Cognitive Behavioral Therapy Training Research Articles

Clinical Consultation During a Trauma-Focused Cognitive Behavioral Therapy Community-Based Learning Collaborative: Examination of Consultation Content, Consultative Strategies, and Provider Engagement

Consultation following evidence-based practice (EBP) training enhances the uptake of EBPs. Yet, little is known about what occurs during consultation, and it is often difficult for providers to engage in consultation. This study examined provider engagement in consultation and the content and strategies used during consultation following training in Trauma-focused Cognitive Behavioral Therapy (TF-CBT) as part of a community-based learning collaborative (CBLC). Minute-to-minute live coding of consultation calls revealed most content was clinically-oriented and the most common strategies used by consultants were didactic in nature. Providers with more years of professional experience and those with greater TF-CBT knowledge attended significantly more consultation calls. Providers with a greater average weekly caseload and providers who were supervisors presented significantly more cases on calls. Providers with greater TF-CBT knowledge spoke significantly more minutes on calls. Consistent with previous work, findings highlight difficulties with provider engagement in consultation and that providers with more baseline expertise are most likely to be engaged. Findings suggest tailoring EBP training efforts to better engage providers at greatest risk for low engagement.

Expanding Access to Cognitive Behavioral Therapy: A Purposeful and Effective Model for Integration

Integrated behavioral health (IBH) in primary care is growing as an approach to decrease barriers and provide earlier intervention for youth experiencing behavioral and mental health symptoms. However, increasing access to mental health providers alone without ensuring evidence-based treatment (EBT) is provided will not sufficiently address the current mental health crisis. To spread to scale, IBH needs to be implemented and tested in community-based practices with integrity to EBT. This paper provides a model for implementing cognitive behavioral therapy (CBT) in community pediatric primary care via master’s prepared therapists through an academic-community partnership. This paper describes the hiring practices, training in CBT, ongoing supervision and consultation, and use of data to inform the evolution of the model. Using a retrospective review of the rate of emergency department (ED) admissions per 1,000 patients with a diagnosis of depression, we compared practices enrolled in our academic-community partnership IBH model to practices who implemented their own IBH and practices with no IBH. Across a four-year period, we found that practices enrolled in the academic-community partnership IBH model had a lower number of patients per 1,000 patients with a diagnosis of depression admitted to the ED with behavioral health concerns compared to practices that did not incorporate an IBH therapist. There was no difference in ED admission rates per 1,000 between practices that hired their own IBH and those without IBH. Analysis of costs of the program against generated revenue from billed services demonstrated that the academic-community partnership model shows promise of sustainability.

Plenary Session 2: Late onset psychosis / schizophrenia

Overview: This presentation will focus on late-onset schizophrenia (LOS) as well as ageing of persons with early-onset schizophrenia (EOS). 20% of middle-aged and older patients with schizophrenia have onset of illness after age 40. LOS is characterized by female preponderance, better premorbid functioning, fewer positive symptoms, and less cognitive impairment than EOS. EOS presents a paradox of aging – i.e., there is accelerated physical aging with multimorbidity and elevated mortality, while the mental well-being tends to improve with age. Adverse social determinants of health such as childhood traumas, social isolation, discrimination, and food insecurity worsen health. On the other hand, family and social support and access to necessary healthcare enhance the likelihood of sustained remission and recovery. Antipsychotics tend to be effective at doses lower than those in young adults, though the risk of side effects is higher. Psychosocial interventions like cognitive behavior therapy and social skills training are useful. It is important to employ the principles of Positive Psychiatry including promotion of resilience, social connections, optimism, and healthy lifestyle in people with schizophrenia

Psychotherapy for Ketamine's Enhanced Durability in Chronic Neuropathic Pain: Protocol for a Pilot Randomized Controlled Trial.

