Intensive Cognitive Behavioral Therapy Research Articles

Intensive Cognitive Behavioral Therapy for Adolescents with Anorexia Nervosa Outcomes before, during and after the COVID-19 Crisis.

Studies comparing treatment outcomes in patients with eating disorders before and during the coronavirus (COVID-19) pandemic have yielded conflicting results. Furthermore, no study has yet evaluated treatment outcomes in adolescent patients with anorexia nervosa before, during and after the crisis. Hence, this study investigated the outcomes of an intensive Cognitive Behavioral Therapy-Enhanced (CBT-E) program on adolescents with anorexia nervosa consecutively treated before (n = 64), during (n = 37) and after (n = 31) the period of emergency spanning 8 March 2020 to 31 March 2022. Results show consistent and similar improvements in eating disorder psychopathology, general psychopathology and body mass index-for-age percentiles across all three periods, with approximately 60% of patients maintaining a full response at the 20-week follow-up, suggesting that treatment efficacy remained robust. Overall, the study underscores the effectiveness of intensive CBT-E as a viable treatment option for adolescents with anorexia nervosa, even during and after unprecedented challenges such as those posed by the COVID-19 pandemic.

Illness duration and treatment outcome of intensive cognitive-behavioral therapy in adolescents with anorexia nervosa.

This study aimed to compare the effectiveness of an intensive treatment based on enhanced cognitive-behavioral therapy (CBT-E) in patients aged between 12 and 18 years with anorexia nervosa with a duration of illness <3 versus ≥3 years. One hundred and fifty-nine consecutively treated patients (n = 122 with illness duration <3 years and n = 37 ≥ 3 years) were enrolled in a 20-week intensive CBT-E program. All patients underwent assessment at admission, end of treatment (EOT), and 20-week follow-up. The following measures were used: body mass index (BMI)-for-age percentile and percentage of expected body weight (EBW), Eating Disorder Examination Questionnaire, Brief Symptom Inventory, and Clinical Impairment Assessment. Approximately 81% of eligible patients began the program, with over 80% successfully completing it. Patients with a longer or shorter duration of illness did not show significantly different treatment outcomes. In detail, BMI-for-age percentile and percentage of EBW outcomes were significantly improved from baseline to EOT, remaining stable until 20-week follow-up in both groups. Similarly, in both groups, scores for eating disorder psychopathology, general psychopathology, and clinical impairment decreased significantly at EOT and remained stable from EOT to follow-up. Furthermore, a substantial percentage of adolescents in both groups achieved a good BMI outcome at EOT and 20-week follow-up, with approximately 60% maintaining a full response at the latter time point. These findings suggest that intensive CBT-E appears to be an effective treatment for severely ill adolescent patients with anorexia nervosa, regardless of whether the duration of illness is shorter or longer than 3 years. Existing treatment outcome studies in adolescents, whether randomized controlled trials or longitudinal investigations, typically involve patients with less than 3 years of illness, while data on the treatment outcomes for adolescents with anorexia nervosa with an illness duration of 3 years or over is very limited. Our findings suggest that adolescents with anorexia nervosa, irrespective of the duration of their illness, can derive similar benefits from intensively CBT-E.

Study protocol for a single-blind, parallel-group, randomised, controlled non-inferiority trial of 4-day intensive versus standard cognitive behavioural therapy for adults with obsessive–compulsive disorder

IntroductionIndividual cognitive behavioural therapy (CBT) with exposure and response prevention is an effective treatment for obsessive–compulsive disorder (OCD). However, individual CBT is costly and time-consuming, requiring weekly therapy sessions for...

