Cognitive Behavioral Therapy Model Research Articles

Islamic Coping, Post Traumatic Stress Disorder (PTSD) and Islam Oriented Trauma Focused Cognitive Behavioral Therapy (IO-TF-CBT) in Post-Kahramanmaraş Earthquake Period

The Great Southeast Turkey Earthquakes (GSTE) of February 2023 were not only a physical disaster but also seem to have triggered the onset of Post-Traumatic Stress Disorder (PTSD) among survivors in Kahramanmaraş and surrounding areas. This review emphasizes the need for culturally appropriate clinical interventions in PTSD therapies, addressing the psychological impacts left by the earthquakes. The Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) models implemented after the 1999 Marmara earthquake failed to integrate cultural and Islamic thoughts effectively. With this critical perspective, the article advocates for a holistic healing process that integrates Islamic coping mechanisms with clinical psychology. The importance of religious and spiritual practices in PTSD recovery, especially reliance on Allah, patience, the concept of ummah, prayer, almsgiving, and belief in destiny, is highlighted. While analyzing the potential effectiveness of Islamic approaches in PTSD rehabilitation, the study criticizes the inadequacies of current clinical practices and advocates for the adoption of faith-integrated therapeutic strategies. It proposes a structured methodology for Islamic-Oriented TF-CBT that integrates spiritual practices with scientifically supported psychological interventions, highlighting the gaps in current practices. The aim is to bridge the gap between Islamic practices and clinical psychology, offering a treatment approach compatible with the religious values and traditions of the Muslim population affected by the GSTE. This critical perspective strengthens the call for progress towards cultural competency in mental health services, ensuring that PTSD treatments adapt to the diversity and complexity of earthquake victims. The article emphasizes the need to comprehensively address the psychological needs of individuals affected by the GSTE, particularly those battling PTSD. Recognizing PTSD as not only an individual disorder but also a societal issue, the study suggests that treatment processes should consider not only the individual but also the community. The importance of community-based interventions is highlighted, discussing the current shortcomings and areas for development in this field. In conclusion, the article underscores the significance of cultural sensitivity and community-based approaches in PTSD treatment, calling for more research and implementation in this area.

Use and Engagement With Low-Intensity Cognitive Behavioral Therapy Techniques Used Within an App to Support Worry Management: Content Analysis of Log Data.

Low-intensity cognitive behavioral therapy (LICBT) has been implemented by the Improving Access to Psychological Therapies services across England to manage excessive worry associated with generalized anxiety disorder and support emotional well-being. However, barriers to access limit scalability. A solution has been to incorporate LICBT techniques derived from an evidence-based protocol within the Iona Mind Well-being app for Worry management (IMWW) with support provided through an algorithmically driven conversational agent. This study aims to examine engagement with a mobile phone app to support worry management with specific attention directed toward interaction with specific LICBT techniques and examine the potential to reduce symptoms of anxiety. Log data were examined with respect to a sample of "engaged" users who had completed at least 1 lesson related to the Worry Time and Problem Solving in-app modules that represented the "minimum dose." Paired sample 2-tailed t tests were undertaken to examine the potential for IMWW to reduce worry and anxiety, with multivariate linear regressions examining the extent to which completion of each of the techniques led to reductions in worry and anxiety. There was good engagement with the range of specific LICBT techniques included within IMWW. The vast majority of engaged users were able to interact with the cognitive behavioral therapy model and successfully record types of worry. When working through Problem Solving, the conversational agent was successfully used to support the user with lower levels of engagement. Several users engaged with Worry Time outside of the app. Forgetting to use the app was the most common reason for lack of engagement, with features of the app such as completion of routine outcome measures and weekly reflections having lower levels of engagement. Despite difficulties in the collection of end point data, there was a significant reduction in severity for both anxiety (t53=5.5; P<.001; 95% CI 2.4-5.2) and low mood (t53=2.3; P=.03; 95% CI 0.2-3.3). A statistically significant linear model was also fitted to the Generalized Anxiety Disorder-7 (F2,51=6.73; P<.001), while the model predicting changes in the Patient Health Questionnaire-8 did not reach significance (F2,51=2.33; P=.11). This indicates that the reduction in these measures was affected by in-app engagement with Worry Time and Problem Solving. Engaged users were able to successfully interact with the LICBT-specific techniques informed by an evidence-based protocol although there were lower completion rates of routine outcome measures and weekly reflections. Successful interaction with the specific techniques potentially contributes to promising data, indicating that IMWW may be effective in the management of excessive worry. A relationship between dose and improvement justifies the use of log data to inform future developments. However, attention needs to be directed toward enhancing interaction with wider features of the app given that larger improvements were associated with greater engagement.

