Integration Of Cognitive Behavioral Therapy Research Articles

Integrating Cognitive-Behavioral Therapy With Compassion-Focused Therapy for the Treatment of Social Anxiety Disorder: An Evidence-Based Case Study

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for social anxiety disorder that has been found to elicit significant changes in process-based mechanisms (e.g., emotion regulation strategies), which subsequently lead to reductions in social anxiety and associated functional impairment; however, CBT may be less effective for socially anxious individuals experiencing high self-criticism and low self-compassion. Compassion-focused therapy (CFT) has been used to address these tendencies in socially anxious individuals, but research in this area is limited. The present case study examined changes in social anxiety symptoms, self-compassion, emotion regulation strategies, and functional impairment throughout the course of treatment with a young, Chinese American woman using a novel integration of CBT and CFT for social anxiety disorder. The client experienced significant reductions in social anxiety and functional impairment across treatment, which was accompanied by reductions in fear and avoidance ratings for feared social scenarios. Significant mechanistic changes were also observed, including decreases in maladaptive emotion regulation strategies (i.e., suppression, rumination) and increases in self-compassion and adaptive emotion regulation strategies (i.e., expressive engagement, cognitive reappraisal). Findings support the efficacy of integrating compassion-focused strategies with CBT for social anxiety for a young adult with prominent tendencies of self-criticism and low self-compassion.

Effectiveness of an integrated motivational cognitive-behavioral group intervention for adolescents with gaming disorder: a randomized controlled trial.

The aim of this study was to test the efficacy of the integrated cognitive-behavioral therapy with a strength-based motivational approach [integrated cognitive-behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China. Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male INTERVENTIONS: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities. The outcomes were measured at pre-treatment (t0 ), post-treatment (t1 ), 3-month (t2 ) and 6-month (t3 ) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t1 and t2 , and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t1 , t2 and t3 . With the intention-to-treat principle, the GD scores at t3 were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges' g = 1.15, 95% confidence interval = 0.67-1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67-0.84) and anxiety symptoms (g = 0.6-0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition. An integrated cognitive-behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.

Disaggregating between- and within-patient effects of ruptures and resolutions on the therapeutic alliance and symptom severity.

The therapeutic alliance is considered a robust predictor of psychotherapy outcome. Ruptures and resolutions in the alliance have been the focus of recent alliance literature. Most previous studies investigated their between-patient effects. We used hierarchical linear models to disaggregate the between- and within-patient effects of ruptures on the alliance from patient- and therapist perspective and symptom severity. Further, the moderating effects of rupture resolutions were analyzed. The sample consisted of 56 patients diagnosed with depressive or anxiety disorders who received 25 ± 3 sessions of integrative cognitive behavioral therapy in the outpatient setting. The observer-rated rupture resolution rating system was applied to all 1st, 8th, 16th and 24th therapy sessions. The alliance quality and symptom severity were assessed using self-report questionnaires after these four sessions. Results showed that a higher intensity of ruptures across treatment was associated with lower alliance ratings from both patient- and therapist perspectives during treatment. After sessions with more intense confrontation ruptures, both reported a weaker alliance. Rupture resolutions significantly moderated the withdrawal rupture effect on the alliance. The results provide meaningful practical implications for therapist feedback and training. They further underline the importance of using appropriate statistical analyses to the data structure and nature of psychotherapy to better understand the role of the alliance, rupture, and repair during therapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Effects of Gender Factors on Students’ Entrepreneurial Career Intention (ECI) and Entrepreneurial Career Selection Behaviour (ECSB) for Entrepreneurial Career Intention Intervention Program (ECIP)

The main objective of this study is to evaluate the effects of gender factors on entrepreneurial career intention and entrepreneurial career selection behavior in an experimental study of the Entrepreneurial Career Intention Intervention Program (ECIP). The program uses modules developed with the integration of Cognitive Behavioral Therapy (CBT) and Theory of Planned Behavior (TPB). The study population was counseling students at Sultan Azlan Shah University in Perak, Malaysia. The sampling was conducted through purposive sampling method which involved100 students as the respondents. The data was analyzed using SPPS, and the results show that gender has no influence on the treatment in the intervention program.

A longitudinal analysis of reflective functioning and its association with psychotherapy outcome in patients with depressive and anxiety disorders.

