Group Cognitive Behavioral Therapy Research Articles

Current Management Approaches and Future Directions for Kratom Use Disorder: A Comprehensive Review

This comprehensive literature review examines the current state of knowledge regarding the management of kratom use disorder (KUD). Kratom, a tropical plant containing psychoactive alkaloids, has seen rising popularity and concerns about dependence and public health impacts. The review covers the pharmacology of kratom, diagnostic criteria and assessment of KUD, and various treatment approaches. Psychosocial interventions like cognitive-behavioral therapy, motivational interviewing, contingency management, and peer support groups are discussed. Pharmacological treatments explored include opioid agonist therapy, alpha-2 agonists, antidepressants, and emerging potential therapies. Integrative and alternative approaches like acupuncture, mindfulness, and supplements are also examined. Challenges highlighted include limited research, societal stigma, and barriers to treatment access. Future directions emphasize developing novel pharmacotherapies, improving treatment availability through specialized programs and telehealth, longitudinal studies on comorbidities and harm reduction, and evidence-based policies balancing public health and therapeutic considerations. The review underscores the need for a multidisciplinary approach combining psychosocial, pharmacological, and alternative modalities supported by robust research to effectively address the growing public health challenge of KUD.

Comparing the Effectiveness of Cognitive Behavioral Therapy and Compassion-Focused Therapy in Improving Distress Tolerance and Self-Compassion in Women with Experiences of Marital Infidelity

Objective: Distress tolerance and self-compassion play a significant role in mitigating the harm caused by the experience of infidelity. This study compares the effectiveness of cognitive behavioral therapy (CBT) and compassion-focused therapy (CFT) in improving distress tolerance and self-compassion among women who have experienced marital infidelity. Materials and Methods: This quasi-experimental study employed a pre-test, post-test, follow-up design with a control group. The study population included women who had experienced infidelity by their spouse and sought counseling and psychotherapy services in Tehran in the year 2021. From this population, using purposive sampling, 45 women were selected based on the study's criteria and randomly assigned to two experimental groups and one control group (15 per group). The first experimental group received cognitive behavioral therapy, and the second received compassion-focused therapy. The control group did not receive any intervention. Data were collected using the Distress Tolerance Scale (Simons & Gaher, 2005) and the Self-Compassion Scale (Neff, 2003). Data were analyzed using repeated measures analysis of variance and SPSS software version 22. Findings: The results showed that both distress tolerance and self-compassion scores in the cognitive-behavioral and compassion-focused therapy groups were higher in the post-test compared to the pre-test (p<0.01). Furthermore, a comparison of the two experimental groups revealed no significant difference in scores of distress tolerance and self-compassion between the groups. Conclusion: It can be concluded that both cognitive-behavioral therapy and compassion-focused therapy were equally effective in improving distress tolerance and self-compassion among women.

Comparison of the Effectiveness of Mindfulness-Based Cognitive-Behavioral Therapy and Reality Therapy on Emotional Regulation and Self-Efficacy in Women Seeking Divorce

Objective: This study aimed to compare the effectiveness of mindfulness-based cognitive-behavioral therapy and reality therapy on emotional regulation and self-efficacy among couples seeking divorce. Methods and Materials: The present research was a quasi-experimental study with a pre-test, post-test, and follow-up design, including a control group. The population consisted of all couples seeking divorce referred by the judiciary to the psychodynamic center of Jolfa city from spring to winter 2021. The sample comprised 60 individuals chosen through purposive sampling and randomly assigned to three groups of 20. Following sampling, two experimental groups received either group mindfulness-based cognitive-behavioral therapy in eight 90-minute sessions (weekly) or group reality therapy in eight 90-minute sessions (weekly), while the control group received no intervention. Data were collected using the Garnefski and Kraaij Cognitive Emotion Regulation Questionnaire (CERQ-P-short) and the Sherer Self-Efficacy Questionnaire (DCI-SF). Data analysis was performed using mixed repeated measures ANOVA and Bonferroni post-hoc tests with SPSS version 24. Findings: The findings indicated that there was a significant difference between the overall means of emotional regulation and self-efficacy in both the mindfulness-based cognitive-behavioral therapy and reality therapy groups, with mindfulness-based cognitive-behavioral therapy having a greater impact on emotional regulation and self-efficacy (P<0.05). Conclusion: Based on the results obtained, both mindfulness-based cognitive-behavioral therapy and reality therapy are effective in improving emotional regulation and self-efficacy among women seeking divorce. However, it can be said that mindfulness-based cognitive-behavioral therapy is preferable to reality therapy.

