Cognitive Behavioral Therapy Program Research Articles

Verifying the Effectiveness of an Online-based Brief Cognitive Behavioral Sandplay Therapy Program to Reduce Depressive Symptoms and Anxiety and Increase Resilience for Adults. : Focusing on the comparison between online and face-to-face counseling

본 연구는 성인의 우울감과 불안감 감소 및 회복탄력성 증진을 위한 온라인 단기 인지행동 모래놀이치료 프로그램을 실시하여 효과성을 검증하는 것을 목적으로 한다. 이를 위하여 서울시의 우울감과 불안감을 호소하는 만18세 이상의 성인 18명을 연구대상으로 선정하여 실험집단과 비교집단, 통제집단에 각각 6명씩 배치하였다. 실험집단은 온라인을 통해, 비교집단은 대면으로 6회기의 단기 인지행동 모래놀이 프로그램을 실시하였으며, 통제집단은 아무런 처치도 하지 않았다. 사전-사후 검사를 실시하여 효과성을 검증한 결과, 실험집단과 비교집단은 우울감과 불안감이 유의하게 감소하였고, 회복탄력성은 유의하게 증가하였다. 반면 통제집단은 우울감, 불안감 및 회복탄력성에 유의한 변화가 나타나지 않았다. 이는 단기 인지행동 모래놀이치료 프로그램이 성인의 정신건강 증진에 효과적인 중재가 될 수 있으며, 나아가 온라인으로 진행되는 상담이 대면으로 진행되는 상담과 유사한 수준의 효과를 가질 수 있음을 의미한다.The purpose of this study was to investigate the effectiveness of an online-based brief cognitive behavioral sandplay therapy program to reduce depressive symptoms and anxiety and increase resilience for adults. For this purpose, 18 adults over the age of 18 who complained of depressive symptoms and anxiety were recruited in Seoul. They were assigned to the experimental group (online), comparison group (face-to-face), and control group (no treatment), with 6 people in each group. The cognitive behavioral sandplay therapy program was performed 6 times for the experimental group and the comparison group, while the control group did not receive any treatment. As a result of verifying the effectiveness of the pre-post test, it was found that depressive symptoms and anxiety were significantly reduced for the experimental group and the comparison group, and resilience was significantly increased. However, there was no significant change in the control group. It was verified that the intervention of the brief cognitive behavioral sandplay therapy program was effective. Furthermore, it was confirmed that the online method had similar effects with the face-to-face method. This suggests that online counseling can be an effective intervention for the recovery of mental health, such as depressive symptoms, anxiety, and resilience in adults.

The Effect of a Brief Physician-Delivered Neurobiologically Oriented, Cognitive Behavioural Therapy (Brief-CBT) Intervention on Chronic Pain Acceptance in Youth with Chronic Pain-A Randomized Controlled Trial.

At the Stollery Children’s Chronic Pain Clinic, new referrals are assessed by an interdisciplinary team. The final part of the intake assessment typically involves an explanation and compassionate validation of the etiology of chronic pain and an invitation to the youth to attend the group outpatient Cognitive Behavioural Therapy (CBT) program, called Pain 101, or to individual outpatient CBT. It was hypothesized that a brief physician-delivered CBT (brief-CBT) intervention at first point of contact improves subsequent pain acceptance. Using a randomized double blinded methodology, 26 participants received a standard intake assessment and 26 the standard assessment plus the brief-CBT intervention. Measures were taken at three points: pre and post-intake assessment and after Pain 101 or individual CBT (or day 30 post-assessment for those attending neither). The primary outcome measure was the Chronic Pain Acceptance Questionnaire—Adolescent version (CPAQ-A). Comparing pre and post-intake measures, there was a significant (p = 0.002) increase in the CPAQ-A scores—four-fold more in the brief-CBT intervention group (p = 0.045). Anxiety (RCADS-T Score) was significantly reduced post-intake and significantly more reduced in the intervention group compared to the control group (p = 0.024). CPAQ-A scores were significantly increased (p < 0.001) (N = 28) and anxiety (RCADs-T) was significantly reduced by the end of Pain 101 (p < 0.003) (N = 29) as was fear of pain as measured by the Tampa Scale for Kinesiophobia (p = 0.021). A physician-delivered brief-CBT intervention significantly and meaningfully increased CPAQ-A scores and reduced anxiety in youth with chronic pain. Furthermore, CBT through Pain 101 is effective at increasing acceptance, as well as reducing anxiety and fear of movement.

