Cognitive Therapy Research Articles

The Effectiveness of Cognitive-Behavioral Therapy on Dimensions of Emotional Reactivity and Brain-Behavioral Systems in Individuals Prone to Extramarital Relationships

Introduction: Marriage is considered the most significant event in an individual’s life and the most fundamental human connection. Objective: The present research aimed to determine the effectiveness of cognitive-behavioral therapy (CBT) on the dimensions of emotional reactivity and brain-behavioral systems in individuals prone to extramarital relationships. Method: This research was a semi-experimental pretest-posttest design with a control group. The study population consisted of married women prone to extramarital relationships referring to psychological counseling centers in the city of Babol during the first quarter of 2023. A sample of 30 individuals was selected using a convenience sampling method and were randomly assigned to two groups: Experimental (n=15) and control (n=15). The Emotional Reactivity Scale (Nock et al., 2008), the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales (Carver and White, 1994), and the Cognitive Therapy Protocol (Epstein and Baucom, 2002) were used for eight 90-minute sessions to collect data. Multivariate analysis of covariance (MANCOVA) using SPSS version 24 was employed to analyze the data. Results: The results indicated a significant difference between the experimental and control groups in terms of dimensions and factors of emotional reactivity and brain-behavioral systems (BIS/BAS) (P=0.001). The results of the covariance analysis demonstrated revealed that CBT increased BIS scores and decreased BAS and emotional reactivity scores. Conclusion: Based on the findings, it can be concluded that CBT has a positive impact on the brain-behavioral systems and emotional reactivity of individuals prone to extramarital relationships.

The effect of peri-operative pain neuroscience education on pain and recovery in adult patients receiving laparoscopic inguinal hernia repair

To optimize the efficacy of analgesia for patients receiving laparoscopic inguinal hernia repair, peri-operative pain neuroscience education (PNE) as a pain-specific cognitive therapy was incorporated into multi-modal analgesia. A randomized controlled trial was conducted to compare conventional analgesia (group CA) and the addition of pain neuroscience education into it (group PNE) in patients receiving laparoscopic inguinal hernia repair. Characteristics of peri-operative pain was evaluated with Douleur Neuropathique 4 questionnaire (DN-4), central sensitization inventory (CSI), pain catastrophizing scale (PCS) post-operatively and pressure pain threshold. Post-operative quality of recovery was measured with EuroQol five dimensions questionnaire (EQ-5D-5L). The incidence of chronic post-operative pain was also recorded. A total of 184 patients consented to participate in this study and finished follow-up. Compared with those receiving conventional analgesia (group CA, N = 91), patients in group PNE (N = 93) reported reduced incidence of moderate-to-severe pain and less dosages of opioid during hospitalization (p < 0.05). Catastrophing, sensitization related to pain were reduced in group PNE (p < 0.05). Quality of recovery was improved till 1 month after surgery (p < 0.05). The addition of pain neuroscience education improved analgesic effect and quality of recovery for patients undergoing laparoscopic inguinal hernia repair. It also helped reduce sensitization and catastrophic of acute surgical pain. This psychologically-oriented analgesic approach merits future research and application for these patients.

Comparison of cognitive functional therapy and neurofeedback training on kinetic gait in patients with chronic non-specific low back pain: a randomised controlled trial

Purpose of the article Walking disorders are a significant issue for patients with low back pain. The aim of clinical trials is to compare the effects of cognitive functional therapy (CFT) and neurofeedback training (NFBT) on gait kinetics in chronic non-specific low back pain (CNSLBP) patients. Materials and Methods Sixty females with chronic non-specific low back pain were recruitment for clinical trials. They were randomly divided into experimental and one control groups (Each group 20 patients). The experimental group received the relevant interventions for eight weeks. The primary outcome was pain, kinesiophobia and disability. The secondary outcome was vertical ground reaction force (VGRF) parameters. Two-Way Repeated Measures ANOVA statistical method was used for data analysis. Results Within-group comparisons showed that neurofeedback training and cognitive functional therapy groups experienced significant improvement in pain intensity, disability and kinesiophobia after eight-week (p < 0.05). However, the cognitive functional therapy group improved the vertical ground reaction force parameters better than the neurofeedback training group (p < 0.05). Conclusions cognitive functional therapy intervention had a greater effect on the vertical ground reaction force parameters. The reason for the greater effect of cognitive functional therapy intervention on vertical ground reaction force parameters can be partially explained due to the multimodal therapy used through cognitive exercises and motor control.