Evaluation of a codesigned group cognitive–behavioural therapy intervention for trans young people (TAG TEAM): protocol for a feasibility trial and a subsequent pilot RCT

IntroductionTrans young people are at a higher risk of mental health difficulties such as depression, anxiety and suicidality than their cisgender peers, due in part to their experiences of minority...

The effect of aromatherapy on post-stroke depression: study protocol for a pilot randomized controlled trial.

Post-stroke depression (PSD) is a prevalent psychiatric disorder affecting about one-third of stroke survivors, significantly hindering recovery and quality of life. PSD also imposes a substantial burden on caregivers and healthcare systems. Aromatherapy has shown promise in alleviating depression, anxiety, and sleep disorders. This pilot randomized controlled trial aims to assess the feasibility and preliminary efficacy of mixed herb aromatherapy in treating PSD. Feasibility outcomes encompass recruitment, intervention adherence, assessment completion and safety assessment. Secondary outcomes include evaluations of depression, anxiety, cognitive function, sleep quality, quality of life, and brain function using EEG and fNIRS. This single-blind pilot randomized controlled trial will be conducted at the Second Rehabilitation Hospital of Shanghai, enrolling ninety-nine post-stroke patients with PSD. Participants will be randomized into three groups: a Non-Active Control Group receiving standardized rehabilitation therapy, a CBT Group receiving conventional rehabilitation with bi-weekly CBT sessions, and an Aromatherapy Group receiving conventional rehabilitation with daily aromatic inhalation sessions. Interventions will last for four weeks, with efficacy assessed at baseline, post-intervention, and one month post-intervention. Rating scales will be used to measure changes in depression, sleep quality, cognitive function, and quality of life. EEG and fNIRS will specifically be used to measure changes in cerebral cortex activity and their correlations with depression. Feasibility will be evaluated through recruitment, intervention adherence, assessment completion and safety assessment. This pilot study highlights the potential of mixed herb aromatherapy inhalation for treating PSD, addressing limitations of CBT by promoting self-management. While demonstrating feasibility through recruitment, adherence, assessment completion and safety assessment, the study also acknowledges limitations such as unequal intervention times, the lack of physical function data. And the use of culturally relevant plant powders may enhance compliance but limits generalizability. Despite these constraints, the study provides valuable preliminary data and insights into the mechanisms of aromatherapy, encouraging further research and development of effective PSD treatments.

Blended individual and group CBT for OCD in adolescents: model description and a feasibility study

Abstract Cognitive-behavioural treatment for obsessive-compulsive disorder (OCD) is effective across the lifespan but is not widely available across the range of services. Delivering CBT as a blended treatment combining individual and group-based treatment with flexible parental involvement, adapted to the operational style of any particular service, is a promising option which we aimed to examine in OCD with adolescent samples. In a young people’s service based in a University Hospital, we evaluated the impact of a blended treatment combined with flexible parental involvement with adolescents (age 14–18 years of age). The CBT model used with OCD sufferers was a formulation driven approach, emphasising the importance of providing an alternative account linked to the way responsibility beliefs lead to compulsive behaviour. Six consecutively referred adolescents with their parents participated in a treatment group. Intervention consisted of eight individual meetings, eight group meetings and two meetings with parents. Five of six adolescents carried out the whole intervention. Of all participants, 5/5 scored in the clinical range for OCD at baseline, and 5/5 were no longer in the clinical range by the end of treatment; 5/5 were in the clinical range on general psychiatric problems at baseline, and 4/5 were rated as recovered at the end of treatment. Comparable changes were noted in measures of responsibility linked to intrusive thoughts. Use of a blended individual/group treatment based on a CBT model is feasible, with the results obtained being consistent with previous work on individual CBT treatment. Key learning aims (1) Delivering CBT to adolescents with OCD as a blended treatment combining individual and group-based treatment with flexible parental involvement is a promising option which merits further evaluation. (2) OCD symptoms and general psychiatric symptoms were reduced during and after treatment. (3) Use of a blended treatment based on a CBT model is feasible.

