Cognitive Therapy Research Articles

Preliminary feasibility study of a cognitive stimulation therapy programme for older adults with an intellectual disability.

Despite the increased risk for people with an intellectual disability developing dementia, post-diagnostic psychosocial supports such as cognitive stimulation therapy (CST) are not routinely offered and there is limited research examining this intervention with people with intellectual disabilities. The aim of this study was to explore the feasibility of CST for older adults with intellectual disability to support active ageing. Five client participants attended a 14-session CST group and four staff attended a focus group. Reflexive thematic analysis was used to investigate the client and staff narratives. Three key themes were generated: (1) Brain Health, (2) Connecting with others, and (3) Barriers and Enablers. Findings indicated the suitability of CST as a way of supporting active ageing for older adults with intellectual disability. This study adds to the growing knowledge about service provision for older adults and their changing needs as they age and identifies clinical implications such as staff training to support intervention adherence.

Prise en charge non médicamenteuse du TDAH

Attention Deficit Disorder Hyperactivity (ADHD) is characterized by difficulties in regulating the attention, emotions, behavior and motivation of affected children and adults.Before considering prescribing methylphenidate, expert recommendations insist on the use of non-pharmacological treatment to improve the quality of life of sufferers and their families.This article provides an overview of the therapeutic strategies available for children and adults, which may be offered following an assessment of specific needs: psychoeducation, parenting skills training programs, behavioral, cognitive and emotional therapy (CBT) programs and cognitive remediation programs.

The Effectiveness of Mindfulness-Based Cognitive Therapy to Improve Anxiety Symptoms and Quality of Life in Breast Cancer Patients.

Breast cancer patients often experience anxiety, impacting their Quality of Life (QOL) . Mindfulness-Based Cognitive Therapy (MBCT) is a 3rd generation psychotherapy from CBT combined with MBSR where mindfulness methods are carried out in a structured and scheduled manner, able to provide a pause between the stressor and the automatic response it causes. This study aimed to assess MBCT's effectiveness in alleviating anxiety and enhancing QOL in Stage III breast cancer patients undergoing chemotherapy, with mild-moderate anxiety disorders. The experimental research, conducted at Moewardi General Hospital Surakarta from March to June 2023, employed a quasi-experimental pretest-posttest control group design. Thirty subjects were divided into intervention (MBCT) and control (psychoeducation) groups. Participants completed demographic forms, disease history, and assessments using the Hospital Anxiety & Depression Scale (HADS-A) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). There was a significant improvement in HADS-A scores in both groups (P <0.001) where the difference in the median HADS score in intervention group was higher compared to the control group. The effect of MBCT to the score improvement of HADS-A showed statistically significant results P=0.003 with HR 1.288. In the EORTC QLQ C30 Global score, the intervention group experienced a significant increase P<0.001, and in the control group, it did not significantly increase p=0.087 although multivariate analysis showed that MBCT was not significant in improving the global EORTC score. From the continued multivariate analysis of the EORTC QLQ C30 function, score improvement was significantly influenced by MBCT with P=0.035 and HR 3.086. Meanwhile, for the EORTC symptoms, score improvement was influenced by MBCT with P=0.005 and HR3.401. There is a score improvement in HADS-A and EORTC with the provision of MBCT psychotherapy and with the provision of psychotherapy. However, the HADS and EORTC improvement scores were significantly higher with MBCT compared to psychotherapy alone.

Does mindfulness-based cognitive therapy with tapering support reduce risk of relapse/recurrence in major depressive disorder by enhancing positive affect? A secondary analysis of the PREVENT trial.