Access to context-specific lexical-semantic information during discourse tasks differentiates speakers with latent aphasia, mild cognitive impairment, and cognitively healthy adults

PurposeMild language impairments experienced by adults with neurogenic communication disorders are often difficult to detect due to the lack of sensitive traditional performance-based measures. This is problematic since many adults who have mild language deficits experience daily activity and participation limitations that are undetected and not managed. This study evaluates the potential for variables derived through core lexicon analysis to differentiate two clinical groups (latent aphasia, MCI) from each other, and from a cognitively healthy adult group, across three different discourse tasks (Aim 1). Innovatively, it also contrasts the sensitivity with which each task differentiates the groups based on this metric (Aim 2).MethodsTranscribed connected speech data from TalkBank were analyzed for three discourse tasks (i.e., Sandwich Procedure, Cat Rescue Picture Description, and Cinderella Story) from three participant groups [Mild Cognitive Impairment (MCI) n = 30, stroke-induced latent aphasia n = 29, and Cognitive Healthy Adults (CHA) n = 56]. Aim 1 used one-way ANOVAs (or non-parametric equivalents) to identify differences in lexical variables (total number of core lexical items; proportion of core lexical items out of all words produced; and rate of core lexical items produced per second) between participant groups. Aim 2 used linear discriminant analysis with cross validation to characterize the sensitivity of discourse task in identifying lexical variables differentiating the participant groups.ResultsUnivariate analysis revealed significant differences among the three participant groups. During the Cinderella task, the latent aphasia and MCI groups produced significantly fewer core lexical items than CHAs, while their proportion of core lexical items to total tokens was higher than CHAs. The latent aphasia group produced core lexical items more slowly than the MCI group for all three discourse tasks. Finally, individuals with latent aphasia produced significantly fewer core lexical items during the Sandwich task than either the MCI or CHA groups. Aim 2’s sensitivity analysis revealed that number of core lexical items produced during the Cinderella task best differentiated the MCI group from CHAs, number of core lexical items produced during Sandwich best differentiated latent aphasia from CHAs, and core lexical items per second during Cinderella best differentiated latent aphasia from MCI.ConclusionOur study suggests that the Cinderella story is more sensitive than a picture description task for demonstrating the subtle lexical-semantic changes in MCI and latent aphasia compared to CHAs. Core lexicon appears to be a sensitive discourse metric to identify linguistic differences between CHAs and individuals with mild cognitive and/or language deficits. These findings further support calls to provide speech/language and cognitive therapy to individuals with MCI and/or latent aphasia.

Cognitive frailty in maintenance hemodialysis: a scoping review.

To conduct a scoping review of the related research on cognitive frailty (CF) in maintenance hemodialysis (MHD) patients, so as to provide a basis for early diagnosis, treatment and intervention of CF in MHD patients. Utilizing a scoping review approach, we searched PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, the China Biological Medicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu (VIP) for literature on CF in MHD patients up to October 20, 2024. Two researchers conducted independent screening and data extraction of the literature's fundamental characteristics. The study is registered in OSF ( https://doi.org/10.17605/OSF.IO/H6Q89 ). The review included 21 articles, revealing a concerningly high prevalence of CF in MHD patients, ranging from 4.6 to 56.4%. Six diagnostic combinations were identified, with the combination of Frailty Phenotype (FP), Montreal Cognitive Assessment (MOCA), and Clinical Dementia Rating (CDR) scales being the most prevalent. Influencing factors were categorized into demographic and lifestyle, physical condition, disease-related and psychosocial aspects. Interventions included exercise, cognitive therapy combined with exercise, social support and predictive nursing, yet there remains a scarcity of intervention studies. The prevalence of CF in MHD patients is high; however, understanding of CF in MHD patients is insufficient. There are many types of assessment tools, but there is a lack of unified standards and specificity; the influencing factors are complex and diverse; and prevention and intervention studies are scarce.

