Evidence-based Psychotherapeutic Interventions Research Articles

Psychotherapy and Psychosis

Psychosis, characterized by positive symptoms such as hallucinations and delusions and negative symptoms like flat affect and anhedonia, impacts 3% of the population, profoundly affecting functioning and quality of life. Recent advances in psychiatry have integrated psychotherapy into patient-centered care for psychosis, complementing medication management. Cognitive-behavioral therapy for psychosis (CBTp) and its variations, alongside family psychoeducation and social-skills training, represent evidence-based interventions aimed at reducing psychosis-related distress and improving functionality. Challenges such as substance use, cultural barriers, and comorbidities necessitate specialized, integrated approaches. This article reviews evidence-based psychotherapeutic interventions, techniques like reality testing and cognitive restructuring, and adaptations for special populations, including minorities, transgender individuals, and older adults. Despite progress, disparities in treatment access and research gaps persist, particularly for children and adolescents. Addressing these barriers and refining culturally and contextually sensitive interventions is crucial for optimizing outcomes in individuals with psychosis. [ Psychiatr Ann . 2025;55(1):e14–e18.]

FC8: Specific protocol for individual Psychotherapy based on Cognitive Behavioral Therapy for people with Mild Cognitive Impairment (MCI) and Mild Dementia (MDl)

Objectives: To discuss a proposal for a cognitive behavioral psychotherapy protocol for people with Mild Cognitive Impairment and Mild Behavioral Impairment framed within psychosocial treatments.Methods: The lack of a specific psychotherapy protocol in Latin America for the selected population will be presented, as well as the need to complement cognitive stimulation treatment with cognitive behavioral psychotherapy for the corresponding cases. The literature explored in this theoretical framework will be addressed and the steps to follow in the aforementioned project will be proposed.Results: Currently, there are two main intervention pathways for MCI and DM, known as pharmacological and psychosocial treatments. The latter become indispensable when considering them as multicausal and multidimensional pathologies and psychological treatments are part of them (Berriel and Fernández, 2007). Psychotherapy in particular allows patients to deal with behavioral changes and the experience related to the disease in a more functional way in the long term (Linnemann and Fellgiebel, 2017). However, there are few studies that address evidence-based psychotherapeutic interventions. Even in Latin America, there are no reports of protocols that can be generalized for application in clinical practice. Faced with this absence, the project of developing a specific cognitive behavioral psychotherapy protocol for this population isframed.Conclusions: There are few studies that address evidence-based psychotherapeutic interventions, and there are not even reports of generalizable protocols in Latin America. In light of this absence, a project is underway to develop a specific cognitive behavioral psychotherapy protocol for this population based on the limited evidence, extensive clinical experience and adapted to the preferences and needs of the localpopulation.

The Audacity Health Method: Enhancing Therapeutic Understanding and Client Empowerment

The Audacity Health method utilizes the Feynman Technique, a learning method developed by Nobel Prize-winning physicist Richard Feynman. It emphasizes deep understanding and simplification of complex concepts through teaching. This paper explores the application of the technique within the context of psychotherapy to enhance both therapist and client comprehensions of psychological processes. Implementing a step-by-step approach, therapists can break down and demystify intricate behavioural and emotional patterns, facilitating a more profound grasp of factors that cause and maintain the mental illness the individual is seeking therapy to treat. Through a case study example, this paper demonstrates how the method can be employed to clarify the client’s issues, empowering them to gain insight into their mental health and generate solutions for symptoms. The outcomes suggest that the Audacity Health method fosters more effective communication, reinforces therapeutic alliance, and promotes active client participation in treatment. Ultimately, this integration aims to optimize therapeutic efficacy by merging educational simplification with evidence-based psychotherapeutic interventions to advance mental health.

Metacognitive training in the acute psychiatric care setting: feasibility, acceptability, and safety.

ID: DRKS00020551, https://drks.de/search/de/trial/DRKS00020551.

Posttraumatic Stress Disorder (PTSD) as a Risk Factor for Cardiovascular Disease: Implications for Future Research and Clinical Care.