Chronic pain affects approximately 8 million Canadians (~20%), impacting their physical and mental health while burdening the health care system with costs of upwards of US $60 billion a year. Indeed, patients are often trialed on numerous medications over several years without reductions to their symptoms. Therefore, there is an urgent need to identify new therapies for chronic pain to improve patients' quality of life, increase the availability of treatment options, and reduce the burden on the health care system. The primary objective of this study is to examine the feasibility of a parallel 3-arm pilot randomized controlled trial whereby patients are randomized to either intravenous ketamine alone, cognitive behavioral therapy (CBT) and mindfulness meditation (MM) training (CBT/MM), or the combination of intravenous ketamine and CBT/MM. The secondary outcome is to assess the durability and efficacy of combination intravenous ketamine and CBT/MM for treatment of chronic pain as compared to CBT/MM or intravenous ketamine alone (assessed at week 20 of the study). This is a single-center, 16-week, 3-arm pilot study that will take place at the Chronic Pain Clinic at St. Michael's Hospital, Toronto, Ontario, which receives 1000 referrals per year. Patients will be enrolled in the study for a total of 20 weeks. Participants who are allocated CBT/MM therapy will receive remote weekly psychotherapy from week 1 to week 16, inclusive of health coaching administered through the NexJ Health Inc (NexJ Health) platform. Patients who are allocated ketamine-infusion therapy will receive monthly ketamine infusion treatments on weeks 2, 7, and 12. Patients who are allocated ketamine+CBT/MM will receive weekly psychotherapy from weeks 1 to 16, inclusive, as well as ketamine infusion treatments on weeks 2, 7, and 12. We will be assessing recruitment rates, consent rates, withdrawal rates, adherence, missing data, and adverse events as pilot outcome measures. Secondary clinical outcomes include changes relative to baseline in pain intensity and pain interference. As of November 1, 2023, the recruitment process has not been initiated. Given the recruitment, consent, and intervention target of 30 participants for this feasibility study, with each patient undergoing monitoring and treatments for a course of 20 weeks, we expect to complete the study by December 2025. This study assesses the feasibility of conducting a 3-arm randomized controlled trial to examine the effects of ketamine administration with the concurrent use of CBT/MM in a population with chronic neuropathic pain. The results of this pilot randomized controlled trial will inform the development of a larger-scale randomized controlled trial. Future studies will be aimed at including a sufficiently powered sample that will inform decisions about optimal treatment calibration and treatment effect duration. ClinicalTrials.gov NCT05639322; https://classic.clinicaltrials.gov/ct2/show/NCT05639322. PRR1-10.2196/54406.

Impact of a cognitive behavioural therapy training program on family physician practices: Cross-sectional study in Norway.

To investigate changes in FPs' self-reported clinical practices after participation in a comprehensive 1-year cognitive behavioural therapy (CBT) training course. Cross-sectional study. Norway. Family physicians. Impact of the CBT training course on FPs' delivery of CBT to patients and their use of referral to specialized mental health care providers. Of the 217 FPs who had participated in the training course between 2009 and 2016, 124 completed the survey (response rate=57.1%); 99.2% of participating FPs reported using CBT tools daily in patient consultations, more than three-quarters reported changing the way they organized their workdays to accommodate CBT, and 75.0% reported using structured CBT consultations at least monthly after completing the course. The most common patient groups receiving structured CBT were those experiencing mild or moderate depression (22.8%), anxiety disorders (30.4%), or a combination of an anxiety disorder and depression (43.5%). The odds of making fewer referrals to specialized mental health care providers were 5.4 times higher among FPs who used Socratic questioning (P=.02), 4.7 times higher among those who provided consultation summaries (P=.01), and 3.3 times higher among those who had participated in a refresher course (P=.05). Comprehensive training in CBT promotes the use of CBT tools and strategies in family practice. Further longitudinal research (ideally randomized controlled studies) on patient outcomes related to CBT provided in family practices is required.