Development of a culturally adaptable internet-based cognitive behavioral therapy for Japanese women with bulimia nervosa.

BackgroundThe process of cultural adaptation of internet-based cognitive behavioral therapy (ICBT) programs for bulimia nervosa (BN) have rarely been reported despite the potential influence of cultural adaptation of psychosocial interventions on therapeutic response.AimThis study aimed to illustrate development process of an ICBT program for Japanese women with bulimia nervosa (BN).MethodsA mixed methods approach was used to assess cultural adaptation of the prototype of an original ICBT program by using the Cultural Relevance Questionnaire (CRQ). Five women with BN and seven clinicians were interviewed using the CRQ.ResultsQuantitative analyses were conducted to assess cultural adaptation of the prototype of the program and participants rated cultural adaptation as high. A qualitative analysis of the mixed method supported the culturally sensitive changes implemented.ConclusionsThe results of this study show that a series of processes can make ICBT programs more culturally adapted.

Cognitive behavioral treatment for disordered gaming and problem gambling in adolescents: a pilot feasibility study.

BackgroundDisordered gaming and problem gambling (DG/PG) are associated with a range of functional impairments as well as psychiatric comorbidity. With the proliferation of digital gaming apps aimed at children and adolescents, which involve in-game purchases, there is increasing evidence that DG/PG are on the rise in this age range. The behavior can be detected in youth presenting at school-based health clinics and community psychiatric clinics. Cognitive behavioral therapy (CBT) is one of several recommended treatments for adults, but little evidence is available for the efficacy of this approach in adolescents with DG/PG.AimTo evaluate the acceptability and feasibility of a CBT-based intervention developed for adolescents with DG/PG, which can be delivered in routine psychiatric care facilities.MethodsAdolescents who were patients at a child and adolescent psychiatry service were screened for DG/PG. Those aged 12–17 years with pronounced symptoms were invited to participate in a 7-week CBT program called Relapse Prevention. Nine adolescents agreed to participate and five consented to repeated assessments of outcome (pre-, post-treatment, and 6-month follow-up). In addition to acceptability and satisfaction with treatment, symptoms of DG were assessed with standardized interview and self-report measures.ResultsThere were no dropouts from the treatment. Participants who completed treatment and all outcome assessments reported satisfaction with the treatment. The participants showed fewer symptoms of DG after treatment, and the proportion who met criteria for computer game addiction decreased from 56 to 0%. There was no reduction in the number of participants who met criteria for PG.ConclusionThis study provides preliminary evidence for the acceptability and feasibility of a CBT-based intervention for DG/PG in adolescents. Preliminary data suggest that the treatment may be effective for DG but not PG. Further studies are needed to evaluate the efficacy of this approach for both conditions.

The e-mental health treatment in Stockholm myocardial infarction with non-obstructive coronaries or Takotsubo syndrome study (E-SMINC): a study protocol for a randomised controlled trial

BackgroundIn the aftermath of a myocardial infarction with non-obstructive coronary arteries (MINOCA) or Takotsubo syndrome (TS), patients commonly express high levels of stress and anxiety. Current treatment alternatives rarely address these issues.MethodsThe study is a randomised controlled trial, where 90 patients with a discharge diagnosis of MINOCA or TS who also report symptoms of stress or anxiety will be randomised 2–6 weeks after their cardiac event. The treatment consists of 10 weeks of Internet-based cognitive behaviour therapy (CBT) and starts immediately after randomisation for the treatment group. The control group receives usual care. Main outcomes are symptoms of anxiety measured with the Hospital Anxiety and Depression scale, anxiety subscale, and perceived stress measured with the Perceived Stress Scale, 14-item version, 10 weeks after randomisation. Secondary measures include cardiac specific anxiety, symptoms of post-traumatic stress, quality of life, cortisol measured in hair and physiological stress responses (heart rate variability, blood pressure and saliva cortisol) during a stress procedure. Ten weeks after randomisation, the control group will also receive treatment. Long-term follow-up in the self-report measures mentioned above will be conducted 20 and 50 weeks after randomisation where the total group’s development over time is followed, and the groups receiving intervention early versus late compared.DiscussionAt present, there are no randomised studies evaluating psychological treatment for patients with MINOCA or TS. There is an urgent need for treatment alternatives aiming at relieving stress and anxiety considering the high mental stress and anxiety levels observed in MINOCA and TS, leading to decreased quality of life. CBT aiming at reducing mental stress has been shown to be effective regarding prognosis in patients with coronary artery disease. The current protocol describes a randomised open-label controlled trial evaluating an Internet-based CBT program for reduction of stress and anxiety in patients with increased mental stress and/or anxiety with a discharge diagnosis of either MINOCA or TS.Trial registrationClinicalTrials.govNCT04178434. Registered on 26 November 2019