Mindfulness-based cognitive therapy (MBCT) is a viable alternative to maintenance antidepressant medication (M-ADM) to reduce risk of relapse/recurrence (RR) in recurrent depression, but its mechanism of action is not yet fully articulated. This secondary analysis of the PREVENT trial examined if MBCT with support to taper medication (MBCT-TS) reduces risk of RR in part by enhancing positive affect (PA). In a single-blind, parallel, group randomized controlled trial, adults with ≥3 prior depressive episodes, but not currently in episode and who were taking M-ADM, were randomized to receive either MBCT-TS or ongoing maintenance M-ADM. The primary outcome was RR over 24-month follow-up. Levels of positive affect were assessed at intake and posttreatment. The original PREVENT trial was preregistered (ISRCTN 26666654), but this secondary analysis was not. Four hundred and twenty-four individuals (predominantly female and of White British ethnicity) were recruited, with 212 randomized to each arm. MBCT-TS led to significantly greater PA relative to M-ADM at posttreatment assessment (Δ = 2.78, 95% CI [1.47, 4.08], p < .001). RR was experienced during follow-up by 194 individuals (100 M-ADM; 94 MBCT-TS). Greater intake PA predicted a reduced hazard of RR across treatments (p < .001; hazard ratio = .96, 95% CI [0.94, 0.98]). In individuals who had not relapsed by posttreatment with complete data (121 M-ADM; 145 MBCT-TS), greater increase in PA from intake to posttreatment mediated reduced risk of subsequent RR (p = .04). These findings suggest that greater levels of PA predict reduced risk of RR and that MBCT-TS in part acts to protect from RR when withdrawing from M-ADM by increasing PA. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effect of Cognitive Therapy on Psychosis Clients with Suicide Risk: Literature Review

Psychosis is a mental or psychiatric disorder characterized by hallucinations, delusions, chaotic behavior, and accompanied by poor insight. A systematic review and meta-analysis study showed that individuals with a diagnosis of psychosis have a high prevalence of suicide. One of the psychotherapies given to psychosis clients with suicide risk is cognitive therapy (CT). Objective: To determine the effect of cognitive therapy (CT) on psychosis clients with suicide risk Articles discussed in this literature review were obtained through article searches in electronic journal databases, namely Science Direct, ProQuest, Wiley Online Library, EBSCOhost, Sage Journals, and ClinicalKey. The inclusion criteria of this journal review were human studies, English, and free fulltext. The results showed that CT in clients at risk of suicide has a significant effect in reducing suicide risk through mechanisms to correct thought distortions and build positive thoughts and beliefs to produce adaptive coping mechanisms. This study has implications for the importance of applying cognitive therapy as part of psychotherapeutic interventions for clients with psychosis who are at risk of suicide. This therapy not only helps reduce symptoms associated with psychosis, but also plays a role in reducing suicidal tendencies by correcting maladaptive thoughts and beliefs.

Neural Cyber Augmentation (NCA): A Future Frontier in Public Health

Neural Cyber Augmentation (NCA) is a groundbreaking interdisciplinary field that integrates neuroscience, cybernetics, and biotechnology to enhance human cognitive and physical capabilities. This technology holds transformative potential for public health, enabling advancements in cognitive enhancement, disease management, and human-machine interaction. Early research in brain-computer interfaces (BCIs) demonstrated the feasibility of using neural signals to control external devices, laying the foundation for more complex applications such as advanced prosthetics and cognitive training. Subsequent developments in cybernetic implants have significantly improved the quality of life for individuals with sensory and motor impairments by providing enhanced capabilities beyond natural limits. The integration of artificial intelligence (AI) with neural interfaces has further propelled the field, enabling personalized cognitive training and adaptive therapies. Despite these advancements, the ethical and social implications of NCA, such as privacy concerns, informed consent, and equitable access, must be addressed. Future research should focus on improving neural interfaces, integrating AI for personalized interventions, establishing comprehensive ethical guidelines, conducting longitudinal studies on long-term effects, and developing strategies to ensure accessibility for all. By addressing these challenges, NCA has the potential to revolutionize public health and usher in a new era of human enhancement and well-being.

