Efficacy Of Cognitive Behavioral Therapy Research Articles

Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting.

Numerous randomized controlled trials (RCTs) demonstrate the efficacy of cognitive behavioral therapy (CBT), metacognitive therapy (MCT), and methods to reduce intolerance of uncertainty (IU-CBT) in the treatment of generalized anxiety disorder (GAD). However, few studies have investigated these treatments under conditions of routine clinical care. The main objective of this study was to investigate the effectiveness of psychotherapy for GAD in an outpatient setting and to identify factors influencing treatment outcome. Fifty-nine GAD patients received naturalistic CBT (including MCT and IU-CBT) in an outpatient clinic and postgraduate training center for psychotherapy. Patients completed self-report questionnaires at the beginning and end of therapy regarding the main outcome worry as well as metacognitions, intolerance of uncertainty, depression, and general psychopathology. Worry, negative metacognitions, intolerance of uncertainty, depression, and general psychopathology decreased significantly (p's < .001) with large effect sizes for all symptoms (d = 0.83-1.49). A reliable change in the main outcome worry was observed in 80% of patients, and recovery occurred in 23%. Higher worry scores at posttreatment were predicted by higher pretreatment scores, female sex, and less change in negative metacognitive beliefs during treatment. Naturalistic CBT for GAD appears to be effective in routine clinical care for worry as well as depressive symptoms, with particular benefits associated with altering negative metacognitions. However, a recovery rate of only 23% is lower than the rates reported in RCTs. Treatment needs to be improved, especially for patients with more severe GAD and for women.

Efficacious Web-Based Psychotherapy to Address Depression and Anxiety Among Patients Receiving Oncological and Palliative Care: an Open-Label Randomised Controlled Trial

IntroductionOncological and palliative care patients face unique stressors which increase their risk of developing depression and anxiety. Cognitive behavioural therapy (CBT) and mindfulness has established success in improving this population’s mental health. Traditional face-to-face psychotherapy is costly, has long wait lists, often lacks accessibility, and has strict scheduling, each of which can make attending psychotherapy physically, mentally, and financially out of reach for oncological and palliative patients. Web-based CBT (e-CBT) is a promising alternative that has shown efficacy in this and other patient populations.ObjectivesTo quantify the efficacy of online CBT and mindfulness therapy in oncological and palliative patients experiencing depression and anxiety symptoms.MethodsParticipants with depression or anxiety related to their diagnosis were recruited from care settings in Kingston, Ontario, and randomly assigned to 8 weekly e-CBT/mindfulness modules (N= 25) or treatment as usual (TAU; N=24). Modules consisted of CBT concepts, problem-solving, mindfulness, homework, and personalised feedback from their therapist through a secure platform (Online Psychotherapy Tool- OPTT) Participants completed PHQ-9 and GAD-7 in weeks 1, 4, and 8. (NCT04664270: REB# 6031471).ResultsSignificant decreases in PHQ-9 and GAD-7 scores within individuals support the hypothesis of efficacy. At this time, 10 e-CBT/mindfulness and 12 TAU have completed the study. Decreases in PHQ-9 and GAD-7 scores within e-CBT group support the hypothesis of efficacy. Specifically, PHQ-9 scores decreased over the 3 repeated measures (ANOVA, 2 groups, 3 repeated measures and the decrease in GAD-7 scores was similarly large)ConclusionsAs hypothesized, the results suggest that e-CBT/mindfulness therapy is an affordable, accessible, and efficacious mental health treatment for this population. The virtual, asynchronous delivery format is particularly appropriate given the unique barriers.Disclosure of InterestN. Alavi Shareolder of: OPTT inc, Grant / Research support from: department psychiatry Queen’s University, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, G. Layzell: None Declared, J. Eadie: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, D. Kain: None Declared, C. Soares: None Declared, M. Yang: None Declared

Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings.

Anxiety disorders are common in youth, associated with impairments in daily functioning, and often persist into adulthood when untreated. Cognitive behavioral therapy (CBT) for youth anxiety is a well-established intervention and has been modified to fit several treatment settings. Despite decades of results supporting the efficacy of CBT, there is a large gap in access to this treatment and a need to consider how it can best be administered flexibly to increase uptake and personalization. We first discuss the core components of treatment for CBT through the lens of the Coping Cat treatment. Next, we review the empirical findings regarding adjustments made for CBT for youth anxiety delivered (a) in schools, (b) in community settings, (c) through telehealth, (d) through online computer programs, and (e) by caregivers at home. In each setting, we provide specific suggestions for how to implement CBT with flexibility while maintaining fidelity.

Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial

ObjectiveDiabetes distress typically causes depressive symptoms; common comorbidity of diabetes unpleasantly affects patients’ medical and psychological functions. Psychotherapeutic interventions are effective treatments to treat depressive symptoms and to improve the quality of life in many chronic diseases including diabetes. The present study investigated the efficacy of cognitive behavior therapy (CBT) to treat depressive symptoms in patients with type 2 diabetes mellitus (T2DM) using experimental and waitlist control conditions.Materials and MethodsA total of 130 diagnosed patients with T2DM were taken from outdoor patients services of different hospitals in Faisalabad. Ninety patients met the eligibility criteria and were randomly assigned to experimental (n = 45) and waitlist control (n = 45) conditions. All the patients completed clinical interviews and assessment measures at pre-and post-assessment stages (16 weeks intervals). Medical consultants at the respective hospitals diagnosed the patients on the base of their medical reports and then referred those patients to us. Then we used different scales to assess primary and secondary outcomes: Diabetes Distress Scale (DDS) and Patient Health Questionnaire (PHQ) to assess primary outcomes, and a Short Health Anxiety Inventory (SHAI), a Revised Version of the Diabetes Quality of Life Questionnaire (DQLQ), and a General Medication Adherence Scale (GMAS) were used to investigate secondary outcomes. Repeated measure ANOVA was used to analyze the results.ResultsThe findings indicated that patients who received CBT got a significant reduction in their diabetes distress F(1,60) = 222.710, P < 0.001, η2 = .788), depressive symptoms F(1,60) = 94.436, P < 0.001, η2 = .611), health anxiety F(1,60) = 201.915, P < .0.001, η2 = 771), and a significant improvement in their quality of life F(1,60) = 83.352, P < 0.001, η2 = .581), treatment adherence F(1,60) = 67.579, P < 0.001, η2 = .566) and physical activity schedule F(1,60) = 164.245, P < .0.001, η2 = .736 as compared to the patients in waitlist control condition.ConclusionIt is concluded that cognitive behavior therapy is an effective and promising intervention for depressive symptoms, diabetes distress, and health anxiety which also helps the person to promote quality of life, treatment adherence and physical activity.

Efficacy of Cognitive Behavioral Therapy for Alcohol and Other Drug Use Disorders: Is a One-Size-Fits-All Approach Appropriate?

We provide an overview of Cognitive Behavioral Therapy (CBT) efficacy for adult alcohol or other drug use disorders (AOD) and consider some key variations in application as well as contextual (ie, moderators) or mechanistic (ie, mediators) factors related to intervention outcomes. This work is a narrative overview of the review literature on CBT for AOD. Robust evidence suggests the efficacy of classical/traditional CBT compared to minimal and usual care control conditions. CBT combined with another evidence-based treatment such as Motivational Interviewing, Contingency Management, or pharmacotherapy is also efficacious compared to minimal and usual care control conditions, but no form of CBT consistently demonstrates efficacy compared to other empirically-supported modalities. CBT and integrative forms of CBT have potential for flexible application such as use in a digital format. Data on mechanisms of action, however, are quite limited and this is despite preliminary evidence that shows that CBT effect sizes on mechanistic outcomes (ie, secondary measures of psychosocial adjustment) are moderate and typically larger than those for AOD use. CBT for AOD is a well-established intervention with demonstrated efficacy, effect sizes are in the small-to-moderate range, and there is potential for tailoring given the modular format of the intervention. Future work should consider mechanisms of CBT efficacy and key conditions for dissemination and implementation with fidelity.

Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: a comprehensive meta-analysis including 409 trials with 52,702 patients.