Posttraumatic stress disorder (PTSD) may be an important risk factor for cardiovascular disease (CVD). We explore the literature linking PTSD to CVD, potential mechanisms, interventions, and clinical implications. We outline gaps in current literature and highlight necessary future research. PTSD has been independently associated with deleterious effects on cardiovascular health through biological, behavioral, and societal pathways. There are evidence-based psychotherapeutic interventions and pharmacotherapies for PTSD that may mitigate its impact on CVD. However, there are limited studies that rigorously analyze the impact of treating PTSD on cardiovascular outcomes. Trauma-informed CVD risk stratification, education, and treatment offer opportunities to improve patient care. These approaches can include a brief validated screening tool for PTSD identification and treatment. Pragmatic trials are needed to test PTSD interventions among people with CVD and evaluate for improved outcomes.

Measuring practitioner attitudes toward psychosis and recovery: Exploratory factor analysis of the Psychosis Attitudes Scale.

Practitioner attitudes regarding the nature of psychosis and prospects of recovery are important targets in supervision and training of practitioners who work therapeutically with this population. The 19-item Psychosis Attitudes Scale (PAS) was developed as a way to monitor changes in psychosis-related attitudes among practitioners being trained in an Evidence Based Treatment (EBT) for psychosis. This study reports the development and underlying factor structure of the PAS. Three hundred twenty-five community mental health clinicians completed the PAS following a Cognitive Behavioral Therapy for psychosis (CBTp) multiday workshop training. We conducted an exploratory factor analysis to investigate the underlying structure of the initial set of items. Our analyses suggest that the PAS taps into four attitude groupings, which can be conceptualized as perceived confidence in working with individuals with psychosis (Factor 1), a recovery orientation (Factor 2), expectations of fulfillment (Factor 3), and a stress-vulnerability orientation (Factor 4). Factors 1 and 3 appear to tap into general themes relevant to training practitioners in an evidence-based psychotherapeutic intervention for psychosis. Factors 2 and 4 are consistent with guiding principles of high-fidelity CBTp. At the individual level, practitioner attitudes have implications for training retention and treatment delivery. At the organizational level, the collective attitudes of staff in a given setting may serve as an indicator of readiness for EBT for psychosis implementation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Interventions for Children and Adolescents Living in Foster or Institutional Care - A Systematic Review

Children or adolescents living in foster or institutional care received so far insufficient consideration in therapy intervention research. At the same time, they are a high-risk group for developing mental illness. The aim of this systematic review is to record evidence-based psychotherapeutic interventions of the past 15 years on a national and international level that address children and young people living in foster care and youth welfare institutions and their mental health. Through a systematic literature research, interventions for the target group described were identified and analyzed about their specificity and evidence. From 170 publications, ten interventions with sufficient evidence could be included in the present analysis. The result of the current literature research shows that further specialized psychiatric-psychotherapeutic interventions for children in foster care and youth welfare institutions are necessary. Regarding the transferability to the German youth welfare and health system, cross-system and interdisciplinary cooperation is needed. Hereafter further research is required to establish specific and evidence-based intervention approaches.

The efficacy of short-term individual interpersonal psychotherapy in augmentation with pharmacotherapy in major depressive disorder

Background The high prevalence rates and persistently increasing burden of depression indicate that there are still many unmet needs in the management of depression. Interpersonal psychotherapy (IPT) is one of the main evidence-based psychotherapeutic interventions for depression.Aim To evaluate the efficacy of short-term individual IPT in combination with pharmacotherapy, compared with pharmacotherapy alone, in the treatment of depression and assess its role in improving social functioning.Setting and design This study was conducted in Mansoura University hospitals and was an interventional randomized controlled trial.Patients and methods A total of 40 patients were recruited and randomized into either the interventional group or the control group. The interventional group received IPT in combination with selective serotonin reuptake inhibitor. IPT was in the form of once weekly session for 12 weeks. Patients in the control group received treatment with an selective serotonin reuptake inhibitor with appointments once every 2 weeks. Patients from both groups were assessed by the Montgomery–Asberg Depression Rating Scale and the Social Adjustment Scale Self-Report at the beginning and after 12 weeks.Statistical analysis IBM SPSS Statistics version 20.0 was used for statistical analysis.Results There were highly statistically significant improvements in depressive symptoms and in social functioning between the baseline assessments and after 12 weeks on the used scales in both groups. There was a trend for better improvement in the interventional group (IPT+pharmacotherapy) in depressive symptoms and in overall and specific domains of social functioning when compared with the control group. The interventional group showed statistically significant better improvements in social functioning when compared with the control group.Conclusions Combined IPT and pharmacotherapy shows clear benefits over pharmacotherapy alone, in both alleviating depressive symptoms and improvement of social functioning.