Intensive cognitive behavioral group therapy for the treatment of panic disorder

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

Intensive Cognitive-Behavioral Therapy Telehealth for Pediatric Obsessive-Compulsive Disorder During the COVID-19 Pandemic: Comparison With a Matched Sample Treated in Person

Intensive Cognitive-Behavioral Therapy Telehealth for Pediatric Obsessive-Compulsive Disorder During the COVID-19 Pandemic: Comparison With a Matched Sample Treated in Person

No benefit of antidepressants in inpatient treatment of depression. A longitudinal, quasi-experimental field study

RationaleAntidepressants (AD) are mostly considered indispensable for the treatment of major depression. The vast majority of depressive inpatients are treated with AD. However, there is a growing body of studies indicating that the effectiveness of AD is greatly overestimated due to methodological issues with the AD efficacy studies (e.g., publication bias, unintentional unblinding, confusion between withdrawal symptoms and relapse).ObjectivesThe benefit of the additional use of AD in the inpatient treatment of depression with intensive cognitive-behavioral therapy (CBT) has been investigated in a naturalistic design.MethodsDepressiveness was assessed using the Beck Depression Inventory (BDI-II) during a preliminary interview (T0), at admission (T1), at discharge (T2), and at a 6-month follow-up (T3). Two study phases were compared: During Phase A, AD were recommended in accordance with the German guideline. In Phase B, AD were no longer recommended, and they were only prescribed upon explicit request from patients. In phase A (N = 574), 60.3% of all patients were taking AD at discharge. In Phase B (N = 424), 27.9% of patients were on AD at discharge. Apart from the difference in AD usage, the two treatment conditions were similar, and the samples did not significantly differ in terms of age, sex, diagnoses, history of suicide attempts, comorbid anxiety disorders, and unemployment.ResultsIn both study phases, BDI-II scores were strongly decreased at T2 and T3, respectively, compared with T1. The BDI-II scores of the two phases did not differ at any of the measurement time points. Depression changes were similar in both phases. In sequential multiple regression analyses with the total sample, AD were no significant predictors for the reduction of depression at either T2 or T3.ConclusionsThe inpatient CBT was effective in depression. The effectiveness of CBT is not improved by the additional use of AD. The current prescribing practices of AD should be questioned.

Emotional Behavioural Styles in Violent and Non-violent Juvenile Offenders

Previous studies have found emotional behavioural problems among school children in Pakistan and their impact on academic achievement (Javed et al., 1992; Samad et al., 2005; Soomro &amp; Clarbour 2012; Syed et al., 2007; Syed &amp; Hussein, 2009). The main purpose of the study was to extend the investigation to the juvenile offenders to assess the emotional behavioural problems among violent and non-violent juvenile offenders located in the different prisons of Khyber Pakhtunkhwa (KP), Pakistan. T-test and Binary Logistic Regression were used to analyse the data. T-test revealed that there were significant differences among violent and non-violent juvenile offenders on three emotional style factors: malevolent aggression, social self-esteem, and social anxiety. Binary Logistic Regression analysis indicated that violent juvenile offenders exhibited higher levels of malevolent aggression and low levels of social self-esteem and social anxiety than non-violent juvenile offenders. These results may provide empirical evidences for distinguishing between the violent and non-violent juvenile offenders on the basis of emotional behavioural problems and suggest intensive multimodal Cognitive Behavioural Therapy (CBT) and anger management program to modify the behaviour of violent juvenile offenders.

A pilot evaluation of the role of a children's wellbeing practitioner (CWP) in a child and adolescent mental health service (CAMHS).

In 2017, the Children and Young People's Improving Access to Psychological Therapies (CYP-IAPT) project was extended to deliver low-intensity Cognitive Behavioural Therapy (CBT), delivered by Children's Wellbeing Practitioners (CWPs), but to date evaluation is sparse. To evaluate low-intensity interventions delivered by trainee CWPs for the treatment of anxiety and depression in a child and adolescent mental health service (CAMHS). The evaluation adopted a quantitative, within-subjects, cross-sectional design. The outcome measures of 98 service users aged 8-17years were included in the evaluation. Service users were children and young people accessing CAMHS in the North East of England. Outcome measures included the Revised Children's Anxiety and Depression Scale (RCADS-47) and Goal Based Outcomes (GBOs). Descriptive data relating to the types of interventions used and outcomes following CWP involvement were also explored. Analysis of pre and post intervention data highlighted significant reduction in symptomatology across all RCADS subscales and composite total scales, and significant goal progress as measures by GBO's. Effect sizes ranged from moderate to large (d = 0.75 - 0.90) across all subscales of the RCADS. Large effect sizes were found for depression, total anxiety and total RCADS scores (d = 0.86, d = 1.12, d = 1.14), and GBOs (d = -1.33). Findings support the potential value of low intensity CBT interventions delivered by CWPs in reducing anxiety and depression in this population. Recommendations for the development of the CWP role and CWP services are discussed.