Cognitive behavior therapy (CBT) is by far the most examined type of psychological treatment for depression and is recommended in most treatment guide-lines. However, no recent meta-analysis has integrated the results of randomized trials examining its effects, and its efficacy in comparison with other psychotherapies, pharmacotherapies and combined treatment for depression remains uncertain. We searched PubMed, PsycINFO, Embase and the Cochrane Library to identify studies on CBT, and separated included trials into several subsets to conduct random-effects meta-analyses. We included 409 trials (518 comparisons) with 52,702 patients, thus conducting the largest meta-analysis ever of a specific type of psychotherapy for a mental disorder. The quality of the trials was found to have increased significantly over time (with increasing numbers of trials with low risk of bias, less waitlist control groups, and larger sample sizes). CBT had moderate to large effects compared to control conditions such as care as usual and waitlist (g=0.79; 95% CI: 0.70-0.89), which remained similar in sensitivity analyses and were still significant at 6-12 month follow-up. There was no reduction of the effect size of CBT according to the publication year (<2001 vs. 2001-2010 vs. >2011). CBT was significantly more effective than other psychotherapies, but the difference was small (g=0.06; 95% CI: 0-0.12) and became non-significant in most sensitivity analyses. The effects of CBT did not differ significantly from those of pharmacotherapies at the short term, but were significantly larger at 6-12 month follow-up (g=0.34; 95% CI: 0.09-0.58), although the number of trials was small, and the difference was not significant in all sensitivity analyses. Combined treatment was more effective than pharmacotherapies alone at the short (g=0.51; 95% CI: 0.19-0.84) and long term (g=0.32; 95% CI: 0.09-0.55), but it was not more effective than CBT alone at either time point. CBT was also effective as unguided self-help intervention (g=0.45; 95% CI: 0.31-0.60), in institutional settings (g=0.65; 95% CI: 0.21-1.08), and in children and adolescents (g=0.41; 95% CI: 0.25-0.57). We can conclude that the efficacy of CBT in depression is documented across different formats, ages, target groups, and settings. However, the superiority of CBT over other psychotherapies for depression does not emerge clearly from this meta-analysis. CBT appears to be as effective as pharmacotherapies at the short term, but more effective at the longer term.

Efficacy of bupropion and cognitive behavioral therapy in the treatment of methamphetamine use disorder: a systematic review and meta-analysis.

To assess the efficacy of bupropion and cognitive behavioral therapy (CBT) compared with CBT alone in methamphetamine use disorder management. A systematic review study with meta-analysis was carried out. The selection criteria were randomized clinical trials that investigated the efficacy of bupropion and CBT in methamphetamine use disorder treatment under the detection of metabolites in urine. The search was conducted in Pubmed, PMC, LILACS, Scielo, Cochrane Library, SCOPUS, Google Scholar, Ovid Medline, Clinicaltrials.gov and ICTRP. The primary outcome was relapses. The risk of bias was assessed with ROB 2 tool. The researchers extracted the results of each clinical trial and placed them in an Excel spreadsheet. We performed a meta-analysis using RR with a 95% confidence interval. 597 initial articles were obtained, 498 after the removal of duplicate articles and only 5 studies were included in the meta-analysis. Together they gathered a sample of 539 patients. An overall RR of 0.91 (95% CI 0.78-1.05) was estimated for methamphetamine relapses. Regarding the limitations of our study, we found publication bias. We also included articles with heterogeneous populations. No evidence was found that bupropion and CBT reduced the risk of relapse compared to those receiving CBT and placebo.

The state of psychological treatments for social anxiety disorder in children and adolescents: An Umbrella Review

Social Anxiety Disorder (SAD) is a very common disorder in childhood and adolescence. Many studies have examined various types of Cognitive Behavioral Therapy (CBT), meaning there is a need for a study exploring the efficacy of CBT. The objectives of this study are to determine what treatments and factors can improve treatment outcomes for SAD. We performed an umbrella review of the effectiveness of psychological interventions in treating SAD in children and adolescents. Nine databases were searched using a combination of keywords. Risk of bias was assessed using AMSTAR-2. Six systematic reviews and meta-analysis were selected and reported. All of those studies assessed the efficacy of CBT in children and adolescents with SAD, demonstrating its short- and long-term effectiveness. The components that seem to be most effective are exposure in any modality and social skills training. Other considerations to take into account are addressed in the discussion.