Facilitators and barriers perceived by health professionals in the implementation of Managing Cancer and Living Meaningfully (CALM) psychotherapy in Santiago.

IntroductionPalliative care (PC) for advanced cancer is guaranteed by law in Chile, but the formal training for it is insufficient. Training models have emerged internationally that enable professionals to be better prepared for the provision of psychotherapy in PC. The objective of this study is to explore health professionals’ perceptions of the ‘Managing Cancer and Living Meaningfully’ (CALM) psychotherapy and the perceived barriers and facilitators to its implementation, based on a theoretical training.MethodsA qualitative study was carried out with health professionals working in oncology and/or PC and participating in a CALM training. A focus group was conducted after to explore the experience of CALM training and the perceived barriers and facilitators to its implementation. A thematic analysis of the content and an analysis of the facilitators and barriers to the implementation of mental health services were carried out.ResultsTwenty four professionals participated in the training, six of whom were part of the subsequent focus group. There was a consensus that the training was a positive professional experience and that it is a culturally sensitive and feasible intervention for application in Chile. The barriers identified include institutional bureaucracy as resistance to change, the excess workload of the clinical teams and the absence of spaces for more in-depth training.ConclusionsCALM is a useful and relevant framework for the training of health professionals working in oncology and PC. In Chile, there is a need for training spaces on this topic. Future research and organisational studies should evaluate professionals’ beliefs about, and resistance to, adopting evidence-based psychotherapeutic interventions.

Improving substance misuse outcomes in contingency management treatment with adjunctive formal psychotherapy: a systematic review and meta-analysis

ObjectivesContingency management (CM) is a treatment for substance misuse that involves the provision of incentives. This review examines the hypothesis that adding another formal psychotherapy, such as cognitive–behavioural therapy (CBT)...

Psychotherapeutic interventions for LGBTQ + youth: a systematic review

LGBTQ + youth are at elevated risk for suicidality, substance use, and other mental health concerns. Evidence-based psychotherapeutic interventions are often the first line treatment for mental health concerns. However, there is limited research examining the effectiveness of such interventions among LGBTQ + adolescents. This systematic review synthesizes extant literature examining psychotherapeutic interventions for LGBTQ + adolescents with mental illness and/or substance use. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, studies were assessed for inclusion eligibility. Researchers consulted three electronic databases, yielding a total of 666 results. Ten studies, with interventions ranging from drug use prevention to school-counseling, met inclusion criteria. Seven studies implemented adaptations to standard intervention protocol to make intervention content more accessible to LGBTQ + clients. Outcomes included decreased depressive symptoms, substance use, and social isolation. Significant design and methodological limitations were present across most studies, with four using a case study design and only two using a randomized controlled trial design. The review highlights preliminary evidence supporting the use of mental health interventions for LGBTQ + youth. However, more rigorous research is needed to determine if adapted interventions that include population-specific concerns of minority stress are more effective than treatment as usual.

The effectiveness of Mindfulness-Based Cognitive Therapy on the illness perception and Psychological Symptoms in patients with Rheumatoid Arthritis

This study was conducted to evaluate the Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on the Illness Perception (IP) and Psychological Symptoms (PS) for Patients in primary care with an active symptom of Rheumatoid Arthritis (RA). The present design is a clinical trial that uses the pre-test and post-test design with a control group. MBCT as an evidence-based psychotherapeutic intervention and Mindfulness-Based Intervention (MBI), is an 8-week course developed for patients with relapsing depression that integrates mindfulness meditation practices and cognitive therapy. This semi-experimental study was conducted using a pretest-posttest and control group. Diagnostic criteria for the diagnosis of patients with RA were all patients with RA who visited the clinic of Jam Rheumatology Centers and met other inclusion criteria in Mashhad in the spring of 2018. Therefore, 28 patients were randomly selected from the diagnostic group. They were randomly assigned to an experimental group and a control group (14 individuals in each group) and then were post-tested after two months. The data were collected using the revised Illness Perception Questionnaire (IPQ-R) and Depression Anxiety Stress Scales (DASS-21 scores) which were completed by the participants. The data were analyzed using repeated measures MANOVA. The results showed that there was a significant difference between the mean scores of pre-test (before MBI) and post-test (after MBI) in the experimental group compared to the control group, and MBCT had a significant effect on the perception of the disease and the psychological syndrome in the experimental group compared to the control group. Therefore, it can be concluded that MBCT is effective on IP and psychological syndrome and can be used as an MBI method to reduce the illness perceptions in people with RA. The future researches with longer pursuing period's efficacy continuation are suggested.

Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.

Psychotherapy of psychotic disorders

Psychotherapy of psychotic disorders Abstract. The efficacy of psychotherapy for individuals with psychotic disorders is well documented and its implementation is recommended by international guidelines. Goals of psychotherapeutic interventions are reduction of symptoms, prevention of relapse, improvement of cognitive, emotional and social functioning, social integration and participation, and enhancement of quality of life as well as self-perception. Cognitive-behavioral and family interventions, cognitive and social trainings as well as psychoeducation are particularly recommended according to the literature. Fundamental factors for a favorable treatment result are a profound therapeutic relationship, a therapeutic setting according to patients' needs, and a specific coordination with other interventions within the individual treatment concept. The implementation of evidence-based psychotherapeutic interventions for individuals with psychotic disorders in clinical routine practice seems to be most challenging for future mental health service organization and research.

Factors associated with psychotic relapse in patients with schizophrenia in a Pakistani cohort.

Despite a large body of research evaluating factors associated with the relapse of psychosis in schizophrenia, no studies in Pakistan have been undertaken to date to identify any such factors, including specific cultural factors pertinent to Pakistan. Semistructured interviews and psychometric measures were undertaken with 60 patients diagnosed with schizophrenia (49 male and 11 female) and their caregivers at four psychiatric hospitals in the Peshawar region in Pakistan. Factors significantly associated with psychotic relapse included treatment non-adherence, comorbid active psychiatric illnesses, poor social support, and high expressed emotion in living environments (P<0.05). The attribution of symptoms to social and cultural values (97%) and a poor knowledge of psychosis by family members (88%) was also prevalent. In addition to many well-documented factors associated with psychotic relapse, beliefs in social and cultural myths and values were found to be an important, and perhaps treatable, factor associated with relapse of psychosis in Pakistan. The provision of evidence-based psychotherapeutic interventions, such as behaviour and family therapy and cognitive behaviour therapy for psychosis, could potentially ameliorate the relapse rate of psychosis in Pakistan.

Inpatient Cognitive Behavior Therapy Approaches for Suicide Prevention

Within the current healthcare system, individuals recognized to be at imminent risk for suicide are likely to be referred for inpatient psychiatric care. The hospitalization setting provides a safe and supportive environment for specialty acute care services and stabilization. However, the majority of current interventions that are delivered to suicidal patients during this sensitive timeframe do not directly target suicide risk. Cognitive Behavior Therapy (CBT) is an evidence-based psychotherapeutic intervention that can easily be adapted for use in psychiatric inpatient settings. A specialized outpatient CBT protocol for suicide prevention has been developed and empirically evaluated by Drs. Aaron Beck and Gregory Brown at the University of Pennsylvania. This brief and targeted outpatient CBT program has been found to be efficacious in reducing the likelihood of subsequent suicide attempts by 50 %. Post-Admission Cognitive Therapy (PACT) is an inpatient adaptation of the CBT protocol for suicide prevention, developed by Dr. Marjan Ghahramanlou-Holloway at the Uniformed Services University of the Health Sciences. PACT is currently undergoing empirical validation, but it is important to note that the components of PACT are all cognitive behavioral practices recognized to reduce suicide risk. PACT is a promising inpatient CBT program that can be delivered in individual format to suicidal patients during their hospital stays. This intervention provides an opportunity to collaboratively review the suicide narrative, to conceptualize underdeveloped and overdeveloped skills directly tied to suicide risk, and to plan for safety and relapse prevention. Moreover, based on their conceptualization of the suicide mode activation for each patient, PACT clinicians choose cognitive behavioral strategies to modify thoughts, emotions, and/or behaviors that are most likely to result in a recurrence of suicidal behaviors. This paper provides a brief review of inpatient-based CBT options, introduces providers to the PACT inpatient protocol, and describes several promising alternate interventions.