"It was very nice to be in a room where everyone had ADD-that's kind of VIP": Exploring clients' perceptions of group CBT for ADHD inattentive presentation.

This qualitative study explored the perceptions of adult clients participating in a new psychological treatment for attention-deficit/hyperactivity disorder inattentive presentation (ADHD-I, also called "attention deficit disorder", ADD). The study aimed to explore (i) what aspects of treatment the participants found to be helpful, and (ii) if there were areas that ought to be developed to make the protocol more useful to clients with ADHD-I. Participants were recruited from treatment groups following the protocol of cognitive-behavioral therapy for ADHD-I (CADDI), at three psychiatric outpatient units in Stockholm, Sweden. Individual semi-structured interviews, lasting on average 44,6 minutes, were conducted with 14 adults after the completion of CADDI. Interviews explored participants' perceptions of CADDI, its usefulness, and asked for suggestions for improvement. Interviews were conducted by independent interviewers and were transcribed verbatim. The text was analyzed using reflexive thematic analysis. The analysis generated three themes: "Factors of importance for change", with the subthemes; the group, therapeutic components, structure of treatment, and motivation,"Gains in treatment", with the subthemes; insight and understanding, increased attention, and planning and acting, and "Challenges with ADHD-I and remaining needs", with the subthemes; ADHD as a lifelong condition, maintaining gains in treatment, and wish for further support. Participants emphasized the importance of the group setting as a facilitator of therapeutic effects of increased understanding and self-acceptance. Further, they considered the practice of mindfulness to enhance attention and awareness of thoughts, feelings, and activities and considered the structure of treatment as supporting the work in therapy. These findings support the value of the group setting and confirm the usefulness of CADDI. However, participants were concerned about how to maintain gains of treatment after its termination and suggested follow-up sessions to improve the CADDI protocol. Preregistered at Clinical Trials: NCT05037903.

Prospectively assessed summer mood status in major depression, recurrent with seasonal pattern: Evidence for SAD's construct validity

ObjectiveSeasonal patterns are often undetectable in population-based depression studies, calling into question the existence of winter seasonal affective disorder (SAD). If SAD has construct validity, individuals with SAD should show spontaneous depression remission in the summer. Data are sparse on prospectively assessed summer mood status in confirmed SAD patients. MethodWe conducted prospective summer followup of community adults who, the winter before, were diagnosed with Major Depression, Recurrent with Seasonal Pattern on the Structured Clinical Interview for DSM-IV Axis I Disorders, developed a current SAD episode on the Structured Interview Guide for the Hamilton Rating Scale for Depression—Seasonal Affective Disorder Version (SIGH-SAD), and enrolled in a clinical trial comparing group cognitive-behavioral therapy for SAD and light therapy. In July/August after treatment, 143/153 (93.5 %) participants provided data on the SIGH-SAD, the Beck Depression Inventory-Second Edition, and the Longitudinal Interval Followup Evaluation (LIFE). ResultsSummer mean depression scores were in the normal range, with the substantial majority in remission across different measures. On the LIFE, 113/143 (79.0 %) experienced complete summer remission, 19/143 (13.3 %) experienced partial summer remission, and 11/143 (7.7 %) had major depression in the summer. Depression scores were significantly lower at summer than post-treatment in both treatments, indicating incomplete treatment response. LimitationsThis was a single-site study with a relatively homogeneous sample. ConclusionsSupporting construct validity for SAD, the substantial majority experienced complete summer remission, with a minority in partial remission and a very small minority in episode. Both treatments left residual symptoms at treatment endpoint compared to summer.

