Group Cognitive Behavioral Therapy Research Articles

Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy.

Depression in youth is a significant public health problem worldwide, particularly for autistic youth who are over twice as likely to experience depression than their non-autistic peers. Although pathways to depression are complex, emotional reactivity and negative self-esteem are two risk factors for depression in autistic and non-autistic youth. Although autistic youth are more likely to experience depression than their non-autistic peers, psychotherapy options for autistic youth are very limited; community guidance in the development and testing of psychotherapy programs is a promising approach in autism. Therefore, in this study, we designed an autism-adapted CBT-DAY, in collaboration with autistic community members. Specifically, CBT-DAY combined neurodiversity-affirming and cognitive behavioral approaches to target emotional reactivity and self-esteem in youth to improve depressive symptom severity in a group setting across 12 weeks. We examined the preliminary feasibility, acceptability, and efficacy of CBT-DAY in a pilot non-randomized trial. In addition, we implemented a rigorous protocol for assessing, monitoring, and addressing potential harms in this intervention. Results from 24 autistic youth (11-17 years old) suggest that CBT-DAY may be feasible to use in an outpatient clinical setting and generally acceptable to youth and their caregivers. Participation in CBT-DAY may be associated with significant improvements in youth emotional reactivity and self-esteem, as well as depressive symptom severity per self-report only. Exploratory analyses showed that participation in CBT-DAY may also be associated with significant improvements in internalizing symptoms. Findings demonstrate the potential promise of neurodiversity-affirming and cognitive behavioral approaches to treating depressive symptoms in some autistic youth.

MEREDUKSI AGRESIFITAS DENGAN COGNITIVE BEHAVIORAL ART TERAPY PADA SISWA SMPN 14 PONTIANAK

The aim of this study was to test the effectiveness of group counseling with cognitive behavioral art therapy in reducing aggression using a mixed methods model embedded in an experiment. The scale used is the Buss and Pery aggressiveness scale (Garofalo, 2018) with a total of 30 statement items. Based on data analysis, the average pretest value was 83.7 and after being given CBAT treatment the posttest value was 57.8 with a Wilcoxon sign-rank test Z value of -2.201, with a p value of 0.028, which means the p value is smaller than 0.05. So it can be concluded that Ha is accepted and Ho is rejected, which means that cognitive behavioral art therapy group counseling is effective in reducing student aggression. Viewed qualitatively analysis of counseling conversations with high aggressiveness Referring to harsh words, being angry, negotiating, does not reduce emotional control. The changes that occur are in the moderate to low category, this shows that cognitive behavioral art therapy group counseling has a therapeutic impact on group members who are counselees.

Effectiveness of brief cognitive behavior therapy on symptoms severity in relation to social avoidance among patients with panic disorder: a randomized controlled trial

Background. Panic disorder is a debilitating condition characterized by severe symptoms and social avoidance. Due to insufficient knowledge, this study examined the effectiveness of brief cognitive behavioral therapy (CBT) on symptom severity and social avoidance in patients with panic disorder. Patients and Methods. In this randomized controlled trial (RCT), 44 patients were included in the Brief CBT group or the control group after addressing issues related to lost-to-follow-up. Panic disorder symptom severity (PDSS) and the work and social adjustment scale (WSAS) were used to assess symptom severity and social adjustment, respectively. Results. After one month of treatment, the total PDSS scores (1.79 vs. 4.47; P=0.0409) and WSAS scores (2.97 vs. 7.41; P=0.0015) in the brief CBT group were significantly lower compared to the control group. The study revealed that in the brief CBT group, the mean score of PDSS and WSAS significantly decreased from 21.53 to 1.79 (P<0.0001) and from 24.63 to 2.95 (P<0.0001), and in the control group from 19.59 to 4.47 (P<0.0001) in PDSS and from 22.18 to 7.41 (P<0.0001) in WSAS, respectively. Furthermore, the change in WSAS scores in the brief CBT group was independent of the decrease in PDSS. Conclusions. This study demonstrated that the application of brief CBT is an effective technique for reducing symptom severity and social avoidance in patients with panic disorder.