Defining and empirically testing a two-stage build-maintain model of cognitive behavioural therapy for insomnia

Cognitive Behavioural Therapy for Insomnia is the front-line intervention for Insomnia Disorder. However, few studies have reported data on how CBT-I implementation evolves over the course of therapy or the time course of client response. This is due, in part, to no formal framework for defining stages of CBT-I. Here, we follow Spielman's original conceptualisation of Sleep Restriction Therapy (SRT) to report a two-stage model for defining stages of CBT-I, based on progression through the phases of SRT. Using data from a prior randomized clinical trial, we show the model helps identify patterns of treatment progression, which are in turn associated with baseline insomnia severity. The reported model is parsimonious and easy to implement and it holds potential for further examining and understanding a variety of CBT-I processes currently not fully understood, such as adherence and the optimal order of various CBT-I treatment components.

CBT for Generalized Anxiety Disorder in Parkinson’s Disease: A Case Study

ABSTRACT Objectives To examine the use of cognitive behavioral therapy (CBT) in a case of co-occurring generalized anxiety disorder (GAD) and Parkinson’s disease (PD). Methods This case study refers to a male aged 75 years with a diagnosis of Idiopathic Parkinson’s disease. It focuses on applying a CBT model to address the psychological difficulties with PD and GAD. Results This case study reveals key aspects in presentation, diagnosis, and psychological treatment between PD and GAD, and is one of few studies published in this area. Conclusions Symptoms of anxiety in an older adult with PD decreased during a course of CBT. The implications of the treatment outcome of this study and further considerations of treatment plans for comorbid PD and anxiety have been discussed. Clinical Implications Using CBT could positively impact non-motor symptoms of Parkinson’s, such as sleep difficulties and speech impediments. Using CBT for the catastrophic thinking and worry content in GAD seems to act as a complementary therapy for psychological/non-motor symptoms of PD.

Closing the Gap for Children with OCD: A Staged-Care Model of Cognitive Behavioural Therapy with Exposure and Response Prevention

Childhood obsessive–compulsive disorder (OCD) is among the most prevalent and disabling mental health conditions affecting children and adolescents. Although the distress and burden associated with childhood OCD are well documented and empirically supported treatments are available, there remains an unacceptable “treatment gap” and “quality gap” in the provision of services for youth suffering from OCD. The treatment gap represents the large number of children who never receive mental health services for OCD, while the quality gap refers to the children and young people who do access services, but do not receive evidence-based, cognitive behavioural therapy with exposure and response prevention (CBT-ERP). We propose a novel staged-care model of CBT-ERP that aims to improve the treatment access to high-quality CBT-ERP, as well as enhance the treatment outcomes for youth. In staged care, patients receive hierarchically arranged service packages that vary according to the intensity, duration, and mix of treatment options, with provision of care from prevention, early intervention, through to first and second-line treatments. Based on a comprehensive review of the literature on treatment outcomes and predictors of treatments response, we propose a preliminary staging algorithm to determine the level of clinical care, informed by three key determinants: severity of illness, comorbidity, and prior treatment history. The proposed clinical staging model for paediatric OCD prioritises high-quality care for children at all stages and levels of illness, utilising empirically supported CBT-ERP, across multiple modalities, combined with evidence-informed, clinical decision-making heuristics. While informed by evidence, the proposed staging model requires empirical validation before it is ready for prime time.