Complementing cognitive behavioral therapy (CBT) for Pacific peoples in New Zealand

This study aimed to determine the efficacy of cognitive behavioral therapy (CBT) delivery to Pacific peoples by exploring Pacific psychologists’ perspectives. The research was qualitative in its approach, using the Pacific methodology of “ talanoa.” The study carried out two face-to-face focus-group interviews using the talanoa method. Initially, nine participants expressed their interest in the study. However, five participants did not attend the interviews. Three participants participated in the first focus group discussion, and one participant participated in the second focus group, which resulted in an individual interview. All four participants were clinically trained psychologists, with an average of 14 years of clinical experience. These participants worked continuously with Pacific service users in various mental health settings and private practice. The need to enhance the compatibility of CBT with the culture of Pacific peoples was highlighted throughout the study. From the psychologists’ perspectives, there were significant challenges regarding the delivery of CBT among Pacific peoples. These included: accessibility barriers due to socioeconomic and financial stressors; funding constraints and the availability and affordability of therapy sessions; the appropriateness of treatment that needed to be tailored to suit Pacific peoples; and the lack of spiritual and cultural aspects of treatment. The results of the study provide preliminary validation for the efficacy of CBT among Pacific peoples. There is an increasing awareness that delivering culturally relevant and appropriate care to Pacific peoples living in New Zealand requires a deeper understanding of valuing the realities and unique experiences they bring both collectively and individually. Ultimately, the findings provide significant insight into the barriers to the efficacy of CBT and strategies to overcome these.

Supplemental Material for A Meta-Analytic Test of the Efficacy of Cognitive Behavioural Therapy for Perfectionism: A Replication and Extension

Supplemental Material for A Meta-Analytic Test of the Efficacy of Cognitive Behavioural Therapy for Perfectionism: A Replication and Extension

Effectiveness of psychological interventions for eating disorders in adolescence: An overview of systematic reviews

Eating disorders (EDs) are high prevalent among adolescents with serious consequences. Evidence of effectiveness of psychological interventions for eating disorders in adolescents lacks a systematic synthesis of systematic reviews. The goal of this umbrella review is to summarize evidence from systematic reviews examining effects of psychological interventions for eating disorders targeting adolescents. Web of Science, PsycINFO and Cochrane Database of Systematic Reviews were searched for systematic reviews on effectiveness and/or efficacy of any psychological intervention aiming to treat eating disorders in terms of outcomes in adolescents (improvement of eating-disorder symptoms, weight restoration and treatment retention). The methodological quality of each study was assessed using AMSTAR 2. The original search identified 831 reviews, 9 of which were included in the overview of systematic reviews rated as having a low methodological quality. Predominant psychological interventions for EDs in adolescents are family-based interventions. The efficacy of cognitive behavioral therapy and third-wave treatments has been less researched. Anorexia nervosa and bulimia nervosa are the EDs that have been studied the most. This study provides evidence supporting the positive impact of psychological interventions on eating disorders in adolescents. Family based treatment is the most evidence-based psychological intervention. There is a need for high-quality systematic reviews as well as systematic reviews to examine if psychological interventions are effective for different eating disorders.

The Efficacy of Cognitive-Behavioral Therapy on Coping Strategies and Anxiety Sensitivity of Patients With COVID-19 Obsession

Background: One of the factors affecting people’s mental health is having repeated and confused thoughts about COVID-19. In this regard, the present study was conducted to investigate the effectiveness of cognitive-behavioral therapy on coping strategies and anxiety sensitivity of patients with COVID-19 obsession. Methods: The present research method was quasi-experimental and pre-test-post-test design with a control group. The statistical population of the study included patients with COVID-19 obsession in 2021. The study sample includes 30 patients with COVID-19 obsession who were selected using the convenience sampling method and were randomly divided into two experimental groups (n=15) and control groups (n=15). The collection tool included a questionnaire on COVID-19 obsession, coping strategies, and anxiety sensitivity. The experimental group received ten 90-minute sessions of cognitive-behavioral therapy, but the control group received no intervention. Finally, the obtained data were analyzed by multivariate covariance analysis in SPSS software, version 24 (P&lt;0.05). Results: The results showed that cognitive-behavioral therapy significantly increased the problem-oriented coping strategy and decreased the emotion-oriented coping strategy, avoidance coping strategy, and anxiety sensitivity (physical, cognitive and social) in patients with COVID-19 obsession (P&lt;0.01). Conclusion: The obtained findings indicated that cognitive-behavioral therapy can significantly improve the patients with COVID-19 obsession. Considering the long-term consequences of COVID-19, psychology and counseling centers should take measures to identify and treat vulnerable groups.