Cognitive-Behavioral Therapy (CBT) Versus Cognitive Retraining (CR) in Depression

Mood disorders are recurrent or episodic with significant cognitive deficits and incomplete recovery. Cognitive behavior therapy (CBT) has been a well-established evidence-based intervention, and Cognitive retraining (CR) is emerging to reduce cognitive deficits by application of techniques that improve attention, memory, and/or executive functions that enhance psychosocial functioning. Method: The present study compared CBT and CR delivered as independent interventions as well as combined with medicines employing pre-post intervention and experimental research design. Outcome measures were Beck Depression Inventory (BDI-II), Metacognitive Questionnaire (MCQ30), World Health Organization Quality of Life- Brief (WHOQOLBref), and Global Assessment of Functioning (GAF). Results: CBT group statistically had highest QOL supported by environment and global functioning. The change in mean scores on outcome measures was greater for CR groups. Conclusion: CR with or without medicine is a feasible treatment option when CBT promulgation is inhibited by patient, therapist, or environmental variables.

Randomized controlled trial: Comparing the effectiveness of brief group cognitive behavioural therapy and group eye movement desensitisation and reprocessing interventions for PTSD in internally displaced persons, administered by paraprofessionals in Northern Iraq

Randomized controlled trial: Comparing the effectiveness of brief group cognitive behavioural therapy and group eye movement desensitisation and reprocessing interventions for PTSD in internally displaced persons, administered by paraprofessionals in Northern Iraq

VirtualPain. Preliminary findings from a group-based digital therapeutics intervention for fibromyalgia.

Fibromyalgia (FM) is a disorder characterized by chronic pain, with significant medical, psychological, and socio-economic implications. Although there is limited evidence, cognitive-behavioral therapy (CBT) has shown to be effective in improving FM symptoms. An alternative to enhance CBT effectiveness is to incorporate digital therapeutics (DTx). We conducted a pilot study to investigate whether the addition of a DTx intervention (VirtualPain) to cognitive-behavioral group therapy (CBGT) can reduce pain perception and associated symptoms in patients with FM. Ten patients with FM were initially recruited from a public hospital in Barcelona. The treatment consisted of 6 weeks of VirtualPain group sessions and 16weeks of CBGT. Measures of catastrophizing, self-efficacy, and coping were recorded before, during, and after the protocol. In the DTx sessions, pain intensity was recorded before and after each session. The program (DTx and CBGT) showed a significant improvement in pain-related self-efficacy and relaxation measures. Improvement in pain perception was observed only after the DTx intervention. This study provides preliminary results regarding the added value of DTx (VirtualPain) as part of a CBGT for FM. The use of the program has facilitated a significant reduction in pain perception in each of the VirtualPain sessions, which provides further evidence of how this technology can be beneficial for improving FM treatments.

Adapting, Implementing, and Maintaining a Group Cognitive Behavioral Therapy Program at an Inpatient Addiction Treatment Facility.

Quality training is an oft-cited barrier to effective implementation and ongoing delivery of high-quality evidence-based practice (EBP) across fields. This is especially true in the addiction field, but there is little cited evidence for optimal methods to improve EBP in inpatient addiction facilities with minimal resources. The current paper focuses on evaluating the state of our facility's group CBT manual and clinical training on the manual in a "realistic" (ie, non-RCT, non-grant-funded) inpatient addiction treatment setting. Five full-time clinicians volunteered to take part in the study (woman = 60%; Mage = 36.20 years). The study involved a mix of semi-structured interviews and surveys designed to measure seven outcomes (barriers, feasibility, useability, appropriateness, acceptability, burden, trialability). Three themes emerged from the data that impacted the group CBT manual: training, timing, and functionality. Addressing these themes allowed for a new, optimal manual and training procedure to be put into place. The current study highlights that under-resourced inpatient addiction facilities can still methodically utilize implementation approaches to study their EBP, namely CBT. Such an approach will ensure that the highest quality care is being delivered to patients and actively addresses known training barriers that prevent proper EBP delivery.

Benefits and challenges of an online CBT group, utilizing self-practice/self-reflection paradigm for psychology trainees.

Benefits and challenges of an online CBT group, utilizing self-practice/self-reflection paradigm for psychology trainees.