The Effect of Counseling Based on Functional Analytic Psychotherapy with Enhanced Cognitive Therapy on Married Adolescent Women’s Sexual Self-efficacy: A Prospective Study

Background: Sexual well-being is a vital aspect of the overall quality of life. Sexual self-efficacy is a key factor in improving of women’s sexual well-being. This study aimed to determine the effect of counseling based on functional analytic psychotherapy (FAP)-enhanced cognitive therapy (CT) on sexual self-efficacy in married adolescent women. Methods: This prospective clinical trial, conducted in 2019, used a pre-test/post-test design with a control group. The study included 80 urban and rural married adolescents who met the inclusion criteria and were referred to the health centers in Darab and surrounding villages. Out of 350 participants, 150 adolescents were included in the study and were allocated to two groups. The counseling program for the intervention group was carried out by the researcher over 16 sessions, held twice a week for 90 minutes each. In contrast, the control group received routine education. The intervention group received counselling based on FAP-enhanced CT, while the control group did not receive this training during the study. The data collected from the questionnaires were imported into SPSS 24, and analyses were performed using analysis of covariance (ANCOVA), paired t-test, and independent t-test. Results: There was no significant difference in sexual self-efficacy between the two groups at pre-test time (p &gt; 0.05); however, a significant difference was observed at post-test (p &lt; 0.0001). Additionally, there was a significant difference between the mean scores of sexual self-efficacy before and after the intervention in the intervention group (p &lt; 0.0001), while no significant difference was observed in the control group (p = 0.25). Conclusion: The results suggest that counselling based on FAP-enhanced CT provided to married adolescent women significantly improves their sexual self-efficacy. Clinical Trial Registration: The trial protocol was registered with the Iranian Registry of Clinical Trials on 16/06/2019, IRCT20190217042736N1 (https://www.irct.ir/trial/37718).

Fetal Alcohol Syndrome: Impact on Neurodevelopment, Diagnosis, Early Intervention and Motor Disorders in Children under 3 Years

Fetal Alcohol Syndrome (FAS) is the most severe outcome of prenatal alcohol exposure, characterized by a combination of somatic and neurological abnormalities, including facial dysmorphism, growth deficits, and neurocognitive impairments. Fetal Alcohol Spectrum Disorders (FASD) encompass a broader range of outcomes from prenatal alcohol exposure, with varying degrees of severity. Alcohol consumption during pregnancy can disrupt fetal development, with no known safe threshold for its intake at any stage of gestation. The consequences are particularly profound on the central nervous system (CNS), where damage to structures like the cerebellum can lead to motor dysfunctions, balance issues, and cognitive impairments. Early identification and diagnosis of FAS or FASD, especially during the critical first years of life, is essential for improving developmental outcomes. Intervention strategies, including physical and cognitive therapy, can help mitigate long-term disabilities associated with these conditions. Diagnostic methods, such as ultrasound for fetal structural abnormalities and the AUDIT screening tool, are integral for early detection. This review highlights the impact of prenatal alcohol exposure on motor skill development, particularly the persistence of primitive reflexes in infants with FAS, which is indicative of CNS immaturity and necessitates early therapeutic interventions. Understanding these motor and neurological markers is critical for providing appropriate support and improving outcomes for affected children.

Desvenlafaxine with mindfulness-based cognitive therapy reduces Hamilton anxiety scores compared to escitalopram with mindfulness-based cognitive therapy in treatment-resistant generalized anxiety disorder.