Trying to name what doesn't change: Neural nonresponse to Cognitive Therapy for depression.

Theoretical models of neural mechanisms underlying Cognitive Behavior Therapy (CBT) for major depressive disorder (MDD) propose that psychotherapy changes neural functioning of prefrontal cortical structures associated with cognitive-control processes (DeRubeis, Siegle, & Hollon, ); however, MDD is persistent and characterized by long-lasting vulnerabilities to recurrence after intervention, suggesting that underlying neural mechanisms of MDD remain despite treatment. It follows that identification of treatment-resistant aberrant neural processes in MDD may inform clinical and research efforts targeting sustained remission. Thus, we sought to identify brain regions showing aberrant neural functioning in MDD that either (1) fail to exhibit substantive change (nonresponse) or (2) exhibit functional changes (response) following CBT. To identify treatment-resistant neural processes (as well as neural processes exhibiting change after treatment), we collected functional magnetic resonance imaging (fMRI) data of MDD patients (n = 58) before and after CBT as well as never-depressed controls (n = 35) before and after a similar amount of time. We evaluated fMRI data using conjunction analyses, which utilized several contrast-based criteria to characterize brain regions showing both differences between patients and controls at baseline and nonresponse or response to CBT. Findings revealed nonresponse in a cerebellar region and response in prefrontal and parietal regions. Results are consistent with prior theoretical models of CBT's direct effect on cortical regulatory processes but expand on them with identification of additional regions (and associated neural systems) of response and nonresponse to CBT.

CBT for difficult-to-treat depression: self-regulation model.

Cognitive behavioural therapy (CBT) is an effective treatment for depression but a significant minority of clients do not complete therapy, do not respond to it, or subsequently relapse. Non-responders, and those at risk of relapse, are more likely to have adverse childhood experiences, early-onset depression, co-morbidities, interpersonal problems and heightened risk. This is a heterogeneous group of clients who are currently difficult to treat. The aim was to develop a CBT model of depression that will be effective for difficult-to-treat clients who have not responded to standard CBT. The method was to unify theory, evidence and clinical strategies within the field of CBT to develop an integrated CBT model. Single case methods were used to develop the treatment components. A self-regulation model of depression has been developed. It proposes that depression is maintained by repeated interactions of self-identity disruption, impaired motivation, disengagement, rumination, intrusive memories and passive life goals. Depression is more difficult to treat when these processes become interlocked. Treatment based on the model builds self-regulation skills and restructures self-identity, rather than target negative beliefs. A bespoke therapy plan is formed out of ten treatment components, based on an individual case formulation. A self-regulation model of depression is proposed that integrates theory, evidence and practice within the field of CBT. It has been developed with difficult-to-treat cases as its primary purpose. A case example is described in a concurrent article (Barton et al., 2022) and further empirical tests are on-going.

Effects of personalized movement models in virtual reality on pain expectancy and motor behavior in patients with chronic back pain: a feasibility study

Cognitive-behavioral therapy (CBT) of chronic pain focuses on behavioral, cognitive, affective and social factors that play a role in the transition from acute to chronic pain, which often is initially caused by a specific event but then takes on “a life of its own”. CBT models assume that fear of pain and subsequent avoidance behavior contribute to pain chronicity and the maintenance of chronic pain. In chronic back pain (CBP), avoidance is often addressed by teaching patients to reduce pain behaviors (such as guarding and bracing that may become dysfunctional over time) and increase healthy behaviors (such as physical exercise and meaningful social activities). The current study explored if personalized virtual movement models (doppelganger avatars), who maximize model-observer similarity in virtual reality (VR), can influence fear of pain, motor avoidance and movement-related pain and function. In a randomized controlled trial, participants with CBP observed and imitated an avatar (AVA, N = 17) or a videotaped model (VID, N = 16) over three sessions, where moving a beverage crate, bending sideward (BS), and rotation in the horizontal plane (RH) were shown. Self-reported pain expectancy, as well as engagement, functional capacity and pain during movements, were analyzed along with range of motion (ROM). The AVA group reported higher engagement with no significant group differences observed in ROM. Pain expectancy increased in AVA but not VID over the sessions. Pain and limitations did not significantly differ. However, we observed a significant moderation effect of group, with prior pain expectancy predicting pain and avoidance in the VID but not in the AVA group. This can be interpreted as an effect of personalized movement models decoupling pain behavior from movement-related fear and pain expectancy. Thus, personalized virtual movement models may provide an additional tool for exposure and exercise treatments in cognitive-behavioral treatment approaches to CBP.