Brain connectomics improve prediction of 1-year decreased quality of life in breast cancer: A multi-voxel pattern analysis

PurposeWhether brain connectomics can predict 1-year decreased Quality of Life (QoL) in patients with breast cancer are unclear. A longitudinal study was utilized to explore their prediction abilities with a multi-center sample. Methods232 breast cancer patients were consecutively enrolled and 214 completed the 1-year QoL assessment (92.2%). Resting state functional magnetic resonance imaging was collected before the treatment and a multivoxel pattern analysis (MVPA) was performed to differentiate whole-brain resting-state connectivity patterns. Net Reclassification Improvement (NRI) as well as Integrated Discrimination Improvement (IDI) were calculated to estimate the incremental value of brain connectomics over conventional risk factors. ResultsParacingulate Gyrus, Superior Frontal Gyrus and Frontal Pole were three significant brain areas. Brain connectomics yielded 7.8–17.2% of AUC improvement in predicting 1-year decreased QoL. The NRI and IDI ranged from 20.27 to 54.05%, 13.21–33.34% respectively. ConclusionBrain connectomics contribute to a more accurate prediction of 1-year decreased QoL in breast cancer. Significant brain areas in the prefrontal lobe could be used as potential intervention targets (i.e., Cognitive Behavioral Group Therapy) to improve long-term QoL outcomes in breast cancer.

Effectiveness of a culturally specific school-based cognitive-behavioural group therapy for primary school children with anxiety problems in Hong Kong

ABSTRACT This study explores effective outcomes of a social worker-delivered, culturally adapted school-based cognitive-behaviour group to improve anxiety symptoms among primary school children in Hong Kong. Pre- and post- scores of the intervention groups were compared with waiting-list control groups using repeated measures ANOVA. A statistically significant reduction in anxiety level was evident in the treatment groups compared with the control groups. This article concludes by identifying policy and practice measures that could reduce anxiety and improve the lives of primary school children in Hong Kong.

Early Intervention Programs for Adolescents and Young Adults With Eating Disorders

What Is the Problem? How Might Early Intervention Help Fix the Problem?
 
 The number of adolescents and young adults living with eating disorders is on the rise. This increase was especially noticeable during the height of the COVID-19 pandemic, with more than a 50% increase in the number of young women being hospitalized with an eating disorder.
 Early intervention programs are those delivered by community or health care–based organizations that offer interventions to treat adolescents and young adults living with eating disorders within the first 3 years of diagnosable disorder, with the intention of providing earlier access and preventing disease progression.
 
 What Did We Do?
 
 Advisors with lived experience of eating disorders shared their perspectives and priorities to help reviewers contextualize the evidence and interpret the findings in the literature. Advisors highlighted their treatment experiences and priorities for early intervention, highlighting equity considerations and challenges.
 We conducted a literature search to identify, gather, synthesize, and summarize relevant evidence to inform our understanding of the clinical effectiveness and clinical harms of early intervention programs.
 A search of the economic literature was conducted to identify economic evaluations of early intervention programs to treat adolescents and young adults living with eating disorders. Based on an assessment of the clinical evidence, the uncertainty and heterogeneity of the information precluded a de novo cost-effectiveness analysis (CEA). As such, a narrative summary of the health care resources required to implement an early intervention program for adolescents and young adults living with eating disorders was conducted.
 
 What Did We Find?
 
 Advisors with lived experience of eating disorders described a need for greater access to specialized services focused on eating disorder treatment, equity, capacity building, and culture change. Specific treatment approaches mentioned included family-based treatment, cognitive behavioural therapy, peer support, and group therapy.
 We identified 14 studies related to the clinical effectiveness of early intervention programs. We did not identify any studies evaluating clinical harms.
 The findings from included studies suggest that earlier engagement and access to eating disorder support could have clinical benefits; however, interpretation of these findings are uncertain due to various factors.
 No evidence was identified in the search for information on the cost-effectiveness of early intervention programs for the treatment of adolescents and young adults living with an eating disorder.
 The resources needed to run early intervention programs (or other similar interventional programs) to treat eating disorders may include administration, staffing, training, IT support and infrastructure, and other overhead costs related to the location in which the service is provided.
 
 What Does This Mean?
 