Care coordinator delivered method of levels therapy to improve engagement and other outcomes in early psychosis (CAMEO): protocol for a feasibility cluster-randomised controlled trial

BackgroundRates of disengagement from early intervention in psychosis (EIP) services are high. Care coordinators make up the largest staff group in EIP services and have the most frequent and sustained contact with service users. The quality of relationships between service users and care coordinators plays a central role in determining the effectiveness of EIP services. Care coordinators, however, are not routinely offered training in psychosocial interventions that could enhance the therapeutic impact of their role. Method of levels (MOL) is a flexible, transdiagnostic cognitive therapy with potential advantages over previously evaluated approaches. Training care coordinators in MOL could make their routine contacts with service users more helpful and improve outcomes such as recovery rates and levels of engagement.AimsThis study aims to assess the feasibility of training care coordinators in EIP services to deliver MOL, to understand whether this approach might improve service user engagement and recovery from psychosis compared to treatment as usual, and to assess the feasibility of conducting a cluster-randomised controlled trial (C-RCT) with clustering at the level of teams. Specific feasibility outcomes relate to the recruitment and retention of participants, care coordinators’ level of engagement with the MOL training and supervision programme, implementation of MOL in practice, and the acceptability of the intervention amongst participants.MethodsA feasibility parallel group cluster-randomised controlled trial (C-RCT) designs with two arms: (1) treatment as usual (TAU) or (2) TAU plus support from a care coordinator who has received training in MOL. Randomisation will take place at the level of EIP teams with an allocation ratio of 1:2 in favour of the intervention arm. Our recruitment target is 12 EIP teams, 24 care coordinators working in participating EIP teams, and up to 96 service users working with participating care coordinators. Outcomes will be collected at baseline, 3 months, and 6 months. Qualitative methods will be used to understand participants’ experiences of the study, MOL training programme, and MOL intervention.DiscussionThis is the first study that aims to evaluate the feasibility of training EIP care coordinators to deliver MOL in their routine practice. Training care coordinators in MOL could enhance the quality of relationships between care coordinators and service users and improve outcomes for people experiencing early psychosis. Results will be used to determine the appropriateness of progressing to a larger evaluation trial.Trial registrationThis study was prospectively registered with the ISRCTN Registry (14082421).

Treatment mechanism and outcome decoupling effects in cognitive therapy, mindfulness-based stress reduction, and behavior therapy for chronic pain.

Findings suggest that cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) for chronic pain produce improvements through changes in putative mechanisms. Evidence supporting this notion is largely based on findings showing significant associations between treatment mechanism variables and outcomes. An alternative view is that treatments may work by reducing or decoupling the impact of changes in mechanism variables on changes in outcomes. We examined the degree to which relationships between previous changes in potential treatment mechanisms and subsequent changes in outcomes changed as treatment progressed and vice versa. Cognitive therapy, MBSR, BT, and treatment as usual (TAU) were compared in people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of putative treatment mechanisms and outcomes. Lagged analyses revealed mechanism × session number interactions and outcome × session number interactions, such that associations between mechanism and outcome variables were strong and significant in the first third of treatment, but weakened over time and became nonsignificant by the last third of treatment. These effects were similar across treatment conditions but did not emerge among people undergoing TAU. Results suggest that during the course of CT, MBSR, and BT, the links between changes in treatment mechanism variables became decoupled from subsequent changes in outcomes and vice versa. Thus, starting by midtreatment and continuing into late treatment, participants may have learned through participation in the treatments that episodes of maladaptive pain-related thoughts and/or spikes in pain need not have detrimental consequences on their subsequent experience.

Past, Present, and Future of Cognitive Behavioral-based Psychotherapies for Moral Injury

Past, Present, and Future of Cognitive Behavioral-based Psychotherapies for Moral Injury

Kidnapping-Induced Post-Traumatic Stress Disorder in an Elderly Nigerian Woman: Biopsychosocial Insights and Cognitive Processing Therapy Outcomes

Kidnapping-Induced Post-Traumatic Stress Disorder in an Elderly Nigerian Woman: Biopsychosocial Insights and Cognitive Processing Therapy Outcomes

Psychotherapy of generalized anxiety disorder

Generalized anxiety disorder is characterized by persistent, poorly controlled anxiety and fears for various reasons. Thoughts are dominated by the themes of danger. Nonspecific symptoms include tension, restlessness, fatigue, poor concentration, irritability and dysautonomia. In the long run, the risk of depression and alcoholism is increased, comorbidity with affective, addictive and other disorders is often encountered. The article provides a brief overview of psychotherapy methods for this disorder. The cognitive behavioral psychotherapy appears to be most effective. One of the main goals of the therapy is training of realistic and objective thinking. Using self-observation, the patient becomes aware of his tendency to seek out and exaggerate threats. The problem-solving training can be used to improve social competence and coping skills. Various relaxation methods and other varieties of psychotherapy are applied. The schema therapy is an integrative approach including elements of different methods. Internet counseling can be used in isolation or as an adjunct to conventional psychotherapy. Anxiety disorders were diagnosed relatively rarely in Russia, and the number of psychotherapists was smaller than in other developed countries. Today, the situation is changing thanks to success of psychotherapy and development of individual rehabilitation regimes.