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

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

The Transcending Protocol: A Cognitive-Behavioral Approach for Addressing the Psychosocial Impact of Minority Stress in Transgender and Gender Diverse Individuals

This article describes an innovative, trauma-focused cognitive behavioral protocol, Transcending, to address the effects of minority stress on mental health among transgender and gender diverse individuals. The protocol merges minority stress and cognitive behavioral therapy models to provide a framework for (a) understanding the impact of minority stress (i.e., distal and proximal stressors) and (b) developing skills to address maintenance factors of associated psychological distress. The Transcending protocol is intended to provide a structured approach to filling an important gap in counseling services and increasing therapeutic competence with transgender and gender diverse individuals.

Addressing equality, diversity and inclusion as part of CBT training: a course evaluation study

Abstract It is widely documented that Black, Asian and Minority Ethnic (BAME) communities experience poorer mental health, and have a poorer experience of mental health services. Therapists delivering cognitive behavioural therapy (CBT) in services such as NHS Talking Therapies Services for Anxiety and Depression, are working with increasingly diverse client groups, but treatment access and recovery rates remain below what they should be compared with the White British population. Previous research indicates that CBT therapists may not receive appropriate training that allows them to develop the skills required to work effectively transculturally. The present study therefore aimed to evaluate a CBT training programme within this context, from the perspective of previous course graduates. Thirty participants took part in an online survey with questions requiring both Likert-scaled answers and free-text responses. Descriptive statistics, inferential statistics and template analysis were used to analyse the data. The results of the survey were favourable overall for both White British and BAME respondents. Positive areas of practice highlighted included peer learning within a diverse cohort, building awareness of own biases, and reflective learning spaces. Areas of development included increased integration of teaching focused on adapting CBT models for minority groups, diversification of teaching staff, and reducing fear and avoidance of exploring issues related to equality, diversity and inclusion. Tentative implications for improving CBT training course delivery in this context have been offered. Key learning aims (1) To acknowledge the challenges faced by service users from BAME communities in accessing equitable mental health treatment, including cognitive behavioural psychotherapy. (2) To consider explanations for why CBT therapists working in NHS services might find it difficult to work effectively transculturally. (3) To establish ways in which CBT training programmes might help therapists to embark more successfully on the journey of developing cultural competence, during training and beyond.

Telehealth for Pediatric Disorders of Gut-Brain Interaction During the COVID-19 Pandemic.

A retrospective chart review was completed to examine psychological treatment duration and response among pediatric patients with a disorder of gut-brain interaction including functional abdominal pain and irritable bowel syndrome. Cognitive behavioral therapy (CBT) was delivered via telehealth with a licensed psychologist or supervised psychology trainee embedded in a pediatric gastroenterology clinic. Participants were 22 youth (mean age = 14.36 years) who received CBT via telehealth between February and September of 2021, after completing an initial evaluation between February and July of 2021. Patients completed reliable and valid self-report measures of functional disability and pain during treatment. A unique CBT model was employed with an initial focus on psychoeducation and function regardless of level of severity of functional impairment. Consistent with study hypotheses, nonparametric statistical analyses demonstrated statistically significant reductions in functional disability and pain following implementation of the CBT model via telehealth. Contrary to predictions, there was no relation found between severity of functional impairment and duration of treatment.