Cognitive behavioral therapy following esketamine for major depression and suicidal ideation for relapse prevention: The CBT-ENDURE randomized clinical trial study protocol

In 2020, esketamine received a supplemental indication as a therapy for major depression with suicidal ideation (MDSI), based on protocols enrolling hospitalized patients. Given the high risk of suicide following hospital discharge and the high relapse rates following discontinuation of esketamine, the optimal long-term treatment approach remains unclear. Cognitive behavioral therapy (CBT) is highly effective in relapse prevention and has been shown to prevent suicide attempts in high-risk populations. Here we describe the study protocol for the CBT-ENDURE trial: Cognitive Behavioral Therapy Following Esketamine for Major Depression and SUicidal Ideation for RElapse Prevention. Patients with depression (N = 100) who are admitted to hospital or are outpatients with clinically significant suicidal ideation will be enrolled in the study. All patients will receive esketamine (twice weekly for four weeks) and will be randomly assigned (1:1 ratio) to receive a 16-week course of CBT plus treatment as usual (CBT group) or treatment as usual only (TAU only group). Patients are followed for a total of 6 months. Supported under a funding announcement from NIMH to conduct safety and feasibility trials for patients at high risk for suicide, the primary outcome of the CBT-ENDURE study is feasibility (as measured by recruitment and retention), with a key secondary outcome being relapse among those who experience substantial benefit following two weeks of esketamine.

An exploration of neural predictors of treatment compliance in cognitive-behavioral group therapy for hoarding disorder

A persistent and influential barrier to effective cognitive-behavioral therapy (CBT) for patients with hoarding disorder (HD) is treatment retention and compliance. Recent research has suggested that HD patients have abnormal brain activity identified by functional magnetic resonance (fMRI) in regions often engaged for executive functioning (e.g., right superior frontal gyrus, anterior insula, and anterior cingulate), which raises questions about whether these abnormalities could relate to patients' ability to attend, understand, and engage in HD treatment. We examined data from 74 HD-diagnosed adults who completed fMRI-measured brain activity during a discarding task designed to elicit symptom-related brain dysfunction, exploring which regions' activity might predict treatment compliance variables, including treatment engagement (within-session compliance), homework completion (between-session compliance), and treatment attendance. Brain activity that was significantly related to within- and between-session compliance was found largely in insula, parietal, and premotor areas. No brain regions were associated with treatment attendance. The results add to findings from prior research that have found prefrontal, cingulate, and insula activity abnormalities in HD by suggesting that some aspects of HD brain dysfunction might play a role in preventing the engagement needed for therapeutic benefit.

Sequenced treatment alternatives to relieve adolescent depression (STAR-AD): a multicentre open-label randomized controlled trial protocol

BackgroundAdolescent major depressive disorder (MDD) is a prevalent mental health problem with low treatment success rates. Whether fluoxetine or fluoxetine combined with cognitive-behavioural therapy (CBT) is the more effective initial treatment for adolescent MDD remains controversial, and few studies have investigated whether treatment switching or augmentation is preferred when the initial treatment is not working well.MethodsWe developed a multicentre open-label Sequential Multiple Assignment Randomized Trial (SMART) design, consisting of two phases lasting 8 weeks each. In phase 1 (at baseline), patients will be recruited and grouped in fluoxetine group or fluoxetine combined with CBT group by patient self-selection. In phase 2 (after 8 weeks of treatment), the nonresponders will be randomly assigned to six groups, in which participants will switch to sertraline, vortioxetine, or duloxetine or added aripiprazole, olanzapine, or lithium carbonate to fluoxetine. After the full 16 weeks of treatment, we will assess the long-term sustainability of the treatment effects by evaluating participants during their subsequent naturalistic treatment. The primary outcome will be the response rate, determined by the Children’s Depression Rating Scale-Revised (CDRS-R). Secondary outcomes include the change in scores on the Beck Depression Inventory (BDI), the Screen for Child Anxiety-Related Emotional Disorders (SCARED) and the Safe Assessment.DiscussionThe results from this study will aid clinicians in making informed treatment selection decisions for adolescents with MDD.Trial registrationThis protocol was registered at ClinicalTrials.gov with Identifier: NCT05814640.