Practitioner Review: Treatments for young people who self-harm - challenges and recommendations for research and clinical practice.

Self-harm is very common in young people and is associated with suicide. Rates of both self-harm and suicide have increased in young people, particularly in females. There is a clear need to identify new approaches to prevent repeat self-harm. We significantly update and build on previous reviews with the aim of identifying issues in research relevant to clinical practice. We identify challenges in developing, implementing and evaluating treatments for self-harm in children and adolescents, suggest a way forward for research, and provide clear and practical guidance for clinicians on how to apply current research evidence in the real world. Currently, there is limited evidence for effective interventions, other than some support for dialectical behaviour therapy for adolescents (DBT-A). To improve research and, by extension, clinical practice, future studies need to address psychosocial factors associated with youth self-harm and suicide, investigate the critical mechanism(s) of action, ensure trials are sufficiently powered and representative, and involve young people more actively in the design, implementation and evaluation of these approaches. Consideration should also be given to alternative research designs, such as pragmatic or adaptive clinical trials, as well as registry-based randomised controlled trials which leverage administrative data collected in routine clinical practice, to help meet these goals. Recommendations for practice include undertaking comprehensive assessment and formulation, and offering DBT-A where indicated. There should be further development and evaluation (with input from young people) of Cognitive Behavioural-based Therapy adapted for young people. Greater attention to the role of the therapeutic relationship and family involvement (where possible) is also an important considerations, irrespective of the specific therapeutic modality. Finally, more consideration should be given to improving staff training to ensure all clinical staff feel equipped to treat young people who self-harm in a person-centred and compassionate manner.

The Effect of Cognitive Therapy on the Ability to Control Negative Thoughts in Low Self-Esteem Patients

Low pride is the appearance of negative thoughts about the meaning of self as a response to a situation. Negative thoughts can influence how you think about yourself and how you view the world and can interfere with work, study, and daily activities. Therapy is cognitively focused on helping the client identify and correct maladaptive thoughts, type automatic behaviors, and change behaviors caused by various emotional problems. This research aims to analyze the influence of cognitive therapy on the ability to control negative thoughts in patients who price themselves low. This research uses a quantitative quasi-experimental study with a pretest-posttest non-equivalent group control design. The sample for this study was 64 respondents from patients with low self-esteem who were hospitalized, divided into 32 intervention groups and 32 control groups. The sampling technique for this research uses purposive sampling. Research data collection used the ATQ-B-15 ( Automatic Thoughts Questionnaire – Believability- 15 ) instrument. Data were analyzed using descriptive statistics, dependent t-test, and independent t-test. The results showed a change in the intervention group's ability to control negative thoughts before and after cognitive therapy (t = 15.84 ; p = 0.00). There was a difference in the ability to control negative thoughts in the post-test of the control and intervention groups ( Sig. (2-tailed) = 0.00 or p-value &lt; 0.05). Giving cognitive therapy has a significant effect on reducing the ability to control negative thoughts in low self-esteem patients.

Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.