CBT- BELCLIST (BELIEF CLIENT LIST) UNTUK MENINGKATKAN KEPERCAYAAN DIRI ANAK ASUH DI YABNI KAB. SUMEDANG

Cognitive Behavior Therapy (CBT) is a counseling approach designed to solve the counsel's current problems by restructuring cognitive and deviant behavior. CBT-BELCLIST (Belief Client List) is a new technological model of cognitive behavioral therapy (CBT) techniques. CBT-BELCLIST is aimed at fostering girls who experience self-confidence problem at the Yayasan Bening Nurani, Sumedang Regency. CBT-BELCLIST is carried out in the second stage of CBT, namely in the stage of looking for negative emotions. CBT-BELCLIST contains two columns, namely irrational thinking and rational thinking, and will be filled by the subject and the subject's social environment. CBT-BELCLIST is intended to increase the confidence of foster children. This study was conducted to obtain an empirical description and analyze the self-confidence of foster children through the CBT-BELCLIST technique. This study uses an experimental research design with a Single Subject Design (SSD) approach with the ABA model. The target behavior observed in this study was managing oneself, starting a conversation with a friend, starting a conversation with a group of friends and giving verbal/non-verbal responses to friends. The result of this study is that with CBT-BELCLIST the subject is able to increase his self-confidence. Subjects begin to be able to manage themselves, start conversations with friends, start conversations with a group of friends and provide verbal/non-verbal responses to friends.Key Words: Cognitive Behavior Therapy (CBT), CBT-BELCLIST (Belief Client List), Self-confidence Problem

Improved emotion regulation following a trauma-informed CBT-based intervention associates with reduced risk for recidivism in justice-involved emerging adults.

ObjectiveMale youth who have been involved in the juvenile legal system have disproportionate rates of trauma and violence exposure. Many justice-involved youth have untreated mental illness, with an estimated 66% of young men who are incarcerated meeting criteria for at least one mental health disorder, including posttraumatic stress disorder (PTSD), depression, and substance abuse. While Cognitive Behavioral Therapy (CBT) approaches are considered among effective evidence-based treatments for addressing and treating behavioral and emotional difficulties, male youth with a history of incarceration and youth who are at risk for (re)incarceration, violence, emotion dysregulation, and trauma face significant barriers in accessing these services.MethodsRoca, Inc. (Roca), an internationally recognized organization moving the needle on urban violence by working relentlessly with young people at the center of violence in Massachusetts and Maryland, employs a trauma-informed CBT-based skills curriculum and approach in their intervention model, to improve youths' educational, employment, parenting, and life skills opportunities, while decreasing risk for recidivism, addressing trauma and increasing skills for emotion regulation. The aim of this analysis was to assess the effectiveness of Roca's trauma-informed CBT skills curriculum on youths' emotional and behavioral outcomes. We analyzed data from over 300 participating emerging adult men from four sites in Massachusetts and one site in Baltimore, Maryland who had at least three series of data collection across multiple skills-based sessions.ResultsWe found improvements in outcomes in overall mean scores related to decreased distress about employment and education, as are expected with standard intervention approaches for justice-involved youth. Participants who show improvement in emotion regulation across engagement (approximately half the cohort), were found to have significant improvements in distress related to relationship and family functioning and self-care, and decreased substance use, along with other outcomes compared to those participants with less improvement in emotion regulation. Furthermore, improvement in different aspects of emotion regulation were associated with improved relationships, life distress, substance use, and improved prosocial thinking.ConclusionsTogether, these data suggest that adding mental health support and skills training, such as with trauma-informed CBT models, to programs for justice-involved youth may lead to significant improvements in functioning, quality of life, and mental health outcomes.