The ability to mentalize has been discussed as potential change mechanism in psychotherapy. Reflective functioning (RF) offers an empirical framework for the assessment of mentalization in therapy sessions. In the present study, we assessed RF longitudinally and examined its association with symptomatic distress, symptom severity of depression and anxiety, and interpersonal problems over the course of treatment. Thirty-seven patients diagnosed with depression or anxiety disorders received 25 ± 3 sessions of integrative cognitive-behavioral therapy (CBT) in an outpatient setting. The observer-rated in-session Reflective Functioning Scale (RFS) was applied to transcripts of therapy Sessions 1, 8, 16, and 24. The effects of RF were investigated both within and between patients using hierarchical linear modeling. RF significantly increased over the course of treatment, and this improvement in RF was significantly associated with depressive symptoms. This means that after a session where patients positively deviated from their own average RF during treatment, they reported lower depression severity. In post hoc analyses, we found a significant interaction effect of the within- and between-patient RF effects on interpersonal problems. Patients with overall higher levels of RF and with positive deviations from their own average RF over the course of treatment tended to have less interpersonal problems during psychotherapy. The present study contributes to the preliminary evidence that changes in RF may serve as a common factor in psychotherapy in contrast to being a specific factor in psychodynamic therapies. More longitudinal studies are necessary to gain a better understanding of RF as a change mechanism in psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Дистанционная психологическая помощь при хронической висцеральной боли на фоне синдрома раздраженного кишечника.

Chronic visceral pain, which increases with stress, is a hallmark of functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Modern pharmacological interventions, diets for patients with chronic visceral pain are usually insufficient, and many of them are fraught with undesirable side effects and short remission. Modern protocols of cognitive behavioral therapy of the third wave, which are available in a remote format, show efficiency, cost-effectiveness in relieving chronic visceral pain caused by stress. The article describes the specifics of the third wave of CBT in relation to the treatment of IBS. A cognitive-behavioral approach to the treatment of irritable bowel syndrome is detailed, which reverses increased stress reactivity and afferent sensitization in the central and peripheral nervous systems, respectively, which leads to a more complete and prolonged relief of IBS symptoms in the patient. The specificity and effectiveness of the protocol of remote cognitive behavioral therapy to enhance awareness in IBS J. is shown. Henrich and integration of cognitive behavioral therapy of the second and third waves to improve the lifestyle of patients with IBS.

Addressing interpersonal patterns in patients with personality disorders partially explains psychotherapy outcome via changes in interaction patterns: A mediation analysis

ABSTRACT Objective Many patients with personality disorders (PDs) present with problematic interaction patterns. These may also manifest in the therapeutic relationship. For successful treatment, therapists must therefore find effective ways to address such problematic interaction patterns. Methods: A total of 382 patients with PDs were recruited within a naturalistic setting and received integrative cognitive–behavioral therapy (CBT). Two subscales of the observer-rated Process-Content-Relationship Scale were applied to sessions 15, 20, and 25 of treatment: one on patient interaction patterns and the other on therapist addressing these. Symptom severity was assessed at intake and discharge. Mediation analysis was applied. Results: We found significant main effects of (1) therapists’ addressing problematic interaction patterns in session 15 on patients’ changes in such patterns from session 15 to 25 and (2) patients’ changes in problematic interaction patterns on symptom severity at treatment termination. Further, the effect of therapists’ addressing problematic interaction patterns on outcome was mediated by changes in patients’ interaction patterns. Conclusion: The results indicate that therapists’ addressing of PD patients’ problematic interaction patterns may be particularly important to improve such patterns and thereby treatment outcome. Future research should identify in which patients the mechanism of addressing interaction patterns works best.

Innovative Multidisciplinary Care Models Provided via Telehealth During the COVID Pandemic

Integrated and collaborative care lead to better care. Addressing the behavioral and mental health care needs of patients results in better health outcomes. Interdisciplinary and multi-disciplinary approaches to health care delivery yield more effective health care planning. A holistic approach to healthcare sees the individual as more than the sum of diseases. Research studies have supported these assertions and yet, in actual practice, they are often more aspirational than actualized. The COVID-19 pandemic has made it even more difficult to implement collaborative care delivered by varied professional disciplines. This symposium describes efforts to provide more holistic and multidisciplinary care in the primary care geriatrics practice of the Dept. of Geriatrics & Palliative Medicine, Icahn School of Medicine. This New York City practice has 4,500 patients with diverse backgrounds and a median age of 85. In the first paper, Baharlou and her colleagues describe the establishment of an IMPACT collaborative care depression model in the middle of the COVID-19 pandemic. It was adapted to be provided by telephone and uses a different psychosocial intervention than is usually implemented. Hinrichsen and Leipzig outline the successful integration of Cognitive Behavioral Therapy for Insomnia into geriatrics primary care to improve insomnia in older adults and deprescribe sleep medications. Munoz and her colleagues describe the ALIGN program which is an interdisciplinary team effort, informed by the social determinants of health framework, to facilitate access to an array of services delivered virtually because of the pandemic.