This study aims to assess the effectiveness of low-dose Escitalopram (10 mg) or low-dose Desvenlafaxine (25 mg) combined with mindfulness-based cognitive therapy (MBCT) in addressing challenges in treating generalized anxiety disorder (GAD), particularly in patients resistant to conventional therapies. A prospective cohort study was conducted with individuals diagnosed with treatment-resistant GAD. group A included patients unresponsive to citalopram, imipramine, paroxetine, and sertraline, who were then treated with low-dose Escitalopram (10 mg) combined with MBCT. group B comprised those unresponsive to venlafaxine and duloxetine, who were treated with Desvenlafaxine (25 mg) alongside MBCT. Participants were monitored over 24 weeks for changes in Hamilton Anxiety Rating Scale (HAM-A) and Mindful Attention Awareness Scale (MAAS) scores, with medication adherence measured using the Medication Adherence Rating Scale (MARS). The primary outcomes focused on the improvement in anxiety symptoms and overall mental well-being. Comparative analysis between the groups showed significant improvement in HAM-A and MAAS scores at week 16 in group B compared to group A (P < 0.01). Within-group analysis also demonstrated a significant reduction in scores at week 12 in group B compared to group A at week 16 (P < 0.01). No significant difference was observed in medication adherence between the two groups (P = 0.122). Patients treated with low-dose Desvenlafaxine combined with MBCT exhibited greater improvements in managing treatment-resistant GAD compared to those treated with low-dose Escitalopram. This approach highlights the potential for more inclusive and effective mental health strategies, contributing to enhanced quality of life and well-being.

Cognitive Therapy of Depression: Second Edition, Aaron T. Beck, A. John Rush, Brian F. Shaw, Gary Emery, Robert J. DeRubeis, and Steven D. Hollon, The Guildford Press, 2024

Cognitive Therapy of Depression: Second Edition, Aaron T. Beck, A. John Rush, Brian F. Shaw, Gary Emery, Robert J. DeRubeis, and Steven D. Hollon, The Guildford Press, 2024

Enhanced computerized cognitive remediation therapy improved cognitive function, negative symptoms, and GDNF in male long-term inpatients with schizophrenia

Enhanced computerized cognitive remediation therapy improved cognitive function, negative symptoms, and GDNF in male long-term inpatients with schizophrenia

Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, and Testing (ADAPT-ITT) Framework to Tailor Evidence-Based Posttraumatic Stress Disorder Treatment for People With HIV to Enhance Engagement and Adherence: Qualitative Results from a Feasibility Randomized Controlled Trial.

Individuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist. This study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV. The Assessment, Decision, Adaptation, Production, Topical experts-integration, Training, and Testing (ADAPT-ITT) framework guided the formative process used to modify an evidence-based PTSD treatment (cognitive processing therapy; CPT) to meet the unique needs of PWH experiencing PTSD. With the integration of Life-Steps for Medication Adherence (Life-Steps), the adapted protocol (CPT-Life-Steps for integration of adherence; CPT-L) targeted HIV-related stigma and HIV medication adherence within a trauma-informed framework. Theater testing was completed with 7 participants to evaluate acceptability of CPT-L for PWH. The qualitative data (N=54 recordings) used to evaluate and adapt CPT-L emerged from individual interviews conducted with participants after each therapy session as well as exit interviews conducted at posttreatment data collection. After challenging stigma-related appraisals, participants expressed feeling less constrained by maladaptive thoughts. These shifts translated to increased self-efficacy with both HIV-related care and mental health. These results indicate that trauma-informed work with PWH should consider the impact of HIV on trauma-related stuck points, intersecting identities (including living with HIV), and challenging internalized stigma. Findings provide evidence that CPT-L is acceptable and effective in addressing internalized HIV stigma that impacts PTSD symptom maintenance and HIV treatment engagement. ClinicalTrials.gov; NCT05275842; https://clinicaltrials.gov/study/NCT05275842?id=NCT05275842&rank=1. RR2-10.1016/j.conctc.2023.101150.

Touch Table Interfaces in Therapeutic Rehabilitation: A Systematic Review

Touch tables have become a common interface in recent decades. However, few studies explore their use in therapeutic rehabilitation. This review analyzes publications identified through a systematic search in four literature databases between 1970 and 2023. A total of 29 publications involving three therapeutic uses of touch tables are presented. 11 studies address work on physical remediation, 14 on cognitive training and 11 on collaborative social skills. Results indicate that research on touch tables in rehabilitation is limited in quantity, but that touch tables are regularly proposed into therapy. Their use has produced relatively beneficial effects in motor, cognitive and social therapy. This review highlights the essential role of accessibility for rehabilitation users, whether they are patients or health practitioners. We conclude by presenting recommendations for research and practices, particularly around inclusive approaches and adaptive techniques to further integrate touch tables into the care pathway.