OTİSTİK ÇOCUKLARIN TOPLUMA ENTEGRASYONUNDA EĞİTİMİN VE SOSYAL ÇALIŞMALARIN ROLÜNE YÖNELİK NİTEL BİR ARAŞTIRMA

The aim of this study is to determine the educational role of social work in the social integration of individuals with an autism spectrum disorder, which is a social issue, through a qualitative research method. The study was carried out with twelve educator employees of three special education practice first-grade schools that teach children with autism spectrum disorder and are affiliated with the Ministry of National Education. The theoretical basis of the study is social learning, system, social exchange theories, and cognitive behavioral therapy, problem-solving, and crisis intervention models. According to the results of the study carried out with the interpretive phenomenology method, it was determined that social work had roles in the social integration of children with autism spectrum disorders such as family, education, care, counseling, sustainable innovation, and ethics. The results determined that ethics in social work was easy, equal, and free access to service. Innovation in social work includes new approaches in education and training, new methods, improvement and continuity in service, adaptation to change, and self-renewal. The problems experienced in the educational function of social work were basically determined as the lack of expertise of the educators, the ethical and social problems raised by the implementation of care and education services in schools by a single teacher, the lack of technological infrastructure of the schools, the deficiencies in the activities that need to be carried out for the children to socialize, the deficiencies in the education of families about autism, the problem with female students' personal care being provided by female staff.

Digital Help for Substance Users (SU): A Systematic Review.

The estimated number of Substance Users (SU) globally has currently reached a very high number and is still increasing. This aspect necessitates appropriate interventions for prevention and specific treatments. The literature shows that digital treatments can be useful in the context of health services and substance abuse. This systematic review focuses mainly on research on the effectiveness of digital treatments for SU. Data sources included studies found on PsycINFO, PubMed, SCOPUS, and WebOfScience (WOS) database searches. The following keywords were used: TITLE (digital OR computer OR software OR tablet OR app OR videogame OR seriousgame OR virtualreality) AND ABSTRACT((mental AND health) AND (addiction OR dependence OR substance OR drug)). We focused on peer-reviewed articles published from 2010 through 2021 using PRISMA guidelines. A total of 18 studies met the inclusion criteria (i.e., type of intervention, efficacy in terms of misuse of substances and scored outcomes from questionnaire or toxicology tests, study methodology). The studies included investigations of specific digital treatments for SU of various kinds of drugs. The interventions were administered using personal computers, smartphones, or, in a few cases, tablets. Most of the interventions focused on the cognitive behavior therapy (CBT) model and/or on the use strategies, tips, or feedback. A minority provided information or training programs. The current review shows that digital treatments and interventions are effective in reducing the frequency of use, augmenting abstinence, or reducing the gravity of dependence for most of the studies at post-treatment. However, due to the heterogeneity of the variables (i.e., substance type, digital tool used, and treatment administered), there was a reduced generalizability of the results. This review highlights the need to continue the research in this field, and above all, to create effective digital protocols.

Response to unexpected social inclusion: A study using the cyberball paradigm.

BackgroundDysfunctional expectations are considered core characteristics of Major Depressive Disorder (MDD) and should be focused in psychotherapy. Dysfunctional expectations are especially pronounced in the interpersonal area (social expectations). In the present study, we examine the effect of unexpected social inclusion (expectation violation) on the change of generalized and specific depression-typical social expectations.MethodWe conducted an online study to investigate the impact of social inclusion after a period of social exclusion (unexpected social inclusion) on social expectation change (sample size 144) in a non-clinical sample. Depressive symptoms were assessed via self-reporting. Participants took part in two rounds of the online ball-game Cyberball. In the first round, all participants were socially excluded by their two co-players (acquisition of negative social expectations). In the second round, participants were either once more excluded (expectation confirmation) or included equally (expectation violation) by the same co-players. Specific and generalized social expectations were assessed after each round.ResultsSpecific and generalized social expectations increased following expectation violation. Even though depressive symptoms were related to lower levels of social expectations, we found that depressive symptoms did not moderate expectation change after positive expectation violations.ConclusionsIn the present experimental setup including the use of the online ball-game Cyberball, the establishment and change of social expectations can be experimentally manipulated. Under the given circumstances and in a non-clinical sample, negative expectations can be updated after unexpected positive experiences regardless of the number of depressive symptoms. The results are discussed in the context of current models of Major Depressive Disorder (MDD), expectation change, and cognitive behavioral therapy.