Results of the first randomized controlled trial of integrated cognitive-behavioral therapy for eating disorders and posttraumatic stress disorder.

Eating disorders (EDs) and posttraumatic stress disorder (PTSD) frequently co-occur and can share a functional relationship. The primary aim of this initial randomized controlled trial was to determine whether integrated cognitive-behavioral therapy (CBT) for co-occurring ED-PTSD was superior to standard CBT for ED in improving PTSD symptoms. Intervention safety and desirability, as well as the relative efficacy of the treatments in improving anxiety, depression, and ED symptomatology, were also examined. Following a course of intensive ED treatment, individuals with ED-PTSD were recruited to participate and randomized to integrated CBT for ED-PTSD or standard CBT for ED. The sample consisted of 42 individuals with a range of ED diagnoses. Outcomes were assessed at end-of-treatment, 3-, and 6-month follow-up using interview and self-report measures. Mixed models revealed significant interactions of time and therapy condition on clinician-rated and self-reported PTSD symptom severity favoring Integrated CBT for ED-PTSD. Both treatments were associated with statistically significant improvements in PTSD, anxiety, and depression. Improvements were maintained at 3- and 6-month follow-up. There was good safety with both interventions, and satisfaction with both treatments was high. However, there was a stronger preference for integrated treatment. Integrating CBTs for PTSD and ED following intensive ED treatment is safe, desirable, and efficacious for improving PTSD symptoms. Future studies with larger sample sizes are needed to determine whether Integrated CBT for ED-PTSD provides benefits over standard CBT for ED with respect to ED outcomes.

The Effectiveness of Integraged Cognitive-Behavioral Therapy and Mindfulness on Marital Conflict and Anxiety in Women with Pathological Spousal Jealousy

Aim: Pathological jealousy toward spouse is one of the most common complaints of couples referring for couple therapy. The research aimed to study the effectiveness of integrated cognitive-behavioral therapy and mindfulnes on decreasing of marital conflict and anxiety in women withpathological jealousy toward spouse.&#x0D; Methods: For this purpose, a quasi-experimental pretest, posttest and follow up design with control group was used. The study sample included 34 women with Pathological jealousy who were selected through purposive sampling among women referredto counseling centers in Isfahan. The intervention method included10integrated sessions of cognitive-behaviorla therapy and mindfulness that was implemented for experimental group. In order to assess variables Marital Conflict Questionnaire (Barati &amp; Sanayi, 2000) and State Anxiety Inventory (Spielberger, et al., 1983) were used. The data analysis conducted by multivariate analysis of variance with pretest and control.&#x0D; Findings: The findings showed a significant decline in the mean scores of experimental group, both in anxiety and in marital conflict, in pretest and follow-up stages, but no tangible changes were observed in the control group scores. (p&lt;0.0005).&#x0D; Conclusion: Thus, integration of cognitive-behavioral therapy and mindfulness has been effective in reducing marital conflict and anxiety in women with pathological jealousy toward spouse, and could be used by couple therapists and other psychotherapists.

Patients’ and therapists’ actions on the precipice of change: Session processes before sudden gains and sudden losses.

In the present study, sessions prior to sudden gains, sudden losses, and neutral control sessions were examined regarding the processes of change resource activation, problem actuation and therapeutic alliance. With respect to these change processes, we examined whether pregain, preloss, and neutral sessions are distinguishable by particular patterns. For the current project, videos of 30 pregain, 29 preloss, and 30 neutral control sessions from n = 89 patients receiving integrative cognitive–behavioral therapy were rated minute-by-minute using Resource-Oriented Microprocess Analysis. The sample was drawn from a total of N = 365 patients, who had completed treatment or who had attended at least 20 sessions of therapy between the years of 2007 and 2011. Discriminant function and survival analyses as well as a binary logistic regression analysis were performed to identify patterns and timing of change processes associated with session types (gains, losses, and neutral sessions). The three session types differed with regard to patterns of resource activation and problem actuation. No difference concerning therapeutic alliance was found. The findings may help future studies to generate new hypotheses regarding processes that are involved in the occurrence of sudden changes. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Predictors and moderators of marijuana and heavy alcohol use outcomes in adolescents treated for co-occurring substance use and psychiatric disorders in a randomized controlled trial