Cognitive Stimulation Therapy (CST): Exploring Perspectives of Trained Practitioners on the Barriers and Facilitators to the Implementation of CST for People Living with Dementia

Dementia is recognised as a disability under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). People with disabilities like dementia have the right to access specialised health and social care services, including interventions that support independence and community participation. Cognitive Stimulation Therapy (CST) is an evidence-based psychosocial intervention that improves cognition, communication, confidence, and quality of life for people living with dementia (PLwD), but an implementation gap means that CST is often not available. This study examines whether trained CST practitioners implemented CST, their perceptions of the acceptability and efficacy of CST, whether the perceived acceptability and efficacy of CST predicted implementation, and practitioners’ opinions on the barriers and facilitators to CST implementation. A mixed-methods approach was used, with 62 participants (91.9% female). Although 95% of participants were trained to deliver CST, 45.2% did not facilitate CST groups. Statistical analysis showed that perceived efficacy significantly predicted both the likelihood of running CST groups (p = 0.006) and the number of groups delivered (p = 0.01). Thematic analysis of qualitative data identified the three key themes of ‘resources’, ‘awareness and education’, and ‘acceptability of CST’. Overall, the results show that while CST is acceptable and deemed highly effective, resources and staffing often impede implementation. The results are discussed in the context of prioritising the rights of people with disabilities and recommendations are made on improving access to evidence-based support.

Pilot of a multicomponent program for people with dementia and their care partners: Health services staff expectations, experiences and observations.

There is increased recognition of the need to improve post-diagnostic pathways for people with dementia and their care partners living in the community to access rehabilitation services to support independence and wellbeing. However, there is minimal evidence on implementing rehabilitation services for this population. The study aimed to present the expectations and experiences of allied health staff involved in piloting the Sustainable Personalised Interventions for Cognition, Care and Engagement (SPICE) program based at an outpatient clinic of a public rehabilitation hospital. Over twelve weeks, the program combines small group and dyadic evidence-based interventions including cognitive stimulation therapy, occupational therapy, physical activity, care partner education, and dietetics. A qualitative exploratory methodology was used with pre- and post-program interviews conducted with ten allied health staff. Questions were designed to elicit the expected and actual benefits and challenges of the initial implementation of the multicomponent program. The multidisciplinary team were motivated by the potential for the SPICE program to meet an important service gap, and confident people with dementia and their care partners would benefit. Staff reported enjoyment, satisfaction, and confidence in delivering the program, and believed the multiple components had synergistic effects on participants, particularly regarding social connection and functional engagement. While staff had pre-program concerns regarding retention, participant fatigue, and managing challenging situations, these were not realised. At times, staff observed program intensity to cause unintended stress for some care partners. Resourcing and strategies to ensure sustainability were identified as important by staff, as well as the need for ongoing support to participants post-program. Overall, the SPICE program exceeded expectations and was rewarding for staff. Further work to refine and evaluate the program is necessary to support its potential to continue providing dementia rehabilitation to promote the independence and wellbeing of people with dementia and care partners living in the community.

Therapeutic alliance during trauma focused treatment in adolescent and young adult patients with PTSD