CBT for post-traumatic stress disorder and depression in the context of pregnancy loss: a case study reflection

Abstract Women who experience pregnancy loss are at increased risk of psychological distress, including post-traumatic stress disorder (PTSD) and depression. Despite the substantial evidence base for trauma-focused cognitive behavioural therapy (CBT) for PTSD, there is limited research on this specific type of trauma, as well as a dearth of research exploring treatment for co-morbid PTSD and depression. This study used a single case experimental design to assess the efficacy of sequential CBT for treating PTSD and depression in a primary care setting in the United Kingdom. Results demonstrate a reduction in scores on the PCL-5 following trauma-focused CBT, but not a clinically significant reduction in depression scores. This write-up reflects on the effectiveness of sequential treatment and suggests alternative approaches. Future directions for research are also given. Dedication: The authors dedicate this paper to all parents who have experienced pregnancy or baby loss. Key learning aims (1) To gain an understanding of some of the challenges in delivering CBT for trauma related to pregnancy loss. (2) To reflect on treatment of co-morbid PTSD and depression through flexible use of evidence-based treatment, and consider alternative approaches to sequential treatment. (3) To consider the impact of grief in formulation and treatment.

Efficacy of virtual reality-based exposure therapy for the treatment of fear of flying: a systematic review

Abstract Previous research has shown that virtual reality (VR)-based exposure therapy is effective in the treatment of anxiety disorders. However, more information regarding the specific features of this intervention for the treatment of fear of flying (FoF) is needed. The primary aim of this systematic review was to update and analyse the existing data on the efficacy of VR exposure treatment (VRET) in FoF, providing information on the optimal methodological conditions for its administration. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed to select the articles. PsycInfo, Medline and Web of Science were chosen as databases with a wide range of publications related to health and psychology. Thirty-three eligible articles were included in this review. Results showed that participants’ anxiety decreased after being systematically exposed to flight-related VR environments. VRET is at least as effective as other evidence-based treatments, such as cognitive behavioural therapy (CBT) or in vivo exposure therapy (IVET), and therefore is a highly recommended alternative when IVET is difficult to administer, and an excellent complement to enhance CBT efficacy. Regarding sensory cues, the addition of motion feedback synchronised with visual and auditory cues during the exposure to VR environments might improve the efficacy of VRET for FoF, but more research supporting this statement is still needed.

Efficacy of cognitive behavioral therapy after the surgical treatment of women with endometriosis: A preliminary case-control study

Regardless of unique status or symptoms, any woman with endometriosis is at risk of developing mental health issues such as anxiety and depression. Cognitive behavioral therapy (CBT) is an effective psychological treatment for depression, anxiety, and stress. The objectives of the study were to see whether usual care combined with CBT improves depression, anxiety, and stress in patients after surgery for endometriosis as compared to usual care alone. Patients aged 18 to 50 years old with endometriosis who were scheduled for surgery were received usual care (Chinese martial arts) with CBT (1 pre-surgery and 6 post-surgery CBT sessions; Case or Intervention group, n = 48) or usual care only (Control group, n = 48). The demographic characteristics questionnaire was given to all individuals. Depression, anxiety, and stress were evaluated at baseline (within 24 hours after admission to the hospital) and postintervention (immediately before discharged) in both groups using the Chinese short version of Depression Anxiety and Stress scale (DASS-21). At postintervention DASS-21 scores for depression, anxiety, and stress of the case group and the control group were decreased as compared to baseline (P < .0001 for all). At postintervention DASS-21 score for anxiety of the case group was decreased compared to the control group (P = .0091). Usual care plus CBT significantly increased the number of females with no symptoms of depression as compared to baseline at postintervention(s) (P = .0356). At postintervention(s), there was no female with extremely severe depression in both groups. Usual care plus CBT significantly decreased the number of females with symptoms of extremely severe anxiety as compared to baseline at postintervention(s) (P = .035). Unlike the control group, in the case group, there were no females with extremely severe stress at postintervention. females with endometriosis who had surgery reported high levels of depression, anxiety, and stress at the time of hospital admission. Patients with endometriosis can benefit from CBT.