Intervention analysis of CBT and entrepreneurship training for college students’ social anxiety

BackgroundSocial Anxiety Disorder (SAD) is a common mental disorder characterized by intense fear and anxiety in social situations. Social anxiety may prevent college students from actively participating in social activities and innovative entrepreneurial practices, thus affecting their personal growth and career development. The combination of cognitive behavioral therapy and college innovation and entrepreneurship training is expected to provide a comprehensive and effective method for the intervention of college students with social anxiety disorder.Subjects and Methods120 college students with social anxiety disorder were randomly divided into an experimental group and a control group, with 60 people in each group. The experimental group received 10 weeks of cognitive behavior therapy (CBT) combined innovation and entrepreneurship training, while the control group only received innovation and entrepreneurship training. Social anxiety and cognitive status were assessed using the Stanford Acute Stress Response Questionnaire and the 3-Minute Disorder Assessment Scale. SPSS23.0 was used for descriptive statistics, analysis of variance and correlation analysis.Results The social anxiety of the experimental group was significantly reduced, and the SASRQ score was significantly reduced compared with the control group. The experimental group performed better on the 3D-CAM score, indicating improved cognitive status.ConclusionsCognitive behavioral therapy combined with innovation and entrepreneurship training has a significant intervention effect on the social anxiety disorder of college students, which is helpful in improving their social ability and innovation and entrepreneurship potential. This comprehensive intervention strategy has a positive significance in promoting the overall development and mental health of college students.

Remotely-administered resilience and self-compassion intervention targeting loneliness and stress in older adults: a single-case experimental design

Objectives Loneliness and chronic stress are prevalent issues for older adults that have been linked to adverse health outcomes. We conducted a remote resilience and self-compassion intervention targeting loneliness and chronic stress. Methods This study utilized a multiple-phase-change single-case experimental design with three consecutive 6-week phases: control, intervention, follow-up. Assessments and biomarker collection (blood pressure, inflammation, sleep actigraphy) were conducted at each phase. Participants completed a 6-week remotely-administered resilience and self-compassion intervention using techniques from cognitive behavioral therapy and resilience training. Repeated measures ANOVAs were conducted over the 12-week period from control (week 0) to intervention completion (week 12) and over the 18-week period from control (week 0) to follow-up (week 18) in supplemental analyses. Results Participants reported a reduction in stress (p < 0.001; ηp 2 = 0.15), depression (p = 0.02; ηp 2 = 0.08), and loneliness (p = 0.003; ηp 2 = 0.18), and an increase in self-compassion (p = 0.01; ηp 2 = 0.13) from control to intervention completion (weeks 0−12). Post-hoc tests revealed that stress reduced significantly during the intervention phase (weeks 6−12) and loneliness reduced significantly during the control phase (weeks 0−6). Some improvements in blood pressure, inflammation, and sleep quality were noted in a subsample of participants. Conclusion Findings indicate that our remote resilience and self-compassion intervention for older adults targeting loneliness and chronic stress was efficacious.

The Effectiveness of Cognitive-Behavioral Approach in Alleviation of Depression, Anxiety and Stress Risks in Diabetic People.

Objective: Stress, anxiety, and depression affect the diabetic patient by causing symptomatic changes. Considering the destructive effects of psychological symptoms on the health status of diabetic people, our aim was to investigate the effectiveness of cognitive-behavioral therapy (CBT) in improving the psychological outcomes of diabetic patients. Method : This trial is a quasi-experimental type that uses a pretest-posttest design with a control group. A total of 62 people were selected based on the inclusion criteria and randomly divided into two experimental and control groups. All subjects in the intervention group underwent CBT training twice a week for eight sessions, while those in the control group did not receive this intervention. Before and following the intervention, the depression, anxiety and stress scale (DASS-42) was utilized to evaluate the psychological symptoms of all participants. The data were analyzed through analysis of covariance (ANCOVA) and SPSS-23 software. Results: There were no significant differences between the two groups in terms of age, gender, marital status, parenthood, and education level (P > 0.05, n = 30 in each group). Additionally, there was no significant difference between the mean DASS-42 scores before the intervention (P > 0.05). However, after the intervention, the experimental group exhibited reduced levels of depression, anxiety, and stress compared to the control group (P < 0.001). The values of Eta for depression, anxiety, and stress subscales were equal to 0.809, 0.669 and 0.776, respectively, which means that 80.9%, 66.9%, and 77.6% of the changes in these symptoms in the experimental group are related to the training received through the CBT approach. Conclusion: It can be concluded that diabetic patients who suffer from psychological symptoms can benefit from the CBT approach to reduce their stress, anxiety, and depression levels.