BackgroundGreater therapeutic alliance has been associated with an improved treatment outcome in various clinical populations. However, there is a lack of evidence for this association in posttraumatic stress disorder (PTSD) in young patients. We therefore investigated the development of the therapeutic alliance during Developmentally adapted cognitive processing therapy (D-CPT) in adolescents and young adults with PTSD following abuse to answer the question whether there was a connection between the therapeutic alliance and symptom reduction.MethodsWeekly assessments of therapeutic alliance, rated by patients and their therapists, as well as PTSD symptom severity from a randomized controlled trial (RCT) of D-CPT were analyzed with multilevel modelling. The sample consisted of n = 39 patients aged 14–21 with a history of sexual and/or physical abuse.ResultsTherapeutic alliance increased during D-CPT. The ratings of the therapeutic alliance by patients and therapists were strongly correlated (r = .512, p < .01); however, at session level, there was a significant difference between the patients’ and their therapists’ alliance assessments. Patients with a higher perceived therapeutic alliance showed a greater reduction in self-reported symptoms over the course of therapy, compared to patients with lower alliance ratings. However, this only applied to the therapeutic alliance assessed by the patients.DiscussionThe therapeutic alliance plays a crucial role in D-CPT with young patients, contributing to a reduction in symptom severity over the course of treatment. It is essential that therapists prioritize the development of a strong alliance and seek feedback from their patients. The results suggest that patients’ perceptions, which often differ from therapists’ assessments, were more important in determining treatment success in the sample. Studies with larger samples sizes and additional independent ratings of alliance are needed to further examine the alliance-outcome link.Trial registrationThe trial was registered at the German Clinical Trial Registry, DRKS00004787, 18 March 2013, https://www.drks.de/DRKS00004787.

Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study.

Obsessive compulsive disorder (OCD) and anorexia nervosa (AN) are conditions associated with poor cognitive flexibility, a factor considered to interfere with treatment, but research into the relationship between cognitive flexibility and treatment outcome is limited. This study explores whether baseline measures of cognitive flexibility predict outcomes in OCD and AN, evaluates whether changes in these measures contribute to treatment outcome, and evaluates the effectiveness of adjunctive cognitive remediation therapy (CRT) in improving cognitive flexibility. This secondary analysis utilized linear mixed model analysis on data from a randomized controlled multicenter clinical trial involving adult participants with OCD (n=71) AND AN (n=61). Participants underwent 10 twice-weekly sessions of either CRT or a non-specific active control intervention (specialized attention therapy; SAT), followed by treatment as usual. Assessments using Yale-Brown Obsessive Compulsive Scale and the Eating Disorder Examination Questionnaire were conducted at baseline, post-CRT/SAT and at 6 and 12 months. Cognitive flexibility was evaluated through the Trail Making Test (TMT), the Color-Word Interference Test (CWIT) and the Detail and Flexibility Questionnaire (DFlex). Levels of cognitive flexibility at baseline did not predict or moderate treatment outcome, nor did change in cognitive flexibility (baseline post-CRT/SAT) mediate treatment outcome, with CRT providing no greater improvement in measures of cognitive flexibility than SAT. This study failed to find any relationship between measures of cognitive flexibility and treatment outcome in OCD and AN, and thus questions hypothetical associations between measures of cognitive flexibility and mechanisms of change in patients with OCD and AN.

Effectiveness of cognitive functional therapy (CFT) for chronic spinal pain: a systematic review with meta-analysis.

To assess the effectiveness of cognitive functional therapy (CFT) in reducing disability and pain compared to other interventions in chronic spinal pain patients. Five databases were queried to October 2023 for retrieving randomized controlled trials (RCTs), including patients with chronic spinal pain and administering CFT. Primary outcomes were disability and pain. Secondary outcomes included psychological factors, quality-of-life, patient satisfaction and adverse events. Two independent reviewers performed study selection, data extraction, risk of bias assessment (Cochrane RoB 2.0), and evidence certainty (GRADE approach). Random-effect models were used for meta-analyses. Clinical relevance was assessed with the Smallest Worthwhile Effect. Eight RCTs (N = 1228) for chronic low back pain (CLBP), one (N = 72) for chronic neck pain (CNP) were included. Compared to other conservative interventions, CFT may reduce disability (MD: -9.41; 95%CI: -12.56, -6.27) and pain (MD: -1.59; 95%CI: -2.33, -0.85 for CLBP) at short-term follow-up with probable to possible clinical relevance in CLBP and with low and very low evidence certainty, respectively. Similar results, with larger effect sizes, were observed for CFT compared to any unstructured or unsupervised minimal care treatments. Efficacy persisted in longer-term follow-ups, except for comparison with other conservative interventions. The CNP study showed positive results for CFT. Evidence certainty was low to very low. Sparse evidence was found for secondary outcomes. CFT may offer clinically relevant benefits for CLBP, although the evidence remains mainly of low to very low certainty. Well-conducted studies, particularly in CNP and other spinal pain conditions are needed to strengthen these findings. PROSPERO CRD42023482667.