Developing cognitive-behavioral therapy in relieving the symptoms of depression, generalized anxiety and social anxiety in adolescents. Case study

Adolescents are characterized by distinct features of the affective sphere, and bio-social conditions trigger affective disadvantages revealed by an advanced level of depression and anxiety. This is exacerbated at this stage by the fact that value and content orientations have become more diffuse, and the adolescent's personality is increasingly prone to disorders of the emotional, mental, cognitive and behavioral spheres. elucidation of the mechanisms that determine the occurrence of emotional disorders in adolescents, the possibility of reducing emotional disorders in adolescents has been demonstrated, the model of cognitive behavioral therapy has been used to alleviate the symptoms of depression, generalized anxiety and social anxiety. in adolescents

Integration of Clinical Neuroscience Into Psychotherapy: A Narrative Review of Neuroscience-Informed Psychotherapy Models for the Treatment of Depression and Anxiety Disorders

The development of neuroscience-informed psychotherapy models that attempt to refine existing psychotherapy models, especially for the treatment of depression and anxiety disorders, is a current topic in psychotherapy research. This narrative review appraised the existing literature on neuroscience-informed psychotherapy models to understand the extent to which the integration of neuroscience can advance the practice of psychotherapy for the treatment of depression and anxiety disorders. The literature search on online databases identified 21 articles that report five different neuroscience-informed psychotherapy models specifically designed to overcome the limitations of top-down-focused cognitive behavioural therapy (CBT) models for depression and anxiety disorders, such as inconsistent treatment effects. Unlike conventional top-down-focused CBT models, which primarily focus on promoting top-down regulation of the brain by improving the cognitive functioning regulated by the higher brain system, the models reviewed commonly focus on promoting bottom-up regulation of the brain by improving the emotional and physiological functioning regulated by the lower brain system with a diverse combination of techniques. However, most reviewed neuroscience-informed psychotherapy models lack research evidence from clinical trials that support the efficacy of these models. The development of a neuroscience-informed psychotherapeutic model is still in its infancy. Future neuroscience-informed therapeutic models will need to be continuously modified, adjusted, and developed by integrating the latest psychotherapy and neuroscientific knowledge and feedback from clinical trials and case studies. Such research may promote the credibility and effectiveness of neuroscience-informed therapeutic models.

Neuronal Activity during Exposure to Specific Phobia through fMRI: Comparing Therapeutic Components of Cognitive Behavioral Therapy.

Cognitive behavioral therapy (CBT) packages for anxiety disorders, such as phobias, usually include gradual exposure to anxious contexts, positive self-verbalizations, and relaxation breathing. The objective of this research was to analyze the specific neural activation produced by the self-verbalizations (S) and breathing (B) included in CBT. Thirty participants with clinical levels of a specific phobia to small animals were randomly assigned to three fMRI conditions in which individuals were exposed to phobic stimuli in real images: a group underwent S as a technique to reduce anxiety; a second group underwent B; and a control group underwent exposure only (E). Simple effects showed higher brain activation comparing E > S, E > B, and S > B. In particular, in the E group, compared to the experimental conditions, an activation was observed in sensory-perceptive and prefrontal and in other regions involved in the triggering of emotion (i.e., amygdala, supplementary motor area, and cingulate gyrus) as well as an activation associated with interoceptive sensitivity (i.e., insula and cingulate cortex). According to the specific tool used, discrepancies in the neural changes of CBT efficacy were observed. We discuss the theoretical implications according to the dual model of CBT as a set of therapeutic tools that activate different processes.