Expert consensus on the diagnosis and treatment of adult attention deficit hyperactivity disorder in China (2023 Edition)

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children, with 30%-50% persisting into adulthood. In addition, adult ADHD patients have more comorbidities, are more difficult to identify, and have a wider range of impairments on individual function, thereby leading to more serious adverse effects on medical care, economy and society. This consensus establishes the diagnose of adult ADHD based on the 11th edition of International Classification of Diseases (ICD-11), determines the treatment plans based on the etiology and pathogenesis of the disease, recommends psycho-stimulants as the first-line pharmacotherapy for adult ADHD and selective noradrenalin reuptake inhibitors (NARIs) as the second-line pharmacotherapy to reduce the core symptoms, and combines non-pharmacological treatments, such as cognitive behavioral therapy, health education and lifestyle training, aiming to improve patients' functioning and quality of life to the utmost.

Evaluation of the impact of a self-stigma reduction programme on psychosocial outcomes among people with schizophrenia spectrum disorder

PurposeThe purpose of this study is to evaluate the effectiveness of a self-stigma reduction programme on self-stigma.Design/methodology/approachA randomized controlled trial was conducted from November 2017 to December 2018 with 278 people diagnosed with schizophrenia (PDwS). Participants were randomly assigned to receive a self-stigma reduction programme (psychoeducation, cognitive behavioural therapy and social skills training) or treatment as usual.FindingsPDwS in the intervention group experienced a greater reduction in the level of self-stigma (20.19 vs −0.62; p < 0.001) at post-intervention and (37.35 vs −0.66; p < 0.001) at six-month follow-up.Originality/valueThe first RCT examines the problem and implements intervention in middle east country. Also, the authors have conducted high-quality RCT.

Adverse events in cognitive behavioral therapy and relaxation training for children and adolescents with obsessive-compulsive disorder: A mixed methods study and analysis plan for the TECTO trial

BackgroundKnowledge on adverse events in psychotherapy for youth with OCD is sparse. No official guidelines exist for defining or monitoring adverse events in psychotherapy. Recent recommendations call for more qualitative and quantitative assessment of adverse events in psychotherapy trials. This mixed methods study aims to expand knowledge on adverse events in psychotherapy for youth with OCD. MethodsThis is an analysis plan for a convergent mixed methods study within a randomized clinical trial (the TECTO trial). We include at least 128 youth aged 8–17 years with obsessive-compulsive disorder (OCD). Participants are randomized to either family-based cognitive behavioral therapy (FCBT) or family-based psychoeducation and relaxation training (FPRT). Adverse events are monitored quantitatively with the Negative Effects Questionnaire. Furthermore, we assess psychiatric symptoms, global functioning, quality of life, and family factors to investigate predictors for adverse events. We conduct semi-structured qualitative interviews with all youths and their parents on their experience of adverse events in FCBT or FPRT. For the mixed methods analysis, we will merge 1) a qualitative content analysis with descriptive statistics comparing the types, frequencies, and severity of adverse events; 2) a qualitative content analysis of the perceived causes for adverse events with prediction models for adverse events; and 3) a thematic analysis of the participants’ treatment evaluation with a correlational analysis of adverse events and OCD severity. DiscussionThe in-depth mixed methods analysis can inform 1) safer and more effective psychotherapy for OCD; 2) instruments and guidelines for monitoring adverse events; and 3) patient information on potential adverse events. The main limitation is risk of missing data. Trial registrationClinicalTrials.gov identifier: NCT03595098. Registered on July 23, 2018.