Family accommodation as a predictor of treatment outcome in outpatient intensive cognitive behavioral therapy of adult obsessive compulsive disorder

Family accommodation in obsessive compulsive disorder (OCD) consists of participation in symptoms and modification of family routines in order to reduce patients' anxiety and impairment, manage relatives’ own distress, and maintain family functioning. Higher levels of accommodation are associated with increased symptom severity and worse treatment outcome. However, this has not been investigated for adults with OCD receiving intensive cognitive behavioral therapy (iCBT). The aim of this study was to examine if change in family accommodation during the intensive phase of iCBT predicted treatment outcome. Within an observational study design, 52 adult patients received iCBT with pre-, between- and post-treatment measurements. Results showed that family accommodation was reported by 94% of relatives of OCD patients and was associated with self-reported OCD symptoms but not global functioning. Family accommodation was significantly reduced from pre-to post-treatment. Greater reductions in family accommodation were associated with lower levels of OCD symptom severity and better global functioning at post-treatment, and greater likelihood of achieving remission status. However, changes on the outcome measures from pre-to post-treatment were not dependent on the magnitude of change in family accommodation during the intensive phase of treatment. Therefore, findings are inconclusive in supporting that targeting family accommodation might directly affect treatment outcome for adults with OCD receiving iCBT.

Cortisol response under low intensity exercise during cognitive-behavioral therapy is associated with therapeutic outcome in panic disorder-an exploratory study.

Patients with Panic Disorder (PD) show an abnormal stress-induced functioning of the Hypothalamic-Pituitary-adrenal (HPA)-axis. Different protocols for stress induction are of rather low relevance for the psychotherapeutic treatment. In practice, interoceptive exposure is often realized as Low Intensity Exercise (LIE), as compared to an incremental cycle exercise test to exhaustion. Currently, it is not known, whether LIE displays an effective interoceptive stressor 1.) leading to a significant anxiety induction; 2.) a comparable HPA- and Sympathetic-Adreno-Medullar (SAM)-axis response in both patients and healthy controls; 3.) stress responses under LIE are associated with treatment outcomes. N = 20 patients with PD and n = 20 healthy controls were exposed to ten minutes of LIE on an exercise bike. LIE was applied as part of the interoceptive exposure, during an intensive Cognitive-Behavioral Therapy (CBT) in a day clinic. Heart rate was monitored and salivary cortisol samples collected. Before and after the LIE, state anxiety/ arousal were assessed. In order to evaluate psychopathology, the Panic and Agoraphobia Scale, Mobility Inventory, Agoraphobic Cognitions Questionnaire and Body Sensations Questionnaire were applied, before (T1) and after five weeks (T2) of an intensive CBT. LIE led to a significant and similar heart rate increase in both groups. Cortisol decreased over time in both groups, especially in male patients. A higher psychopathology before, and after CBT, was associated with a significantly lower cortisol response under LIE. In the present study, LIE led to a divergent stress response: while there was a significant heart rate increase, cortisol decreased over time, particularly in male patients. A lower reactivity of the HPA-axis seems to be associated with a lower treatment outcome, which may affect extinction based learning. The findings suggest, that interoceptive stimuli should be designed carefully in order to be potent stressors.