The Power of Perception: Unpacking the Role of Negative Thinking in High School Students’ Test Anxiety

The main purpose of this study is to determine the factors that contribute to the formation and maintenance of negative cognitions in adolescents. The present study employs a qualitative methodology to examine test-related negative cognitions of senior high school students with test anxiety. The consensus qualitative research (CQR) method was employed in the study design. Subsequently, fifteen randomly selected students were administered an inventory prepared using semi-structured interview questions, test anxiety, cognitive and behavioral therapy literature, and expert opinions. It was revealed that students' negative cognitions were clustered in four domains: self-oriented, other-oriented, future-oriented, and test-oriented. The self-orientated domain had three themes: self-criticism, lack of confidence, and high self-expectations. Other-oriented domain contained two themes: blaming others and concern about the social consequences of failing. The future-orientated domain had two themes: reading the future and intolerance to uncertainty. Lastly, the test-oriented domain had three themes: distraction during test, inefficient test-taking strategies, and negative study skills assessment. The study’s findings revealed that students have negative cognitions that have emerged as thoughts related to self, others, the future, and testing itself. These negative thoughts may affect students’ test anxiety levels, confidence, academic performance, and well-being. These findings were generally consistent with the literature and were discussed considering the relevant literature. It is suggested that mental health professionals and educators can use the cognitions addressed within the scope of the research to support students to improve their well-being, academic performance and resilience.

Examining Ethnoracial Differences in Retention in Evidence-Based Treatments for Posttraumatic Stress Disorder Secondary to Military Sexual Trauma.

Improving and expanding mental health treatment for Veterans who have experienced military sexual trauma (MST) is currently a top priority in Veterans Healthcare Administration. Many of these Veterans develop posttraumatic stress disorder (PTSD), and there is increasing recognition that diversity is a core treatment consideration for Veterans who have experienced trauma. As such, more information is needed concerning the relationship between trauma-focused treatment attrition and ethnoracial identity in Veterans who have experienced MST. This article presents two studies exploring dropout from a Midwestern Department of Veterans Affairs (VA) PTSD clinic in samples of Veterans who experienced MST. These studies aim to reduce this knowledge gap by contrasting Black and White Veterans' retention in trauma-focused care. In Study 1 (n = 141), we examined ethnoracial differences in dropout in a cohort of treatment-seeking Veterans who experienced MST and engaged in cognitive processing therapy (CPT) in a VA specialty PTSD clinic. In Study 2 (n = 109), we explored the same questions related to treatment attrition in a separate cohort of treatment-seeking Veterans who experienced MST and engaged in prolonged exposure (PE) in a VA specialty PTSD clinic. Results from both studies did not indicate ethnoracial differences in attrition rate (for both total sessions and an 8-week minimally adequate care [MAC] window) across evidence-based PTSD treatment. However, it remains important to consider the impact of racial and cultural factors on retention. Future research should aim to recruit a larger racially and ethnically diverse sample to explore possible varying retention outcomes of CPT and PE for MST-related PTSD.

Implementasi Algoritma Teorema Bayes Dengan Pemodelan UML Untuk Mendiagnosis Tingkatan Gangguan Autisme Di SLB Pelita Hati

Autism, as a complex developmental disorder in children with special needs, involves delays in aspects of cognition, emotion, behavior, and social interaction. This research proposes an innovation by applying UML modeling and Bayes Theorem Algorithm to detect the level of autism disorder in Sekolah Luar Biasa (SLB) Pelita Hati. The SLB environment, faced with limited human resources and an increasing number of students, is a major challenge. The developed expert system provides an efficient solution with quick recommendations, reduces the expert's workload, and increases the detection accuracy of autism disorders. The expert approach with Bayes' Theorem provides an accurate insight into the complexity of autism disorders. Bayes' theorem is used to calculate the probability of events based on relevant observations. The application of UML modeling in the design of the expert system proved successful, producing an effective solution to support the diagnosis and treatment of autism disorders in SLB Pelita Hati. The results showed an accuracy of 94%, signifying a heavy level of confidence, with therapy recommendations such as Physiotherapy Therapy, Speech Therapy, Remedial Therapy, Cognitive Therapy, and Game Therapy, Occupational Therapy, Sensory Integrity. This research makes an important contribution in addressing the challenges in autism diagnosis approaches in special education settings.