Effect of Cognitive-Behavioral Therapy on Nocturnal Autonomic Activity in Patients with Fibromyalgia: A Preliminary Study.

Objective: fibromyalgia is a complex chronic pain syndrome characterized by widespread musculoskeletal pain, insomnia and autonomic alterations. Cognitive-behavioral therapy (CBT) is regarded as a promising treatment in fibromyalgia, but its impact on autonomic function remains uncertain. In this research, we studied the effect of CBT on autonomic functions in fibromyalgia. Methods: Twenty-five participants underwent overnight polysomnographic recordings before and after CBT programs focused on pain (CBT-P) or a hybrid modality focused on pain and insomnia (CBT-C). Sleep quality, daily pain, depression and anxiety were assessed by self-reported questionnaires. We analyzed heart rate variability (HRV) using high-frequency power (HF) as a marker for parasympathetic activity, and low-frequency power (LF) and the LF/HF ratio as relative sympathetic markers during wakefulness and at each sleep stage. Results: After treatment, 14 patients (/25, 58.0%) reported improvement in their sleep: 6 in the CBT-P condition (/12, 50%), and 8 in the CBT-C condition (/13, 61.5%). We found that, regardless of the type of CBT, patients who reported improvement in sleep quality (n = 14, 58%) had an increase in HF during stages N2 (p < 0.05) and N3 (p < 0.05). These changes were related to improvement in sleep quality (N2, r = −0.43, p = 0.033) but not to pain, depression or anxiety. Conclusions: This study showed an improvement in parasympathetic cardiac control during non-rapid-eye-movement sleep following CBT in fibromyalgia participants who reported better sleep after this therapy. CBT may have a cardio-protective effect and HRV could be used as a sleep monitoring tool in fibromyalgia.

Effectiveness of a cognitive-behavioral therapy program in reducing the risk of relapse for recovering addicts

The study aimed to identify the effectiveness of the cognitive-behavioral therapy program in reducing the risk of relapse for recovering addicts. The study applied the quasi-experimental approach, where the study sample consisted of (10) individuals addicted to the substance (Ceptagon and Synthetic cannabinoids), who are present in the addiction treatment center / Arjan. They were divided into two equal groups, an experimental group consisting of (5) drug addicts, and a control group consisting of (5) drug addicts. The criteria for evaluating the factors of addict’s relapse were applied to them, in addition to the treatment program. Moreover, the study found the effectiveness of the program in reducing the risk of relapse for the recovering addicts, the research sample. It showed the presence of statistically significant differences between the ranks of the degrees of the two measurements, pre and post tests, for the experimental group, and also showed that there were no statistically significant differences between the ranks of the degrees of the two measurements.

Content Analysis Informing the Development of Adapted Harm Reduction Talking Circles (HaRTC) with Urban American Indians and Alaska Natives Experiencing Alcohol Use Disorder