Efficacy of cognitive behavioural therapy for insomnia or sleep disturbance in pregnant women: A systematic review ad meta-analysis.

During pregnancy many women may experience negative emotions and sleep disturbances. This systematic review and meta-analysis was conducted to assess the efficacy of cognitive behavioural therapy for insomnia (CBT-I) or sleep disturbance in pregnant women. From the earliest available publications to 15 April 2022, seven electronic literature databases were searched: PubMed, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure, Wanfang Data, and VIP Database for Chinese Science and Technology Journal. Randomised controlled trials of CBT-I in pregnant women with insomnia or sleep disorders were included. The methodological bias of the included studies was assessed using the Cochrane risk of bias tool. The meta-analysis was performed using RevMan 5.4 software. Stata Statistical Software: Release 15 was used for sensitivity analysis and publication bias. We included eight randomised controlled trials involving 743 pregnant women. Meta-analysis showed that, compared with the control group, CBT-I significantly improved the Insomnia Severity Index (mean difference [MD]=-4.25, 95% confidence interval [CI, -6.32, -2.19], p < 0.001), The Pittsburgh Sleep Quality Index (MD=-3.30, 95% CI [-4.81, -1.79], p < 0.001), sleep onset latency (standardised mean difference [SMD]=-1.25, 95% CI [-2.01, -0.50], p=0.001), anxiety (SMD=-0.99, 95% CI [-1.32, -0.67], p < 0.001), and depression (SMD=-0.40, 95% CI [-0.72, -0.07], p=0.02). No significant differences were found in total sleep time (SMD=0.31, 95% CI [-0.54, 1.17], p=0.47) and sleep efficiency (SMD=0.80, 95% CI [-0.53, 2.13], p=0.24). CBT-I significantly improved pregnant women's sleep quality, insomnia severity, depression, and anxiety. This meta-analysis provides evidence that CBT-I is valid for insomnia or sleep disturbances during pregnancy.

Efficacy of Cognitive Behavioral Therapy and Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Systematic Review.

The treatment of attention deficit hyperactivitydisorder (ADHD) in children and adolescents can be challenging and involve a combination of pharmacologic and non-pharmacological approaches. Using recent literature, we aim to identify the effectiveness of cognitive behavioral therapy (CBT) and methylphenidate (MPH) in reducing the symptoms and improving the quality of life. The investigators conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)2020 guidelines. Investigators independently conducted a routine search on PubMedand Google Scholar for articles published within the last five years through July 30, 2022. Fourteen studies were identified as generally good quality but with some limitations. The final analysis included 2098 patients with an age range of three to eighteen. Nine studies reporting the efficacy of MPH in children, adolescents, or both had different formulations and doses. Six studies documenting the effectiveness of CBT had varying sessions, duration per therapy, modality of administration, and participants. The diagnostic assessment measures showed that the parent symptom rating was the highest and appeared in 11 studies, reflecting the burden on the family. In addition, a structured-self-rated questionnaire rating appeared in eight studies, and two diagnostic assessment measures, teacher symptom rating and investigators, appeared in six. The studies demonstrated significant reductions in the primary symptoms of ADHD at assessment, which led to improved behavioral and functional status with a reduced impact on family and society. Further trials are needed to understand the benefits of CBT and MPH when combined to reduce psychiatry co-morbidities and improve learning and overall quality of life in the long term.

Eye Movement Desensitization and Reprocessing versus Cognitive Behavior Therapy for Treating Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis.

This meta-analysis review compared eye movement desensitization and reprocessing and cognitive behavior therapy efficacy in reducing post-traumatic stress disorder (PTSD), anxiety, and depression symptoms. A systematic search for articles published between 2010 and 2020 was conducted using five databases. The RevMan software version 5 was used. Out of 671 studies, 8 fulfilled the inclusion criteria and were included in this meta-analysis. Three studies reported that eye movement desensitization and reprocessing reduced depression symptoms better than cognitive behavior therapy in both children, adolescents, and adults (SDM (95% CI) = -2.43 (-3.93--0.94), p = 0.001). In three other studies, eye movement desensitization and reprocessing were shown to reduce anxiety in children and adolescents better than cognitive behavior therapy (SDM (95% CI) = -3.99 (-5.47--2.52), p &lt; 0.001). In terms of reducing PTSD symptoms, eye movement desensitization and reprocessing and cognitive behavior therapy did not demonstrate any statistically significant differences (SDM (95% CI) = -0.14 (-0.48-0.21), p = 0.44). There was no statistically significant difference at the three-month follow-up and at the six-month follow-up for depression (p = 0.31), anxiety (p = 0.59), and PTSD (p = 0.55). We recommend randomized trials with larger samples and longer follow-up times in the future.