A parallel-arm, randomized trial of Behavioral Activation Therapy for anhedonia versus mindfulness-based cognitive therapy for adults with anhedonia

BackgroundAnhedonia, deficits in motivation and pleasure, is a transdiagnostic symptom of psychopathology and negative prognostic marker. MethodsIn this randomized, parallel-arm clinical trial, a novel intervention, Behavioral Activation Treatment for Anhedonia (BATA), was compared to an individually administered Mindfulness-Based Cognitive Therapy (MBCT) in a transdiagnostic cohort of adults with clinically significant anhedonia (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). Participants received 8–15 individual psychotherapy sessions, once weekly, with either BATA (n = 61) or MBCT (n = 55) and completed repeated self-report assessment of anhedonia and other internalizing symptoms. ResultsIndicators of treatment feasibility were similar across conditions, though MBCT showed a trend towards greater attrition rates than BATA, with an adjusted odd's ratio of 2.04 [0.88, 4.73]. Treatment effects on the primary clinical endpoint of anhedonia symptoms did not significantly differ, with a 14-week estimated difference on the Snaith Hamilton Pleasure Scale (SHAPS) of −0.20 [-2.25, 1.84] points in BATA compared to MBCT (z = 0.19, p = 0.845, d = 0.05). The expected 14-week change in SHAPS scores across conditions was −7.18 [-8.22, −6.15] points (z = 13.6, p < 0.001, d = 1.69). There were no significant differences in the proportion of participants demonstrating reliable and clinically significant improvements in SHAPS scores, or in the magnitude of internalizing symptom reductions. LimitationsLimitations included a modest sample size, lack of longer-term follow up data, and non-preregistered analytic plan. DiscussionThere was no evidence to support superior clinical efficacy of BATA over MBCT in a transdiagnostic cohort of adults with elevated anhedonia. Both interventions reduced anhedonia symptoms to a comparable magnitude of other existing treatments.

La thérapie fonctionnelle cognitive dans la prise en charge de la lombalgie chronique non spécifique

IntroductionNon-specific chronic low back pain (NSCLBP) is a condition that accounts for almost one-third of patients treated by physical therapists. Although only one in ten low back pain patients suffers from NSCLBP, it represents up to 80 % of healthcare costs for this disease. NSCLBP is the leading cause of work absenteeism, and healthcare costs have tripled over the past 40 years. Many therapies and techniques are being developed and studied, including Cognitive Functional Therapy (CFT), which provides a new approach based on a precise assessment and awareness of all dimensions of the condition.The aim of this study is to determine the prevalence of CFT among physical therapists and to identify the determinants of its importance in their practice. MethodA literature review followed by a questionnaire administered to licensed physical therapists and physical therapy students. ResultsIn all, 80% of physical therapy students and 67.9% of licensed physical therapists surveyed were not familiar with CFT. Among the licensed physical therapists, more than 50% frequently use this therapy and find it effective in treating NSCLBP. Among the students, 93.1% were interested in studying this therapy as part of their initial training. The lack of training among physical therapists in this area and the importance of patient impact as a barrier to CFT may explain its limited use in practice. The main limitations of this therapy are described by the study's authors.

A randomized controlled experiment testing the use of virtual reality to trigger cigarette craving in people who smoke

Automated delivery of therapy in virtual reality (VR) has the potential to be used for smoking cessation. Most obviously, it could be used to practise and establish alternative reactions to smoking cues. The first step in treatment development is to show that VR environments can trigger sufficient cravings in smokers. We evaluated a new VR public house outdoor scenario with 100 individuals who smoked daily. Participants were randomly assigned to the VR scenario with smoking cues or a neutral experience in VR. The VR experiences were presented in a standalone VR headset. Before and after VR, we collected self-reported craving scores for cigarettes and alcohol using the Tobacco Craving Questionnaire (TCQ) and visual analogue scales (VAS). Physiological data were also collected. Compared to the neutral condition, exposure to the smoking cues led to a large increase in craving for a cigarette (TCQ β = 11.44, p < 0.0001, Cohen’s d = 1.10) and also a moderate increase in craving for alcohol (β=0.7,p=0.017,d=0.50)\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$(\\upbeta =0.7,\ ext{ p}=0.017,\ ext{ d}=0.50)$$\\end{document}. There were no significant physiological differences between the two conditions. These results provide good evidence that VR experiences can elicit strong craving for cigarettes. The programming can be part of developing a new VR cognitive therapy to help people reduce smoking.