Prior studies with Native populations have highlighted concerns about the cultural acceptability of highly directive, Eurocentric approaches, such as cognitive behavioral therapy and 12-step programs in treating alcohol use disorder (AUD). When asked in a prior qualitative study how they would redesign AUD treatment, urban American Indian and Alaska Native (AI/AN) participants reported wanting more low-barrier, harm-reduction treatment options, Native treatment providers, and culturally relevant practices. Talking Circles, which are gatherings where people share what is on their hearts, were the most requested Native cultural practice. After developing and piloting its initial iteration, researchers, community members, and traditional health professionals collaborated on the present qualitative research study to further refine an adapted Harm Reduction Talking Circle (HaRTC) protocol to address AUD with urban AI/ANs. This study features a conventional content analysis of 31 patient interviews, 6 key informant interviews with management and traditional health professionals, and 5 staff and provider focus groups to inform the development of the HaRTC. Specifically, this study describes staff, management, traditional health professionals, provider, and patient participants’ a) perspectives on HaRTC, including potential benefits, risks and mitigating factors, b) preferred traditional medicines and practices, c) preferred approaches/Circle Facilitator stance for engagement and facilitation, and d) HaRTC logistics (e.g., timing, frequency). Analyses indicated a central tendency preference for 8, weekly HaRTC sessions. Although participants expressed concerns about the potential inclusion of intoxicated people in HaRTC sessions, a large majority of staff, management and patient participants felt it was important to have HaRTC be as inclusive and accepting of community members as possible. Participants provided suggestions for how to structure facilitation of the HaRTC and mitigate risks of intoxication and patient escalation. Participants preferred an approach that is acceptance-based, respects individuals’ autonomy and culture, and creates a safe space for recovery. Most participants felt the specific traditions and medicines applied in the HaRTC should be maximally inclusive to honor the diversity of tribal affiliations and backgrounds represented among urban AI/ANs. In conclusion, participants largely supported an integration of harm-reduction principles and the North American Indigenous tradition of the Talking Circle to provide a compassionate, culturally appropriate healing practice to a larger spectrum of AI/ANs with AUD. Future research is planned to test the efficacy of this community-informed approach.

The effectiveness of cognitive-behavioural consultation on sexual function and sexual self-efficacy of women after childbirth.

ObjectiveThe purpose of this study was to investigate the effect of the cognitive-behavioral therapy program (CBT) on the sexual function and sexual self-efficacy of 100 women after childbearing.MethodsIn this experimental pretest-posttest and control group design study, women who passed eight weeks of their delivery and were referred to three health centers, in Shadegan, Iran, from January to April 2019 registered using the simple sampling method and randomly allocated into two groups of case and control. For the CBT group eight weeks of counseling (one session/week), and for the control group, routine educations were provided by health care providers. Both groups filled out the female sexual function index and sexual self-efficacy questionnaires before intervention and eight weeks after the last session.ResultsThere was no significant difference between the CBT and control groups before the intervention in terms of sexual function and sexual self-efficacy, but eight weeks after the intervention, there was a statistically significant difference between the two groups (P = 0.001).ConclusionProper implementation of counseling based on the CBT model improved sexual function and self-efficacy of nulliparous women after childbirth.

Improvements in Depression Outcomes Following a Digital Cognitive Behavioral Therapy Intervention in a Polychronic Population: Retrospective Study.

BackgroundDigital mental health interventions have shown promise in reducing barriers to effective care for depression. Depression and related mental disorders are known to be highly comorbid with common chronic physical conditions, such as obesity and type 2 diabetes. While some research has explored the interaction dynamics of treating populations living with both mental and physical disorders, very little is known about such dynamics in digital care.ObjectiveWe aimed to examine the effectiveness of a 12-week, therapist-supported, app-based cognitive behavioral therapy program in improving symptoms of depression and anxiety. The studied population included adults with a heavy burden of chronic physical disease, including obesity and type 2 diabetes.MethodsA total of 1512 participants with at least moderate depression were enrolled. The treatment cohort consisted of 831 (54.96%) participants who completed a follow-up assessment. The program included structured lessons and tools (ie, exercises and practices) and offered one-on-one weekly video counseling sessions with a licensed therapist for 12 weeks and monthly sessions thereafter. The clinically validated 8-item Patient Health Questionnaire (PHQ-8) and the 7-item Generalized Anxiety Disorder scale (GAD-7) were used to assess depression and anxiety, respectively. Linear mixed-effects modeling was employed to examine changes in depression and anxiety over time. Given correlation among various measures of program usage, a composite variable for depth of usage was used to analyze the correlation between usage and changes in depressive symptoms. Body weight changes from baseline were assessed primarily with digitally connected scales.ResultsOut of 831 participants in the treatment cohort, 74.5% (n=619) showed a clinically significant reduction in depressive symptom severity after 12 weeks, where follow-up PHQ-8 scores had shifted downward by at least one diagnostic category. In total, 67.5% (n=561) of the participants showed a reliable improvement in PHQ-8 scores as measured by the reliable change index. There was an average reduction of 5.9 (SD 5.2) points (P<.001) between baseline and follow-up. Greater program usage was correlated with greater likelihood of reliable improvement in depressive symptoms (odds ratio 1.3, 95% CI 1.1-1.5; P=.002). An exploratory analysis of body weight changes with a multilevel, mixed-effect model suggested that reliable improvement in depressive symptoms at follow-up was associated with significantly greater weight loss at 9 months (β=–1.11, P=.002).ConclusionsThe results provide further support that digital interventions can support clinically meaningful improvements in depression. Some form of synergy in treatment of comorbid depression and obesity or diabetes could be studied in future research. The study was limited by postintervention participant attrition as well as the retrospective observational study design.