Effectiveness of group cognitive behavioral intervention in reducing test anxiety among psychology undergraduates in Kathmandu, Nepal

Background: High test anxiety negatively impacts students, affecting academic performance, well-being, focus, and retention rates. Cognitive Behavioral Therapy (CBT) is a promising approach to reducing test anxiety, and we aimed to assess the effectiveness of group-based CBT in reducing test anxiety among undergraduate students. Material and Method: This experimental, independent two-group design enrolled 80 test-anxious participants, randomly assigning them to a control or intervention group (40 participants each). Westside Test Anxiety Scale was the primary outcome measure, and participant's feedback was collected. The intervention group received ten sessions of group-based CBT. Baseline and endline data were analyzed, and effect size was reported. Results: Participant feedback was analyzed qualitatively. The intervention group demonstrated 16% reduction in test anxiety score from their baseline, while the control group showed only 5.54% reduction from their baseline. In contrast, the control group showed a 2-point reduction, representing a 5.54% decrease. This difference was statistically significant (effect size= -0.53), supporting moderate effectiveness. Further, scores in specific test anxiety areas, such as worry about forgetting during the study and performance after exams, showed notable improvement. Participant feedback highlighted improved stress management, self-awareness, and understanding of emotions. Suggestions incorporating visual aids and increasing interactivity for the future. Conclusion: This study demonstrates utility of group-based CBT in reducing test anxiety among undergraduate students. A larger scale randomized controlled trial is needed to evaluate the effectiveness of group CBT in a larger population, and future studies can focus on examining the effect of group CBT delivered by non-specialists in a broader population.

Intensive cognitive behavioral group therapy for the treatment of panic disorder

Panic disorder is one of the most commonly occurring emotional disorder, showing increased prevalence rates since the COVID-19 pandemic. The ever-growing number of patients in need of treatment is a heavy burden on the healthcare system, which draws attention to the importance of low-intensity, short and effective psychological interventions in the treatment of mental disorders, especially in the field of primary care. According to international guidelines, the recommended evidence-based treatment of panic disorder is cognitive behavioral therapy, which is based on the cognitive model of panic disorder. According to the model, a panic attack develops in those who catastrophize the symptoms of the normal stress reaction, i.e., consider them a sign of a serious physical illness such as heart-attack and react to this with intense anxiety. Based on Salkovskis and Clark (1986), we developed a 5 session, intensive cognitive behavioral group therapy protocol for panic patients. Effectiveness of the short group therapy was assessed with questionnaires (Spielberger's State-Trait Anxiety Inventory, Beck Depression Inventory) and an additional subjective scale. Paired sample t-tests were conducted. Our results suggest that the intensity of anxiety and depressive symptoms (t(36) = 5.497, p<0.0001; Z = -4.871, p<0.0001) as well as the frequency of panic attacks (Z= -5.190, p<0.0001) decreased significantly after the 5 session group therapy. Our clinical study provides further evidence by the effectiveness of low-intensity psychological interventions, offering an evidence-based protocol for professionals working in primary as well as mental health care. Orv Hetil. 2023; 164(42): 1665-1672.

Comparing 12-Month Outcomes for Group CBT Versus Group CBT Plus Yoga for Depression and Anxiety: a Mixed-Methods Study

AbstractEmerging research shows yoga, a body-based mindfulness practice, appears to augment the benefits of transdiagnostic group CBT up to 3-month post-treatment, but less is known about longer-term outcomes. This mixed-methods study reports on 12-month findings of a pragmatic preference trial with adults (N = 59) diagnosed with depression or anxiety. It compares longer-term outcomes between adults who completed either a group CBT program or group CBT with an adjunct therapeutic yoga program. A fixed effects linear mixed model explored symptoms of depression and anxiety (DASS-21) between the groups at 12-month follow-up (CBT alone, n = 13; CBT+Yoga, n = 15). Focus groups and semi-structured interviews were also conducted (n = 20) to identify what practices were maintained at follow-up. At 12-month follow-up, participants in the combined CBT+Yoga group had sustained reductions in anxiety and depression, with significantly superior outcomes when compared to those receiving group CBT alone. Qualitative data suggested that therapeutic yoga enhanced longer-term access to CBT concepts and contributed to overall increases in positive feelings and actions. Therapeutic yoga as an adjunct to group CBT appears to augment the longer-term benefits of CBT with sustained therapeutic benefits at 12 months.

Cognitive-behavioral group therapy for obesity to reduce cardiovascular risks in patients with type 2 diabetes

Obesity is one of the risk factors for the development and progression of type 2 diabetes (T2D). Decrease in body weight (BW) by 10% from the initial level in patients with T2D and obesity significantly reduces the risk of cardiovascular events. Low effectiveness of measures to reduce body weight in patients with T2D is due to hidden eating disorders against the background of mental imbalance, high levels of anxiety and depression, and frustration with glycemic levels. Solving the problem of the low frequency of achieving target values for reducing weight in type 2 diabetes through the development and evaluation of the clinical effectiveness of cognitive-behavioral therapy protocols is of high scientific and practical significance.