 The clinical evidence suggests that investment of health care resources into early intervention programs shows potential for overall benefit and may help address challenges with access to treatment, which was identified as an issue by those with lived experience.
 The human and financial resources required to implement early intervention programs will vary depending on the treatment options and treatment frequency chosen.
 The demands on an already limited pool of specialized health care resources in eating disorder care are important considerations when choosing whether to implement any new eating disorder treatment programs. Training and recruiting of specialized health care providers will be a key implementation consideration for any new early intervention program for the treatment of eating disorders.
 Further consultation with a diverse group of adolescents and young adults with lived experience with eating disorders might be beneficial to inform implementation of early intervention programs within the Canadian context.

Predictors of homework engagement in group CBT for social anxiety: client beliefs about homework, its consequences, group cohesion, and working alliance

Objective Group cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) is effective, but little data exist on generic relational components of the therapeutic process, such as group cohesion and therapy alliance, and central CBT-specific components such as homework engagement, beliefs, and perceived consequences. The aim of this study was to investigate the relationships between homework, group cohesion, and working alliance during group CBT for social anxiety disorder. Method Participants (N = 105) with SAD engaged in 12 sessions of group CBT. Measures of homework, working alliance, and group cohesion were completed at multiple points throughout treatment. Random-intercept cross-lagged panel models were used to evaluate the prospective relationships between measures. Results Prospective relationships between the homework outcomes did not vary throughout the treatment period, with the only significant relationships seen between the random intercepts (“trait” levels). Homework beliefs were a significant negative predictor of future group cohesion, but only in mid- to late-treatment. Homework consequences and working alliance were significantly and positively predictive of each other throughout therapy. Conclusion Early homework engagement is associated with higher engagement throughout therapy. Working alliance and homework engagement are important to bolster early in group CBT. Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12616000579493..

Internet-delivered therapist-assisted cognitive behavioral therapy for gambling disorder: a randomized controlled trial.

Cognitive behavioral therapy (CBT) is the most promising treatment for gambling disorder (GD) but only 21% of those with problematic gambling seek treatment. CBT over the Internet might be one way to reach a larger population. The aim of this study was to assess the effectiveness of Internet-delivered CBT with therapist guidance compared to an active control treatment. Using a single-blinded design, 71 treatment-seeking gamblers (18-75 years) diagnosed with GD were randomized to 8 weeks of Internet-delivered CBT guided by telephone support, or 8 weeks of Internet-delivered motivational enhancement paired with motivational interviewing via telephone (IMI). The primary outcome was gambling symptoms measured at a first face-to-face assessment, baseline (treatment start), every 2 weeks, post-treatment, and 6-month follow-up. Gambling expenditures, time spent gambling, depression, anxiety, cognitive distortions, and quality of life were assessed as secondary outcomes. Analysis was performed on the full analysis sample (n = 60), with intention-to-treat sensitivity analyses (n = 69). In the CBT group, 80% stayed in treatment until the final week, compared to 67% in IMI. Post-treatment and at 6-month follow-up, no differences were found between CBT and IMI for any outcome measure. An exploratory analysis of the total sample (n = 60) showed a significant effect of time during treatment on gambling symptoms (d, [95% CI] 0.52, [-1.15, 2.02]) and all secondary outcomes except the gambling diary (depression (0.89, [-1.07-2.65]); anxiety (0.69, [-1.20-2.38])); cognitive distortions (0.84, [-0.73-2.29]); quality of life (0.60, [-0.61-1.70])). Post-treatment, there were no clinical gambling symptoms in either group. Some deterioration was seen between post-treatment and 6-month follow-up on gambling symptoms (0.42, [-1.74-2.43]), depression (0.59, [-0.82-1.86]), and anxiety (0.30, [-0.99-1.48]). Additionally, it was observed that the largest reduction in gambling symptoms was between the first assessment and baseline. Both treatments offered in this study were effective at reducing gambling symptoms. It is also possible that the process of change started before treatment, which gives promise to low-intensity interventions for GD. Additional research is needed as this approach could be both cost-effective and has the potential to reach more patients in need of treatment than is currently possible. https://www.isrctn.com/, identifier ISRCTN38692394.