Effects of internet-delivered cognitive behavioral therapy for patients with cardiovascular disease and depression on quality of life. A sub-analysis of a randomized controlled trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swedish Research Council (2015-02600), ALF grants Region Östergötland (LIO-600321 and LIO-687531) Background In patients with cardiovascular disease (CVD), depression can cause poorer Health-Related Quality of Life (HRQoL). However, less is known about whether changes in depression over time are associated with changes in HRQoL. We have recently shown that a 9-week internet-based cognitive behavioral therapy (iCBT) program had a significant positive treatment effect on depression in CVD patients and that this effect was maintained at 12-month follow-up. If long-term improvements in depression corresponded to improvements in HRQoL was however not investigated. Purpose To explore if changes in depression after 9 weeks of iCBT are associated with changes in HRQoL at 12 months follow-up. Methods This study is a sub-analysis of a randomized controlled trial evaluating the effects of a nine-week iCBT program for depression in CVD patients. Data from patients who had performed iCBT were analyzed (n=72). Patient Health Questionnaire-9 (PHQ-9) was used to measure depression. The 12-Item Short Form Health Survey (SF12) including the Mental Component Score (MCS) and the Physical Component Score (PCS), and the EQ Visual Analogue Scale (EQ-VAS) were used to measure HRQoL. Data was collected at baseline, 9 weeks, 6 months, and 12 months. Linear mixed model was used to explore long-term treatment effects on HRQoL. Pearson correlation was used to explore the association between changes in depression and HRQoL at 12-month follow-up. Results There was a significant improved treatment effect of iCBT on HRQoL after 12-months (MCS p&amp;lt;.001, PCS p&amp;lt;.032, and EQ-VAS p&amp;lt;.001). Decreased depression was correlated with improved HRQoL after 12-months. The correlation scores between changes in depression and HRQoL were: MCS p&amp;lt;.001, r=-0.62; PCS p&amp;lt;.001, r=-.34; and EQ-VAS r=-.57, p&amp;lt;.001respectively. Conclusion Long term improvement in depression was associated with improvement in HRQoL (Figure 1). Interventions that improve depression in CVD patients are also likely to have sustained positive effect on HRQoL.

Cost-effectiveness of Internet-delivered cognitive behavioural therapy in patients with cardiovascular disease and depressive symptoms

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): The Swedish Research Council and the Medical Research of Southeast Sweden Introduction Cost-effectiveness evaluations of psychological interventions, such as Internet-delivered cognitive behavioural therapy (iCBT) programs, in patients with cardiovascular disease (CVD) are rare. In a recent study we reported that a 9-week iCBT program (n=72) compared to an online discussion forum (ODF) (n=72) had moderate to large effect on depression in CVD outpatients. Purpose To evaluate the cost-effectiveness of this intervention. Methods Cost-effectiveness analysis of a RCT, using an incremental cost-effectiveness ratio (ICER). The costs and effects included in the ICER are from baseline to one year post intervention, but also costs for guidance and support to patients in iCBT and ODF groups. Data on healthcare costs were retrieved from healthcare registries, and the EQ-5D-3L was used to calculate the quality-adjusted life years (QALYs). The ICER can be seen as the additional costs needed to gain an additional QALY by the iCBT compared to ODF. Results At 12-month follow-up, the QALY was significantly higher in iCBT compared to the ODF group (0.713 vs.0.598, p=.007). The mean difference of 0.115 corresponds with 42 extra days in best imaginable health status in favour of the iCBT group over the course of one year. The ICER for iCBT versus ODF was €18,865 per QALY saved. The cost-effectiveness plane indicated that iCBT is a cheaper and more effective intervention in 24.5% of the cases, and in 75% a costlier and more effective intervention than ODF. Only in about 0.5% of the cases, there was an indication of a costlier, but less effective intervention compared to ODF. Conclusions The ICER of €18,865 was lower than the cost-effectiveness threshold range of €23,400-€35,100 as proposed by the NICE guidelines, suggesting that the iCBT treatment of depressive symptoms in patients with CVD is cost-effective.

The Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Tinnitus for Patients with Tinnitus Alone or Combined with Hyperacusis and/or Misophonia: A Preliminary Analysis.

In the United Kingdom, audiologist-delivered cognitive behavioral therapy (CBT) is a key intervention to alleviate the distress caused by tinnitus and its comorbid hyperacusis. However, the availability of face-to-face CBT is limited, and such therapy involves significant costs. CBT provided via the internet provides a potential solution to improve access to CBT for tinnitus. The aim was to perform a preliminary assessment of the effect of a specific program of nonguided internet-based CBT for tinnitus, denoted iCBT(T), in alleviating the problems caused by tinnitus alone or tinnitus combined with hyperacusis. This was a retrospective cross-sectional study. The data for 28 people with tinnitus who completed the iCBT(T) program and answered a series of questions about their tinnitus and hearing status were included in the study. Twelve patients also reported having hyperacusis (including five also with misophonia). The iCBT(T) program has seven self-help modules. Anonymous data were collected retrospectively from patients' answers to the questions in the iCBT(T) initial and final assessment modules. Questionnaires administered within the iCBT(T) program were: 4C Tinnitus Management Questionnaire (4C), Screening for Anxiety and Depression in Tinnitus (SAD-T), and the CBT Effectiveness Questionnaire (CBT-EQ). Responses to the 4C showed a significant improvement from pre- to posttreatment, with a medium effect size. The mean improvement was similar for those with and without hyperacusis. Responses to the SAD-T questionnaire also showed a significant improvement from pre- to posttreatment with a medium effect size. The improvement was significantly greater for participants with tinnitus alone than for participants who also had hyperacusis. For both the 4C and the SAD-T, the improvements were not significantly related to age or gender. Participants' views of the effectiveness of the iCBT(T) program were assessed using the CBT-EQ. The mean score was 50 out of a maximum of 80, indicating moderately high effectiveness. CBT-EQ scores did not differ for those with and without hyperacusis. Based on this preliminary analysis, the iCBT(T) program showed promising results in improving the ability to manage tinnitus and decreasing symptoms of anxiety and depression. Future studies with larger samples and control group(s) are required to further assess various aspects of this program.

Brief Digital Interventions: An Implementation-Sensitive Approach to Addressing School Mental Health Needs of Youth with Mild and Emerging Mental Health Difficulties

Brief digital interventions (BDIs) may help address the mental health needs of students when realworld resource constraints limit access to in-person or longer-form care. This article describes BDIs, which are conceptualized as being at the intersection of short-term interventions, internet-delivered cognitive behavior therapy programs, and measurement-based care. We use a real-world example of a BDI which was delivered in Ontario schools as a practice example for this mode of intervention. We then identify potential clinical and ethical considerations, and we highlight some of the challenges of implementing and evaluating innovative interventions and measurement-based care initiatives in Canadian schools.

Effectiveness of Group Cognitive Behavioral Therapy Programs for Preventing Addiction to Smartphones in Adolescents

Effectiveness of Group Cognitive Behavioral Therapy Programs for Preventing Addiction to Smartphones in Adolescents

Cognitive Behavioral Therapy Program for Cannabis Use Cessation in First-Episode Psychosis Patients: A 1-Year Randomized Controlled Trial

Despite the negative influence of cannabis use on the development and prognosis of first-episode psychosis (FEP), there is little evidence on effective specific interventions for cannabis use cessation in FEP. The aim of this study was to compare the efficacy of a specific cognitive behavioral therapy (CBT) for cannabis cessation (CBT-CC) with treatment as usual (TAU) in FEP cannabis users. In this single-blind, 1-year randomized controlled trial, 65 participants were randomly assigned to CBT-CC or TAU. The primary outcome was the reduction in cannabis use severity. The CBT-CC group had a greater decrease in cannabis use severity and positive psychotic symptoms over time, and a greater improvement in functioning at post-treatment than TAU. The treatment response was also faster in the CBT-CC group, reducing cannabis use, anxiety, positive and general psychotic symptoms, and improving functioning earlier than TAU in the follow-up. Moreover, patients who stopped and/or reduced cannabis use during the follow-up, decreased psychotic symptoms and increased awareness of disease compared to those who continued using cannabis. Early intervention based on a specific CBT for cannabis cessation, may be effective in reducing cannabis use severity, in addition to improving clinical and functional outcomes of FEP cannabis users.