The Effect of Cognitive Behavioral Group Therapy on the Improvement of Postmenopausal Women’s Body Image: A Randomized Clinical Trial

Background: The physiological changes in postmenopausal women, especially age-related physical changes, may lead to negative experiences in body image among these women. Objectives: This study aimed to determine the effectiveness of cognitive behavioral group therapy on the negative body image of postmenopausal women. Methods: This parallel randomized clinical trial study was conducted on 22 eligible postmenopausal women attending a health care center in Ahvaz, Iran, in 2018. They were randomly selected and assigned to intervention and control groups (n = 11 per group). The intervention group attended eight 90-minute sessions of cognitive behavioral therapy (CBT) based on the Cash 8-step model. All participants completed the body image concern inventory (BICI) and Multidimensional Body-Self Relations Questionnaire (MBSRQ) before, immediately after, and 1 month after the intervention. The chi-square test, independent t-test, and repeated measures test were used to investigate the trend of changes in BICI and MBSRQ and their domains over time in both groups. P values less than 0.05 were considered statistically significant for all tests. Results: Before the intervention, there were no statistically significant differences in demographic characteristics (such as age, age of menopause, and body mass index (BMI)) between the 2 groups; also, there were no statistically significant differences in the mean scores of MBSRQ and BICI between the 2 groups (P &lt; 0.05). After the intervention, a significant increase was observed in the mean scores of MBSRQ and its 3 out of 6 domains (appearance evaluation (AE), appearance orientation (AO), and body areas satisfaction (BAS); P &lt; 0.05), while a significant decrease was observed in the mean scores of BICI in the intervention group compared with the control group (P &lt; 0.05). Conclusions: Cognitive behavioral group therapy based on the Cash 8-step model in postmenopausal women can promote satisfaction with their body image.

The effect of cognitive behavioral therapy on depression of people with epilepsy

BackgroundDepression, a common mental problem frequently detected in people with epilepsy (PWE), is a major factor that decreases the quality of life of PWE. The cognitive behavioral therapy (CBT) is the most commonly used non-pharmacological treatment for depressive disorders. The CBT for PWE with depression has not yet been studied in Korea. This study aimed to evaluate the effects of the CBT on depression in PWE in Korea. MethodThis study included 16 PWE with depression who received CBT and 30 control PWE with depression who did not receive CBT. The mean number of CBT sessions per patient was 7.2 in the CBT group. The Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire-9 (PHQ-9) were administered before and after CBT sessions in the CBT group, whereas PHQ-9 was performed at baseline and follow-up in the control group. The difference in PHQ-9 and BDI-II scores were analyzed between the pre- and post-CBT periods in the CBT group. The difference between baseline and follow-up PHQ-9 scores was compared in the control group. ResultsThere was no significant difference in baseline variables between the CBT and control groups. The PHQ-9 score significantly decreased after the CBT sessions in the CBT group (pre-CBT PHQ-9 = 13.56 vs. post-CBT PHQ-9 = 8.56) but it did not change in the control group (Baseline PHQ-9 = 13.83 vs. follow-up PHQ-9 = 14.67). Twelve PWE had undergone four or more CBT sessions with pre-CBT and post-CBT BDI-II. The BDI-II score significantly decreased after CBT sessions (pre-CBT BDI-II = 30.75 vs. post-CBT BDI-II = 21.5). The CBT decreased the sub-field scores of cognitive and physical-emotional factors as well as suicidal ideation, but the score of sleep problems did not significantly improve. The CBT did not significantly change the seizure frequency. ConclusionThe CBT significantly improved depression in Korean PWE. Therefore, it can be considered a treatment tool for depression in PWE. However, a study with more patients and a fixed number of CBT sessions is recommended to generalize this effect.

