in functional impairment, perceived pain, kinesiophobia, depressive symptoms compared to TAU only. The FIBROWALK intervention showed superior effects in improving pain, anxiety and depressive symptoms and physical functioning compared to MPP. ConclusionsThis RCT supports the short-term effectiveness of the video-based multicomponent programs FIBROWALK and MPP for FM and provides evidence that cognitive-behavioural and mindfulness-based techniques can be clinically useful in the context of physiotherapeutic multicomponent treatment programs. Trial registration numberNCT04571528.