The effect of cognitive-behavioral therapy and haptonomy on fear of childbirth in primigravida women: a randomized clinical trial

BackgroundConsidering the role of fear of childbirth (FOC) in the enhancement of unnecessary cesarean sections (CS), the present study aimed at evaluating the effect of Cognitive-Behavioral Therapy (CBT) and haptonomy on the FOC (as primary outcome) and intended birth method and final birth method (as secondary outcomes) among primigravida women.MethodsThis randomized clinical trial was conducted on 99 primigravida women in Tabriz, Iran 2022. Participants were assigned to three groups with a ratio of 1:1:1 using stratified block randomization based on the fear intensity. One of the intervention groups (n = 33) received eight group sessions of CBT from 24 to 28 weeks of gestation and the other intervention group (n = 33) received haptonomy during seven sessions once a week. The control group (n = 33) received routine prenatal care. The Wijma questionnaire was completed by the participants before the intervention, after the intervention at 35–37 weeks of gestation, and after birth. The intended birth method was investigated before and after the intervention at 35–37 weeks of gestation. The final birth method and the reasons for CS were recorded based on the mother’s medical profile. The one-way ANOVA was used before the intervention and RMANOVA after the intervention to compare the mean scores of FOC among the three groups. Further, chi-square test was applied to compare the intended and final birth method.ResultsThe mean (standard deviation: SD) of FOC in the CBT group changed from 74.09 (11.35) at 24–28 weeks of gestation to 46.50 (18.28) at 35–37 weeks and 48.78 (20.64) after birth (P < 0.001). The means (SDs) of FOC in the haptonomy group were 76.81 (13.09), 46.59 (15.81), and 45.09 (20.11), respectively (P < 0.001). The mean (SD) of FOC in the control group decreased from 70.31 (6.71) to 66.56 (18.92) and then, increased to 71.00 (21.14) after birth (P = 0.878). After the intervention, there was no statistically significant difference among the three groups in terms of the intended birth method (P = 0.278), and final birth method (P = 0.107).ConclusionThe findings of the present study revealed that both CBT and haptonomy interventions reduce FOC. Although the desire for vaginal birth and final vaginal birth in the haptonomy group was more than that in the other two groups, there was no statistically significant difference among the three groups.Trial registrationIranian Registry of Clinical Trials: IRCT20170506033834N9. Date of registration: 02.01.2022. URL: http://en.irct.ir.

The effects of cognitive behavioral therapy on health-related quality of life, anxiety, depression, illness perception, and in atrial fibrillation patients: a six-month longitudinal study

BackgroundAtrial fibrillation (AF) often leads to an impaired Health-Related Quality of Life (HRQoL) in many patients. Moreover, psychological factors such as depression, anxiety, and illness perception have been found to significantly correlate with HRQoL. This study aims to evaluate the long-term effectiveness of Cognitive Behavioral Therapy (CBT) in enhancing HRQoL and mitigating psychological distress among AF patients.MethodsEmploying a prospective, open design with pseudo-randomization, this study encompassed pre-tests, post-treatment evaluations, and a 6-month follow-up. A total of 102 consecutive patients diagnosed with paroxysmal AF were initially enrolled. Out of these, 90 were assigned to two groups; one to receive a 10-week CBT treatment specifically focusing on anxiety, and the other to receive standard care. Outcome measures were evaluated using tools such as the Item Short Form Health Survey (SF-12), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), University of Toronto Atrial Fibrillation Severity Scale (AFSS), and Brief Illness Perception Questionnaire (BIPQ). These assessments were conducted at pre-treatment, post-treatment, and at the 6-month follow-up mark. We explored the effectiveness of CBT using Generalized Estimating Equations (GEE).ResultsOur analysis revealed a notable improvement in the CBT group relative to the control group. All metrics displayed consistent improvement across a 6-month duration. At the 6-month checkpoint, the CBT group exhibited a more favorable SF-12 Mental Component Score (MCS) (50.261 ± 0.758 vs. 45.208 ± 0.887, p < 0.001), reduced GAD-7 (4.150 ± 0.347 vs. 8.022 ± 0.423, p < 0.001), BIPQ (34.700 ± 0.432 vs. 38.026 ± 0.318, p < 0.001), and AFSS (9.890 ± 0.217 vs. 10.928 ± 0.218, p = 0.001) scores when compared to the TAU group. Conversely, the SF-12 PCS (44.212 ± 0.816 vs. 47.489 ± 0.960, p = 0.139) and PHQ-9 scores (8.419 ± 0.713 vs. 10.409 ± 0.741, p = 0.794) manifested no significant difference between the two groups.ConclusionThe findings suggest that CBT is effective in improving HRQoL and reducing psychological distress among patients with AF at 6 month follow-up. This highlights the potential benefits of integrating CBT into the therapeutic regimen for AF patients.Trial RegistrationRetrospectively registered with ClinicalTrials.gov (NCT05716828). The date of registration : 5 June 2023.