The effectiveness of psychologically-informed physiotherapy for people with neck pain and the mediating role of illness perceptions: a replicated single-case experimental design study

Purpose (1) To evaluate the effectiveness of personalised psychologically-informed physiotherapy in people with neck pain; (2) To explore the mediating role of changes in illness perceptions. Method In this replicated single-case study, 14 patients with non-specific neck pain at risk for chronicity received a personalised intervention addressing unhelpful illness perceptions and dysfunctional movement behaviour, according to principles of cognitive functional therapy. Outcomes included the mediating role of illness perceptions on overall effect, function, pain intensity and self-efficacy. Linear mixed models were used to analyse the data. Results Repeated measurements (14-20 per patient), including a 3-months follow-up, showed a gradual improvement during and/or after psychologically-informed physiotherapy for overall effect, function, pain and to a lesser extent self-efficacy. Changes in each of the illness perception dimensions showed a mediation effect on overall effect, function and pain. When combining the dimensions “consequences,” “personal control,” “identity,” “concern” and “emotional response,” changes in illness perceptions explained approximately 35% of the improvement in overall effect. Conclusion Addressing unhelpful illness perceptions appears valuable in the management of patients with chronic or recurrent non-specific neck pain. Intervention effects extended beyond the treatment period, indicating that patients’ improved understanding of their health condition continued to have a positive impact.

Internet-based cognitive rehabilitation for working cancer survivors: A process evaluation.

To evaluate the process of an online cognitive rehabilitation program aimed at supporting cancer survivors experiencing cognitive problems at work. Cancer survivors (n = 279) were randomized to one of the intervention groups (i.e., basic and extensive online cognitive rehabilitation) or waitlist control group. Recruitment, reach, dosage, implementation, perceived usefulness and experiences with the program were evaluated using questionnaires and logbooks. Implementation (i.e., reach multiplied by dosage) was acceptable for both versions of the program (range 63% to 76%). Cancer survivors and cognitive therapists perceived the overall program as moderately to highly useful and generally reported positive experiences. Both a basic and extensive version of the online cognitive rehabilitation program were successfully implemented in the context of an RCT, suggesting their feasibility as intervention to support cancer survivors with cognitive problems at work.

Moderators of cognitive and behaviour therapies for prevention and treatment of anxiety disorders in children and adolescents: A systematic review and meta-analysis.

Previous studies have indicated wide variation in the effectiveness of cognitive and behaviour therapies (CBTs) for preventing and treating anxiety disorders in children and adolescents, indicating the presence of moderators influencing outcomes. This meta-analysis investigated whether sample characteristics (child age, child baseline anxiety levels, parental baseline anxiety levels) and intervention characteristics (intervention duration, facilitator contact time, facilitator background, delivery formats, parental involvement) moderate the effectiveness of CBTs for universal prevention, targeted prevention, and treatment of anxiety disorders in children and adolescents. We identified 86 eligible randomized controlled trials (RCTs) assessing the effectiveness of 98 CBTs versus non-active controls. Effect sizes were the post-intervention standardized mean difference of children's broad anxiety symptoms between CBT and non-active controls. Moderation analyses were conducted separately on child- and parent-reported outcomes using meta-regression and subgroup analyses. We found some evidence for (1) a moderating role of child age, facilitator background, and parental involvement on the effectiveness of CBTs for universal prevention; (2) a moderating role of child age and intervention duration on the effectiveness of CBTs for targeted prevention; (3) a moderating role of child age, facilitator contact time, and delivery formats on the effectiveness of CBTs for treatment. There was no evidence for a moderating role of child baseline anxiety levels on the effectiveness of CBTs for universal/targeted prevention or treatment. The moderating role of parental baseline anxiety levels and its potential interaction with parental involvement was not tested given the limited available data. Although these findings provide insights into the question of what works for whom, they should be interpreted cautiously given the limited available data, wide variation in outcomes, potential confounders, and discrepancies between child- and parent-reported outcomes.