The Effectiveness of Cognitive-Behavioral Therapy in the Resilience of Recovered COVID-19 Patients at the Peak of the Pandemic

Background: The onset of the COVID-19 outbreak brought unprecedented psychological and emotional consequences, especially for recovered patients, so resiliency in disasters could be helpful. Objectives: The present study was conducted to evaluate the effectiveness of cognitive-behavioral therapy (CBT) in the increasing resilience of recovered COVID-19 patients at the peak of the pandemic. Methods: This research was quasi-experimental with a pretest-posttest design and control group. The statistical population of this study included all recovered COVID-19 patients with a mean age of 33.06 years at the peak of the pandemic in Isfahan (N = 30) in 2021-2022. They were selected by purposive sampling and randomly assigned to experimental and control groups (15 subjects in each group). After performing the pretest, the experimental group received a CBT program for 12 sessions, and then the post-test was performed. The required data were collected using the Connor-Davidson Resilience Scale (CD-RISC; 2003). Results: The obtained data were analyzed using descriptive statistics (mean and SD) and inferential statistics (analysis of covariance [ANCOVA]) using SPSS version 20. The findings showed that CBT led to increased resilience and had a significant effect on the experimental group (P &lt; 0.01). Conclusions: CBT can be considered an effective treatment in reducing problems and improving the psychological indicators of recovered COVID-19 patients.

Changes in specific and nonspecific psychopathology network structure after intensive cognitive behavior therapy in patients with anorexia nervosa.

This study aimed to compare eating disorder-specific and nonspecific clinical features in patients with anorexia nervosa before and after intensive enhanced cognitive behavior therapy (CBT-E) via network analysis. All consecutive patients admitted to intensive CBT-E were eligible, and the sample comprised patients aged ≥16 years who completed a 20-week intensive CBT-E program. Body mass index (BMI), Eating Disorder Examination Questionnaire and Brief Symptoms Inventory responses were gathered at baseline and end of treatment, and used to generate statistical networks of the connections between symptoms (nodes) and the strength and centrality thereof. A total of 214 patients were included. Most nodes had relatively similar centrality compared to other nodes in the networks. "Eating concern" and "phobic anxiety" showed the greatest bridge centrality at both time points. No differences were found between baseline and the end of treatment in either global network or individual connection strengths. These findings suggest that some clinical expressions not specific to eating-disorder psychopathology remain strongly connected in the generalized network of patients with anorexia nervosa after CBT-E. Future research should examine whether additional procedures specifically designed to target these symptoms should be integrated into this and other treatments.

Pilot Randomized Control Trial of an App-Based CBT Program for Reducing Anxiety in Individuals with ASD without Intellectual Disability.

This study developed and tested the effectiveness of an app-based cognitive behavioral therapy (CBT) program in alleviating anxiety among adolescents and adults with autism without co-occurring intellectual disability. Thirty participants from 15 to 35years old were randomly assigned to either the intervention or waitlist control group, and self- and caregiver proxy report questionnaires were administered, accompanied by direct behavior observation before and after the intervention period. There was a significant decrease in anxiety level, an increase in positive affect, and a decline in stereotypic behaviors, hyperactivity, noncompliance, and inappropriate speech in proxy reports for the intervention group, compared to the control group. A significant rise in passive response in the direct observation was also seen in the intervention group.

Computer-based training for cognitive behavioral therapy for Spanish-speaking substance users: adaptation and satisfaction

There are few available culturally and linguistically adapted behavioral health interventions for substance use among Spanish-speaking adults. The authors describe the cultural adaptation of an innovative computer-based training for cognitive behavioral therapy program (CBT4CBT). Based in cognitive-behavioral skills training, CBT4CBT utilizes a telenovela to teach monolingual Spanish-speaking adults who have migrated to the United States to recognize triggers; avoid these situations; and cope more effectively with the consequences of substance use. Participants endorsed high levels of satisfaction with the program content and found the material to be easy to understand and relevant to their life experiences.