Effectiveness of Group Cognitive-Behavioral Therapy for Managing Anxiety and Depression in Women Following Hysterectomy for Uterine Cancer.

Hysterectomy as well as uterine cancer could be associated with a long-term risk of mental disorders. The purpose of this study is to investigate the effectiveness of group cognitive-behavioral therapy (GCBT) in reducing anxiety and depression in women who have undergone hysterectomy for uterine cancer. This experimental, pretest-post-test study was conducted in an academic hospital. 26 women with uterine cancer who underwent hysterectomy were recruited and randomly divided into two equal groups as the experimental and control groups. The experimental group was treated by GCBT for eight 1-hour sessions (by a senior psychology expert) every week until 8 weeks. Otherwise, no intervention was performed for the control group. The anxiety and depression scores of all participants were assessed and compared before and after the therapy sessions by Beck Anxiety (BAI) and Beck Depression-second version (BDI-II) questionnaires. The mean±SD age of the participants was 33.6±4.1. Our result found significant different after GCBT in both anxiety (p=0.000) and depression (p=0.000) scores in the experimental group. However, no differences between pre and post-test scores in the control group were observed. Compared to the control group the rate of depression (p=0.000) and anxiety (p=0.000) in the case group was significantly decreased after therapy. GCBT is effective in reducing anxiety and depression in women after hysterectomy. The use of GCBT in oncology centers along with medical treatments to reduce mental distress, improve mental health, and accelerate the recovery process of patients with uterine cancer and other cancers seems necessary.

The Effects of Mindfulness for Youth (MYmind) versus Group Cognitive Behavioral Therapy in Improving Attention and Reducing Behavioral Problems among Children with Attention-Deficit Hyperactivity Disorder and Their Parents: A Randomized Controlled Trial

Introduction: There is a lack of studies evaluating mindfulness-based interventions for children with attention-deficit hyperactivity disorder (ADHD) compared with an evidence-based control. This randomized controlled trial (RCT) evaluated the effects of mindfulness for youth (MYmind) in improving children’s attention, behavior, and parent-related outcomes versus cognitive behavioral therapy (CBT). Methods: A total of 138 families of children with ADHD aged 8–12 years were recruited from the community with 69 randomized to MYmind and 69 to CBT. Participants were assessed at baseline, immediately after intervention, at 3 months and 6 months. The primary outcome was the attention score of the Sky Search subtest of the Test of Everyday Attention for Children (TEA-Ch). Secondary outcomes were child behavior and parent-related assessments. Linear mixed models were used to assess the efficacy of MYmind compared with CBT. Results: Both MYmind and CBT significantly improved children’s attention score at 6 months (MYmind: β = 1.48, p = 0.013, Cohen’s d = 0.32; CBT: β = 1.46, p = 0.008, d = 0.27). There were significant within-group improvements in most secondary outcomes. No significant difference was shown for both primary or secondary outcomes between the two arms at any time point. Conclusions: Both MYmind and CBT appeared to improve children’s attention and behavior outcomes, although no difference was found between these two interventions. This is the largest RCT so far comparing MYmind and CBT although there was loss of follow-up assessments during the pandemic. Further RCTs adopting a non-inferiority design are needed to validate the results.