The effect of cognitive behavioral therapy on stress and anxiety of mothers of girls with precocious puberty symptoms: a randomized controlled trial

Introduction: Precocious puberty in girls has been associated with an increased risk of stress and anxiety in their mothers. This study aimed to investigate the effect of cognitive behavioral therapy (CBT) on perceived stress and anxiety of mothers of girls with precocious puberty symptoms.MethodsThis randomized controlled trial was conducted on 70 mothers of girls with precocious puberty symptoms in Tabriz-Iran, 2021. The participants were randomly assigned to CBT and control groups through blocked randomization. Group counseling was provided to the intervention group in eight sessions of 45–60 min weekly with 5 to 7 women. A booklet containing explanations about puberty was provided for the both groups. Data were collected using the questionnaires of socio-demographic characteristics, Spielberger State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and quality of life (SF-36). Independent t-test, ANCOVA, chi-square, and fisher’s exact tests were used to compare the outcomes between the groups.Findings: After the intervention, based on ANCOVA test with adjusting the baseline values, mean scores of stress (mean difference (MD): -10.75; 95% confidence interval (95% CI): -11.77 to -9.72; P < 0.001), state anxiety (MD: -14.36; 95% CI: -15.7 to -12.7; P < 0.001) and trait anxiety (MD: -12.8; 95% CI: -14.4 to -11.1; P < 0.001) were significantly lower in CBT group compared to the control group. Also mean score of quality of life (MD: 9.82; 95% CI: -6.74 to -12.90; P < 0.001) was significantly higher in CBT group compared to the control group.ConclusionBased on the results, group CBT is effective in reducing stress and anxiety and improving the quality of life of mothers of girls with precocious puberty symptoms. However, more studies are required to make a definite conclusion in this field.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20110826007418N6. Date of registration: 11/10/2021. URL: https://en.irct.ir/trial/57346; Date of first registration: 11/10/2021.

Reflections on the group dynamic in a group cognitive behavioral therapy intervention for young adult women with moderate to severe dysmenorrhea: a qualitative analysis

A recent group cognitive behavioral therapy (gCBT) intervention for dysmenorrhea conducted by our team demonstrated feasibility, acceptability, and preliminary efficacy at reducing menstrual pain. This study aimed to use qualitative analyses to explore participants’ reflections about the intervention’s group dynamic. Participants included 20 young women ages 18–24 years with average menstrual pain of 8.0 (SD = 1.1) on a 0–10 (0 = none, 10 = worst pain possible) numeric rating scale. Semi-structured individual and group interviews were conducted after the intervention. Researchers then conducted deductive, iterative thematic analysis using a template analysis approach. Two themes were generated: benefit and logistics. The benefit theme included two sub-themes: (1) camaraderie (an emotional, psychological, or social connection between participants); and (2) sharing (information, advice, or experiences). The logistics theme highlighted how the structure of the group influenced the dynamic and was divided into two sub-themes according to the time frame being described: (1) reactions (participants’ experiences with how the group dynamic was facilitated); and (2) future (how the group structure could be improved). Results of this study contribute to the growing body of literature related to gCBT for pain conditions. Future research is needed to optimize the group dynamic and evaluate its specific therapeutic role in the treatment.

Update on treatment studies for compulsive buying-shopping disorder: A systematic review.

Compulsive buying-shopping disorder (CBSD) is mentioned as an example of other specified impulse control disorders in the ICD-11 coding tool, highlighting its clinical relevance and need for treatment. The aim of the present work was to provide a systematic update on treatment studies for CBSD, with a particular focus on online CBSD. The preregistered systematic review (PROSPERO, CRD42021257379) was performed in accordance with the PRISMA 2020 statement. Aliterature search was conducted using the PubMed, Scopus, Web of Science and PsycInfo databases. Original research published between January 2000 and December 2022 was included. Risk of reporting bias was evaluated with the CONSORT guideline for randomized controlled trials. Effect sizes for primary CBSD outcomes were calculated. Thirteen studies were included (psychotherapy: 2open, 4 waitlist control design; medication: 2 open, 3 placebo-controlled, 2 open-label phase followed by a double-blind discontinuation phase; participants treatment/control 349/149). None of the studies addressed online CBSD. Psychotherapy studies suggest that group cognitive-behavioral therapy is effective in reducing CBSD symptoms. Pharmacological studies with selective serotonin re-uptake inhibitors or topiramate did not indicate superiority over placebo. Predictors of treatment outcome were rarely examined, mechanisms of change were not studied at all. Risk of reporting bias was high in most studies. Poor methodological and low quality of reporting of included studies reduce the reliability of conclusions. There is a lack of studies targeting online CBSD. More high-quality treatment research is needed with more emphasis on the CBSD subtype and mechanisms of change.