How mindfulness-based cognitive behavior therapy and assertiveness training can reduce postpartum depression

How mindfulness-based cognitive behavior therapy and assertiveness training can reduce postpartum depression

Distinct neural networks predict cocaine versus cannabis treatment outcomes.

Treatment outcomes for individuals with substance use disorders (SUDs) are variable and more individualized approaches may be needed. Cross-validated, machine-learning methods are well-suited for probing neural mechanisms of treatment outcomes. Our prior work applied one such approach, connectome-based predictive modeling (CPM), to identify dissociable and substance-specific neural networks of cocaine and opioid abstinence. In Study 1, we aimed to replicate and extend prior work by testing the predictive ability of the cocaine network in an independent sample of 43 participants from a trial of cognitive-behavioral therapy for SUD, and evaluating its ability to predict cannabis abstinence. In Study 2, CPM was applied to identify an independent cannabis abstinence network. Additional participants were identified for a combined sample of 33 with cannabis-use disorder. Participants underwent fMRI scanning before and after treatment. Additional samples of 53 individuals with co-occurring cocaine and opioid-use disorders and 38 comparison subjects were used to assess substance specificity and network strength relative to participants without SUDs. Results demonstrated a second external replication of the cocaine network predicting future cocaine abstinence, however it did not generalize to cannabis abstinence. An independent CPM identified a novel cannabis abstinence network, which was (i) anatomically distinct from the cocaine network, (ii) specific for predicting cannabis abstinence, and for which (iii) network strength was significantly stronger in treatment responders relative to control particpants. Results provide further evidence for substance specificity of neural predictors of abstinence and provide insight into neural mechanisms of successful cannabis treatment, thereby identifying novel treatment targets. Clinical trials registation: "Computer-based training in cognitive-behavioral therapy web-based (Man VS Machine)", registration number: NCT01442597 . "Maximizing the Efficacy of Cognitive Behavior Therapy and Contingency Management", registration number: NCT00350649 . "Computer-Based Training in Cognitive Behavior Therapy (CBT4CBT)", registration number: NCT01406899 .

A Comparative Evaluation of Cognitive Behavioral Therapy and Behavioral Parent Training in Treating Attention Deficit Hyperactivity Disorder

The article summarizes the popular treatment of attention deficit hyperactivity disorder. Attention deficit hyperactivity disorder (ADHD) is a mental disorder characterized as possessing two behavioral issues: inattentiveness and impulsiveness or hyperactivity. An individual with the first subtype of attention deficit hyperactivity disorder is recognized as having six or more symptoms related to inattention and less than six symptoms of hyperactivity in a duration of six months or more. By comparing cognitive behavioral therapy and behavioral parent training in treating attention deficit hyperactivity disorder, a validity and effectiveness declaration is drawn on both therapies. In the scope of this article, cognitive behavioral therapy, and parenting skills training on the consequences of childrens behaviors will be examined and compared. It also provides some aspects of the differences for further studies. Cognitive behavioral therapy and consequence-based behavioral parent training are two effective and adequate treatments for ADHD. While the former consists of the section of planning and organizing, reducing distractibility and applying adaptive thinking, the latter centralizes on the idea of positive reinforcement where parents can choose techniques such as the token economy and praising to motivate particular behaviors.

TF-CBT Training Augmented with a Self-Care Focus: Understanding Facilitators and Barriers to Treatment Implementation.

Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e., Practice What You Preach; PWYP) was developed to help facilitate the implementation of TF-CBT and to enhance clinicians' coping and decrease stress. The primary purpose of this study was to determine whether the PWYP-augmented training met three Objectives: (1) increase clinicians' feelings of TF-CBT competency; (2) improve clinicians' coping abilities/reduce clinicians' stress; and (3) increase clinicians' insight into the benefits and/or challenges clients may experience in treatment. An exploratory aim was also developed to identify additional facilitators and barriers of TF-CBT implementation. The written reflections of 86 community-based clinicians who participated in the PWYP-augmented TF-CBT training were examined using qualitative methods. The majority of clinicians indicated increased feelings of competency and improved coping abilities and/or stress levels; almost half mentioned increased insight into clients' experiences. The most frequently mentioned additional facilitators were related to elements of the TF-CBT treatment model. Anxiety/self-doubt was the barrier most frequently mentioned, though all clinicians who mentioned this barrier indicated it lessened or resolved over the course of the training. Incorporating self-care strategies into trainings may serve as a facilitator for TF-CBT implementation by enhancing the competency and well-being of clinicians. The additional insights into barriers and facilitators can be used to further improve the PWYP initiative and future training and implementation efforts.

Understanding drift in the treatment of eating disorders using a mixed-methods approach

ABSTRACT Despite strong empirical support for treatments of eating disorders, research has demonstrated a trend of clinicians deviating from protocols outlined in empirically supported manuals. The present study used a convergent mixed-methods design to understand clinicians’ use of and drift from empirically supported treatments in a sample of 114 licensed clinicians in the US who had substantial experience (i.e. one-third of caseload) working with patients with eating disorders and training in cognitive-behavioral therapy (CBT), family-based therapy (FBT), and/or interpersonal therapy (IPT) for eating disorders. Results revealed that 63.7–76.3% of clinicians drift from empirically supported treatments and 71.8% were aware they deviated from empirically supported treatments. Qualitative analyses identified client differences (57.2%) to be the primary reason why clinicians drift, with less participants describing therapist factors (20.4%), treatment shortcomings (12.6%), treatment setting (11.7%), logistic constraints (4.9%) and family factors (4.9%) as reasons why they drift. These findings suggest that drift for most clinicians may be better explained under the umbrella of evidence-based practice. Clinicians also identified a number of ways in which treatment and access to treatment can be improved. This broadened understanding of the use of empirically supported treatments within evidence-based practice may serve to help bridge the gap between research and practice.

A CBT-Based Intervention Model for Computer Anxiety Management among first-year students at the National Open University of Nigeria in South-West Nigeria

The study investigated the effectiveness of Cognitive Behaviour Therapy (CBT) in treating computer phobia among distance learning first-year students in south-western Nigeria. The moderating effects of age and gender were examined. Technology Acceptance Model was taken as the framework for the study, with the pre-test-post-test control group quasi-experimental design, where 55 computer anxious students first-year students who met the screening criteria were randomly allocated into the CBT and the Control groups. For screening, the Computer Anxiety Scale Revised (=0.89) with a norm of 60.0 was used, while Computer Anxiety Rating Scale (=0.86) was utilised to measure the criterion variable. Treatment lasted eight weeks using the CBT training guides. Data analysis was conducted using covariance and post-hoc multiple classification analysis at a significance level of 0.05. Participants mean age was =32.70, with 65.5% females. It was found that the treatment group was significantly affected by the management of computer anxiety among NOUN freshmen (F(1,46) = 42.492, p0.05, =0.480). Participants in the CBT had the least adjusted mean (=27.260), and the control group had a higher adjusted mean score (= 39.733). Participants in the treatment groups and the control group are significantly affected by age when it comes to computer anxiety (F(2,123)=4.548, p0.05, 0.090). There is a significant effect of age in the management of computer anxiety among the participants; gender did not significantly impact computer anxiety. It is recommended that educational and counselling psychologists should employ this therapy to reduce computer anxiety. Service providers should consider age in computer appreciation training for distance learners.

Sensa Mobile App for Managing Stress, Anxiety, and Depression Symptoms: Pilot Cohort Study.