P158: Efficacy of a self-help cognitive-behavioral therapy (GSH-CBT) guided by lay providers for generalized anxiety disorder (GAD) in older adults: preliminary results

Background:Only a small proportion of older adults with generalized anxiety disorder (GAD) seek professional help. One reason is the lack of access to mental health professionals licensed to provide psychotherapy. One way to improve access to psychotherapy is through guided self- help (GSH). GSH based on the principles of cognitive-behavior therapy (GSH-CBT) can be guided by trained lay providers (LPs). The purpose of this poster is to report preliminary results from a multisite randomized controlled trial testing the efficacy of a GSH-CBT guided by LPs for GAD in older adults.Methods:The sample included 150 participants (≥ 60 years old) with a diagnosis of threshold or subthreshold GAD randomly assigned to: 1) GSH-CBT guided by LPs (n = 75) or 2) waiting list (n = 75). The GSH-CBT lasted 15 weeks. Participants used a manual presenting weekly reading and at-home exercises. They also received weekly support calls (30 minutes maximum) by LPs (undergraduate psychology students) supervised by psychologists. Repeated-measures regression models were used to compare changes in the groups before and after 15 weeks on three outcomes: severity of GAD symptoms (Generalized Anxiety Disorder 7-item; GAD-7), tendency to worry (Penn State Worry Questionnaire; PSWQ), and level of anxiety (Geriatric Anxiety Inventory; GAI).Results:At the first assessment, both groups were similar in terms of age, sex, level of education, marital status, occupation, and did not differ significantly on outcomes. The GSH- CBT group decreased significantly on all three outcomes (GAD-7: -4.8, 95% CI [-5.7, -3.8], PSWQ: -11.7; 95% CI [-13.6, -9.9], GAI: -5.3 95% CI [-6.5, -4.1]) while the waiting list group remained stable over 15 weeks (GAD-7: -0.3, 95% CI [-1.2, 0.6], PSWQ: 0.7; 95% CI [-1.2, 2.5], GAI: -0.7 95% CI [-1.9, -0.5]).Conclusions:GSH-CBT guided by LPs appears to be an effective intervention for reducing severity of GAD symptoms, tendency to worry, and level of anxiety in older people with GAD. Further analyses will be conducted to test whether the intervention differs in efficacy between participants with a threshold vs. subthreshold GAD. The maintenance of long-term gains (6 and 12 months after the intervention) will also be tested.

A cognitive behavioural group treatment for somatic symptom disorder: a pilot study

BackgroundSomatic symptom disorder (SSD) presents challenges to the healthcare system, including frequent medical visits, lack of symptom relief experienced by individuals with this condition, high associated medical costs, and patient dissatisfaction. This study examined the utility of a novel, low-barrier, brief cognitive behavioural therapy (CBT) group intervention for individuals with SSD.MethodsParticipants were referred by their mental health providers or self-referral. Each participant underwent a telephone screen and in-person psychological and neuropsychological screen. Two cycles of the CBT-based group (n = 30), each consisting of six weekly two-hour sessions, were facilitated at a large outpatient mental healthcare facility in Ontario, Canada. The final sample consisted of 13 individuals of whom 11 completed the treatment. Clinical outcome measures were administered pre-, mid- and post-group, including the Generalized Anxiety Disorder–7, Perceived Stress Scale–4, Pain Self-Efficacy Questionnaire, Pain Disability Index, Revised Illness Perception Questionnaire, and sections of the Patient Health Questionnaire. Six healthcare utilization metrics were collected from electronic medical records at six months pre- and post-group. Paired samples t-tests were used to examine pre- to post-group differences in participants’ somatic symptoms, psychological functioning, health, and degree of healthcare utilization.ResultsWhen comparing pre- and post- group, we observed reductions in the mean scores for somatic symptom severity, depressive symptomatology, anxiety, perceived stress, and perceived disability related to pain. The change in depressive symptomatology yielded a small effect size (d = 0.30). Further, we observed downward trends across participants’ pre- to post-group healthcare utilization, with small effect sizes observed for hospital admission (d = 0.36), days admitted to hospital (d = 0.47), and inpatient consults (d = 0.42). Differences between pre- and post-group measures of somatic symptom severity, psychological functioning, health, or healthcare utilization did not reach significance.ConclusionsCurrent findings provide support for the potential effectiveness of an abbreviated CBT group for individuals with SSD in reducing psychiatric symptomatology. Further research is recommended, including randomized control trials, cost-benefit analyses, and comparisons between abbreviated versus longer-duration treatment programs for SSD.Trial registrationNot applicable.

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.