BackgroundThe current study identifies predictors and moderators of substance use outcomes for 111 adolescents with co-occurring substance use and psychiatric disorders who participated in a randomized controlled trial that compared the effectiveness of two home-based treatments: an integrated cognitive behavioral therapy (I-CBT) protocol, in which masters-level clinic staff received intensive training and ongoing supervision in the use of this protocol versus a treatment-as-usual (TAU) comparison condition in which therapists received a continuing education–style CBT workshop in the same protocol. MethodThe study conducted exploratory predictor and moderator analyses of marijuana and heavy alcohol use outcomes using candidate variables across four domains of psychological characteristics: adolescent substance use, adolescent psychiatric symptoms, parent, and family. ResultsRegardless of treatment condition, low parental monitoring at baseline, as assessed by a videotaped interaction task, but not self-report, predicted greater percentage of marijuana use and heavy alcohol use days over the 6-month follow-up period. If parents entered treatment with low levels of parental monitoring, adolescents in the I-CBT condition reduced their percentage of heavy alcohol use days significantly more than adolescents in TAU over the 6-month follow-up period. Greater adolescent aggression and parental emotion dysregulation at baseline also predicted greater percentage of marijuana use days over the 6-month follow-up period for the sample as a whole. Adolescents in the I-CBT condition who reported low positive urgency at baseline reduced their percentage of heavy alcohol use days significantly more than adolescents in TAU care over the 6-month follow-up period. ConclusionThe article discusses implications for clinical decision-making, improving treatment effectiveness, and tailoring interventions for adolescents with co-occurring substance use and psychiatric disorders.

Integration of Cognitive Behavioral Therapy for Suicide Prevention in Social Work Practice

Purpose: To evaluate the integration of cognitive behavioral therapy (CBT) for depression and suicide prevention (CBT-SP) into social work practice with youth after a 2-day training and 3 months of group consultation. Method: A purposive sample of 22 clinical social workers completed a one-group pre–post and 3-month follow-up assessment to evaluate knowledge of CBT and CBT-SP, utilization, and barriers to utilization of CBT treatment and skills. Results: Knowledge of CBT and CBT-SP skills improved following training. All trainees integrated at least one new skill into practice and increased use of prior skills. No trainees integrated the full-manualized CBT-SP intervention into practice. Participation in group consultation increased the likelihood of integrating CBT-SP skills into practice for males and trainees with more practice experience. Discussion: The findings support the importance of training clinicians in common element skills of CBT and CBT-SP rather than only focusing upon integrating full-manualized treatments into social work practice.

School-based, two-arm, parallel, controlled trial of a culturally adapted resilience intervention to improve adolescent mental health in Vietnam: study protocol

IntroductionThe Resourceful Adolescent Program (RAP) is an evidence-based resilience intervention for adolescents. Operating in a strength-focused paradigm, the programme uses an integration of cognitive behavioural therapy and interpersonal psychotherapy to...

Review of Cognitive Behavioral Group Therapy: Challenges and Opportunities

Ingrid Sochting’s Cognitive Behavioral Group Therapy: Challenges and Opportunities is a well-researched and clearly written integration of cognitive behavioral therapy (CBT) with various forms of g...

Disentangling within- and between-patient effects of defensive functioning on psychotherapy outcome using mixed models

There is a great need to identify predictors of treatment response, and the analysis of defense mechanisms is a promising approach. Defensive functioning may influence psychotherapy outcome in two ways: First, when it is generally higher or lower for some patients relative to others and second, as it shifts in individual patients over time. The present study examined both within- and between patient effects of defenses using hierarchical linear modeling. Forty-seven patients diagnosed with depression, anxiety, or adjustment disorders received 25 ± 3 sessions of integrative cognitive–behavioral therapy in a university outpatient clinic. The Defense Mechanism Rating Scale (DMRS) was used to assess defenses in the 1st, 8th, 16th, and 24th session and relate them to symptom severity of depression and anxiety. A higher number of adaptive defense mechanisms was associated with less severe depressive symptoms during treatment while a higher number of immature defenses was related to more severe depressive and anxiety symptoms. An increase in adaptive and a decrease in immature defenses over the course of treatment predicted symptom reduction of depression whereas a decrease in neurotic and immature defenses was associated with reductions in anxiety symptoms. Our results empirically support defensive functioning as a mechanism of change in psychotherapy.