An increase in depression, anxiety, and stress symptoms worldwide, attributed to the COVID-19 pandemic, has been reported. If not treated, it may negatively affect a person's everyday life by altering physical and social well-being and productivity and increasing expenditure on health care. Cognitive behavioral therapy (CBT)-based interventions are gaining popularity as a means to reduce stress and alleviate anxiety and depression symptoms. Moreover, CBT delivered through a mobile app has the same elements as traditional CBT training (eg, guided discovery). However, unlike conventional training, users of mobile apps are allowed to tailor their own experience at their own speed and schedule. This study aims to analyze Sensa users' retrospective data and explore the dose-duration effect to find the optimal usage time when the user showed results. The study cohort comprised 381 consecutive community-based nonclinical users who started using Sensa between October 2021 and March 2022. All users included in the study took the Depression Anxiety Stress Scale-21 (DASS-21) assessment at least 2 times. Other parameters from the database containing all self-reported data were gender, number of active days, total time of use, and age. The primary outcome of the study was a change in the DASS-21 score. Statistical analyses were performed using GraphPad Prism (version 9, GraphPad Software). In addition, a logistic regression model was created to predict how the obtained independent parameters influenced the DASS-21 score. The main finding of our study was that the majority of participants who started using Sensa were experiencing depression, anxiety, and stress symptoms (92.13%, 80.05%, and 87.93%, respectively). There was a statistically significant decrease of the DASS-21 subdomain scores after the use of the application (anxiety: mean 7.25, SD 4.03 vs mean 6.12, SD 4.00; P=.001; depression: mean 11.05, SD 4.26 vs mean 9.01, SD 4.77; P=.001; stress: mean 11.42, SD 3.44 vs mean 9.96, SD 3.65; P<.001). Finally, the logistic regression model showed that users who were using the app for more than 24 days and had at least 12 active days during that time had 3.463 (95% CI 1.142-11.93) and 2.644 (95% CI 1.024-7.127) times higher chances to reduce their DASS-21 subdomain scores of depression and anxiety, respectively. Using the Sensa mobile app was related to decreased depression, anxiety, and stress symptoms.

Systematic review of training in cognitive-behavioral therapy: Summarizing effects, costs and techniques.

With the steadily growing importance of psychotherapeutic care, there is also an increasing need for high-quality training. We analyze the literature published between 2009 and 2022 on the effectiveness of training in cognitive behavioral therapy. The review addresses current gaps in the literature by focusing on the description of specific training components and their associated costs, as well as examining therapist-level predictors of training effectiveness. Our findings confirm the effect of additional supervision on both therapist competence and patient outcomes. Instructor-led training and self-guided web-based training seem to moderately increase competence, especially when targeting specific and highly structured treatments or skills. The level of prior training and experience of a therapist appears to predict the strength of training-related gains in competence. Few studies analyzed the differential effect of certain elements of training (e.g., the amount of active learning strategies) and training costs were generally not reported. Future studies should replicate or expand the existing evidence on active ingredients and therapist-level predictors of training effectiveness. Costs should be systematically reported to enhance the comparability of different training strategies.

Association between perceived social support and suicide ideation distress among psychiatric inpatients: The role of thwarted interpersonal needs.

The interpersonal theory of suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) are proximal risk factors for suicide ideation; however, there are mixed results regarding this hypothesis among psychiatric inpatients. The current study examined the mediating role of TB and PB in the relationship between perceived social support (i.e., support from family, friends, a significant other, and total) and suicide ideation distress among psychiatric inpatients. Participants (short-term psychiatric inpatients; N = 139) were administered self-report assessments cross-sectionally. Nonparametric mediation results indicated that the total (additive) indirect effects of TB and PB, in parallel, were significant in all models, yet there were only significant specific (unique) indirect effects of PB. TB and PB, in combination, may be proximal risk factors for suicide ideation distress among psychiatric inpatients with lower perceived social support from family, friends, a significant other, and in total. These findings are congruent with the interpersonal theory of suicide's propositions that the combination of TB and PB increases the risk for suicide ideation. Clinicians may consider using interventions that target increasing perceived social support and decreasing TB and PB (i.e., cognitive behavioral therapy and social skills training) for this population.