Initiation of Pharmacotherapy Following CBT in Anxious Youth

Objective: To describe youth with anxiety disorders who initiate pharmacotherapy following cognitive-behavioral therapy (CBT) in a prospective, randomized trial and to identify predictors of the decision to use pharmacotherapy.Methods: Data from CBT-treated youth (aged 7-17 years, N = 139) in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multisite, randomized controlled trial that examined the efficacy of CBT, sertraline, their combination, and placebo for pediatric anxiety disorders (DSM-IV criteria), were evaluated. Initiation of pharmacotherapy following acute CBT treatment was examined over a 24-week period; the study was conducted from December 2002 through May 2007. Logistic regression models identified features associated with initiating pharmacotherapy, including symptom severity (scores on the Pediatric Anxiety Rating Scale [PARS] and the Screen for Child/Adolescent Anxiety Related Disorders [SCARED]), parent and child treatment expectations, Clinical Global Impressions-Improvement/Severity of Illness (CGI-I/S) scores, and clinical and demographic characteristics.Results: CBT non-remitters (CGI-S score > 2) who began pharmacotherapy (n = 10) and those who did not (n = 80) were similar in age (P = .445), sex (P = .324), race (P = .242), and symptom severity based on CGI-S (P = .753), PARS (P = .845), or SCARED (P = .678) scores. Mean ± SD improvement (CGI-I score) at week 12 did not differ between patients who initiated pharmacotherapy (3.00 ± 0.82) and those who did not (2.69 ± 0.89, P = .798). However, in the logistic regression, age (P = .003), race (P = .021), and parents' treatment expectation (P = .037) were significantly associated with the likelihood of initiating pharmacotherapy. Beginning pharmacotherapy in CBT non-remitters was associated with a significant improvement in CGI-S score (mean ± SD decline: -0.99 ± 0.46; 95% credible interval [CrI], -0.088 to -1.89; P = .035) from week 12 to week 36 compared to patients who did not begin pharmacotherapy.Discussion: Very few CBT non-remitters initiated pharmacotherapy, although beginning medication produced significant improvement. Younger and racial and ethnic minoritized patients as well as those with lower expectations for CBT were less likely to begin medication.Trial Registration: ClinicalTrials.gov identifier: NCT00052078.

Experience of psychologists in the delivery of cognitive behaviour therapy in a non-western culture for treatment of substance abuse: a qualitative study

BackgroundPsychotherapy is the preferred form of treatment for psychological disorders worldwide. Cognitive behaviour therapy (CBT) is one of the most widely used psychotherapies due to its proven efficacy for psychological disorders, including substance abuse. However, CBT was developed in the West according to the culture of developed countries. Therefore, it requires cross-cultural adaptation for non-Western countries. Pakistan is one of the developing non-Western countries where substance use disorders are increasing at an alarming rate. Despite the proven efficacy of CBT for substance use disorders, there is a dearth of its utilization in Pakistan. Therefore, in the present study, in-depth qualitative interviews were conducted with CBT practitioners in Pakistan to understand barriers and challenges in this regard. The study was a part of a broader project aimed at cultural adaptation of CBT for people with substance use disorders (SUDs) in Pakistan.MethodsIn-depth qualitative interviews were conducted with CBT practitioners (N = 8) working in rehabilitation centres and hospitals in Islamabad, Pakistan. Thematic content analysis was conducted to develop core themes from the data.ResultsCBT for SUDs requires some adjustments according to Pakistani culture for successful utilization. The challenges in providing CBT for SUDs revolved around three main themes, i.e., the mental health system, societal practices, and therapeutic issues, and 10 subthemes.ConclusionIn order to utilize the benefits of CBT for SUDs in Pakistan, cultural adaptation is necessary as an initial step. However, its delivery requires stringent modifications in the health care system to address these challenges.