THE USE OF "ABC-MODEL" FOR FORMING A VALUE COMPOSITION OF COGNITIVE COMPONENT OF PROFESSIONAL IDENTITY OF A SOCIAL PEDAGOGUE WORKING IN INCLUSIVE EDUCATION SYSTEM

The article deals with the peculiarities of using to influence the value component of the professional identity of teachers working in inclusive education system. Change in cognitive assessments that the teacher gives to a complex situation leads to a decrease in the intensity of emotional experience. The article reveals the peculiarities of the professional activity of the social pedagogue who may cause difficulties in the regulation of unpleasant emotional states. The peculiarities of the use of the ABC-model for the influence on the value component of the cognitive part of the professional identity of the social pedagogue working in the system of inclusive education are explained; the essence of the professional identity of social educators is highlighted; the approaches of different scholars to understanding the value system and the peculiarities of its changes in the context of the professional activities of the social teacher. The characteristic of the ABC model in the interpretation of integrative cognitive behavioral therapy is proposed: sensations and emotions are the result of evaluations that are the product of the deep beliefs and values of a personal values system. The features of the use of the ABC-model for working with the value component are outlined. The scheme of work on changing irrational beliefs with the help of the Socratic Dialogue method is described, which consists in using different types of questions to ascertain the logic of the person's prevailing beliefs. The scheme of work with the value component of the cognitive component of the professional identity of a social teacher is described on the example of the use of the ABC model. It is substantiated how it is possible to approach the change of irrational interpretations and causes of the appearance of unpleasant emotional states on the example of analysis of life situations from social and psychological practice. Conclusions are made on the factors influencing the social teacher who works in the system of inclusive education and associated with the emergence of unpleasant emotional states. Integrative cognitive-behavioral therapy offers a number of techniques for successful work with such problems and one of the most effective is the ABC model. It is shown how the technique allows to influence the system of values of the social teacher related to the causal concepts of the formation and manifestation of emotions, which is an important component of the cognitive part of the professional identity and influences the effectiveness of the manifestation of professional identity in emotionally difficult situations. Using these psychological techniques, the teacher can form new rational beliefs and improve his level of adaptation to complex professional situations. Further research of the topic may be related to the identification of factors that stimulate or slow down the development of new beliefs in the cognitive component of professional identity.

Integration of cognitive behavioral therapy for insomnia.

Integration of cognitive behavioral therapy for insomnia.

Nonverbal synchrony: A new approach to better understand psychotherapeutic processes and drop-out.

Video-based measurement methods are new to psychotherapy research and provide new opportunities to investigate mechanisms of psychotherapeutic change related to nonverbal synchrony (movement coordination between patient and therapist). In this study, we validated the applied video-based procedures and evaluated nonverbal synchrony in association with the therapeutic relationship, therapy outcome, and drop-out. The naturalistic analysis sample consisted of 143 patients (136 videotaped sessions), who were treated with integrative cognitive–behavioral therapy at an out- patient clinic in southwest Germany. The videos were analyzed using Motion Energy Analysis (MEA), which provided a value for nonverbal synchrony. Patients routinely completed questionnaires assessing the therapeutic relationship and treatment success. We tested various confounding variables using multilevel modeling and investigated nonverbal synchrony in relation to measures of the therapeutic relationship. Further- more, we compared different types of outcomes with regard to nonverbal synchrony by means of multilevel modeling. The video-based procedures were shown to be highly valid. We found a link between the amount of nonverbal synchrony and therapeutic success; patients with nonimprovement and consensual termination showed the highest level, improved patients a medium level, and nonimproved patients with drop-out the lowest level of synchrony at the beginning of therapy, even when controlling for the therapeutic relationship. The study applied and evaluated a novel video-based approach in psychotherapy research and related it to common factors and the therapeutic process. Limitations of the automatic measurement methods and opportunities for the future routine prediction of drop-out are discussed.

Is Integrated CBT Effective in Reducing PTSD Symptoms and Substance Use in Iraq and Afghanistan Veterans? Results from a Randomized Clinical Trial

This study is the first to examine integrated cognitive behavioral therapy (ICBT) in a sample of military veterans with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Generalized linear mixed models were used to examine primary outcomes from a small, randomized clinical trial comparing ICBT plus treatment as usual (TAU) to TAU only in a sample (N = 44) of U.S. veterans who served in Iraq and/or Afghanistan. A significant reduction in PTSD and SUD symptoms over time was detected in both conditions. One significant time-by-condition interaction effect for re-experiencing symptoms was observed, with ICBT showing greater reductions from baseline to post-treatment. Overall, the efficacy of ICBT in this veteran sample was not as robust as outcomes with non-veteran patients. Challenges to engagement and retention in treatment and further intervention adaptations for veterans are discussed.