Population health outcome models in suicide prevention policy.

Suicide is a leading cause of death in the U.S. and results in immense suffering and significant cost. Effective suicide prevention interventions could reduce this burden, but policy makers need estimates of health outcomes achieved by alternative interventions to focus implementation efforts. To illustrate the utility of health outcome models to help in achieving goals defined by the National Action Alliance for Suicide Prevention's Research Prioritization Task Force. The approach is illustrated specifically with psychotherapeutic interventions to prevent suicide reattempt in emergency department settings. A health outcome model using decision analysis with secondary data was applied to estimate suicide attempts and deaths averted from evidence-based interventions. Under optimal conditions, the model estimated that over 1 year, implementing evidence-based psychotherapeutic interventions in emergency departments could decrease the number of suicide attempts by 18,737, and if offered over 5 years, it could avert 109,306 attempts. Over 1 year, the model estimated 2,498 fewer deaths from suicide, and over 5 years, about 13,928 fewer suicide deaths. Health outcome models could aid in suicide prevention policy by helping focus implementation efforts. Further research developing more sophisticated models of the impact of suicide prevention interventions that include a more complex understanding of suicidal behavior, longer time frames, and inclusion of additional outcomes that capture the full benefits and costs of interventions would be helpful next steps.

Post-Admission Cognitive Therapy (PACT) for the Prevention of Suicide in Military Personnel With Histories of Trauma

To date, no inpatient evidence-based psychotherapeutic interventions have been developed for suicidal individuals with psychological trauma. Therefore, we have adapted, refined, implemented, and pilot-tested an inpatient-based cognitive behavioral therapy protocol, named Post-Admission Cognitive Therapy (PACT), for the prevention of suicide. This article briefly describes the theoretical and research underpinnings for PACT, components of the treatment protocol, and clinical challenges. A case study of a traumatized military service member hospitalized following a suicide attempt is presented. Baseline and follow-up assessment data show general improvements in suicide ideation, depression, hopelessness, and Post Traumatic Stress Disorder symptomatology over time. While the data for the presented case appears promising, the efficacy of PACT remains unknown and is currently under investigation in a randomized controlled trial. Recommendations for clinicians and students who deliver care to suicidal psychiatric inpatients are provided.

Childhood Trauma and Psychosis

Childhood trauma is a common occurrence and has been associated with psychosis and suggested as a risk factor leading to psychosis and schizophrenia in adulthood. This article introduces the scope of the problem and discusses the evidence for causal relationships between childhood adversities and increased risk for psychosis. The relationship between specific types of trauma and their association with specific psychotic symptoms is described, as well as the manifestations of co-occurring trauma effects and psychosis in adolescents. Clinical presentations and the use of diagnostic instruments, diagnostic comorbidities, and evidence-based psychotherapeutic interventions to treat effects of trauma in youth with psychotic illnesses are discussed.

Comorbid Posttraumatic Stress Disorder and Opiate Addiction: A Literature Review

Treatment of comorbid posttraumatic stress disorder (PTSD) and opioid dependence has been a challenge for many clinicians. There are limited evidence-based guidelines for treatment of this comorbidity. Symptoms of PTSD and opiate dependence may converge, and it is sometimes difficult to differentiate between both conditions. For example, opioid withdrawal symptoms may mimic the hypervigilance and exacerbated startle response of patients with PTSD. A common neurobiologic circuit is suggested for the pathophysiologic mechanism of this comorbidity. There is evidence that opioid substitution therapy may improve treatment outcomes for opioid addiction in patients with comorbid PTSD and opioid dependence. Evidence-based psychotherapeutic intervention is recommended for this population to improve the psychological outcome as well. Combining opioid substitution therapy with evidence-based cognitive behavioral therapy designed for individuals with comorbid PTSD and substance abuse (e.g., Seeking Safety) may improve treatment outcomes in this population. More research is needed to understand the underlying mechanisms for this comorbidity and to improve treatment response.