Intensive Cognitive-Behavioral Therapy for Anxiety Disorders in Adolescents: A Case Study

Anxiety disorders are one of the most common psychiatric conditions in youth and can contribute to impairment in social, academic, and family functioning. Cognitive-behavioral therapy (CBT) has been shown to be efficacious in treating youth anxiety disorders; however, for a multitude of reasons, fewer than 20% of adolescents with anxiety disorders receive services for anxiety-related problems. Intensive treatments, which rely on the same traditional components of CBT but are delivered over a shorter period of time or in a fewer number of sessions, may be particularly helpful for anxiety disorders and can offer a number of advantages over standard CBT. Despite emerging evidence supporting the advantages of the intensive approach, there are few established intensive treatment programs for youth with anxiety disorders. Further, no treatment to date has comprehensively targeted the entire spectrum of comorbid adolescent anxiety disorders in a combined intensive and transdiagnostic format, even though non-intensive (i.e., weekly delivered) CBT has been tested using a transdiagnostic approach. We developed an intensive, six-session intervention based on Angelosante and colleagues’ 2009 The Adolescent Panic Control Treatment with In-Vivo Exposures (Angelosante et al., 2009) and other empirically-supported treatments for youth to target all anxiety disorders in adolescents. We present a case study on an adolescent with multiple comorbid anxiety and related disorders who received intensive CBT treatment as a way to illustrate the clinical benefit and utility of an intensive, transdiagnostic approach. Findings support the acceptability and feasibility of transdiagnostic treatment of youth anxiety.

The impact of the COVID-19 pandemic on intensive cognitive behavioral therapy outcomes in patients with anorexia nervosa-A cohort study.

ObjectiveThis study aimed to assess the impact of the COVID‐19 pandemic on the efficacy of an intensive treatment based on enhanced cognitive behavioral therapy (CBT‐E) in patients with anorexia nervosa.MethodsThis cohort study analyzed 57 patients with anorexia nervosa who experienced the COVID‐19 pandemic during intensive CBT‐E, comparing their outcomes (body mass index [BMI], eating‐disorder and general psychopathology, and clinical impairment) with those of patients with anorexia nervosa matched by gender, age, and BMI given the same treatment before the COVID‐19 outbreak as controls. Patients were assessed at baseline, at the end of treatment and after 20 weeks of follow‐up.ResultsMore than 75% of patients during the pandemic versus 85% of controls completed the treatment, a difference that was not significant. BMI, eating disorder and general psychopathology and clinical impairment scores improved significantly from baseline to 20‐week follow‐up in both groups. However, the improvement was more marked in controls than in those treated during the COVID‐19 pandemic.ConclusionPatients with anorexia nervosa given intensive CBT‐E during the COVID‐19 pandemic had significantly improved psychopathology, albeit to a lesser extent than patients given the same treatment before the COVID‐19 pandemic.Public significance statementIn this study, the outcome of 57 patients with anorexia treated with intensive enhanced cognitive behavior therapy during the COVID‐19 pandemic was compared with a matched group treated before the pandemic hit. The rate of remission from anorexia nervosa was similar between the two groups. However, patients exposed to the COVID‐19 pandemic showed lesser improvement than those not exposed.

Changes in specific and nonspecific psychopathology network structure after intensive cognitive behavior therapy in patients with anorexia nervosa.

This study aimed to compare eating disorder-specific and nonspecific clinical features in patients with anorexia nervosa before and after intensive enhanced cognitive behavior therapy (CBT-E) via network analysis. All consecutive patients admitted to intensive CBT-E were eligible, and the sample comprised patients aged ≥16 years who completed a 20-week intensive CBT-E program. Body mass index (BMI), Eating Disorder Examination Questionnaire and Brief Symptoms Inventory responses were gathered at baseline and end of treatment, and used to generate statistical networks of the connections between symptoms (nodes) and the strength and centrality thereof. A total of 214 patients were included. Most nodes had relatively similar centrality compared to other nodes in the networks. "Eating concern" and "phobic anxiety" showed the greatest bridge centrality at both time points. No differences were found between baseline and the end of treatment in either global network or individual connection strengths. These findings suggest that some clinical expressions not specific to eating-disorder psychopathology remain strongly connected in the generalized network of patients with anorexia nervosa after CBT-E. Future research should examine whether additional procedures specifically designed to target these symptoms should be integrated into this and other treatments.

Presence of Psychiatric Assistance Dogs and Relation to Post-Traumatic Stress Disorder Treatment Outcomes: A Nonrandomized, Observational Study in a Military Sample

The purpose of this study was to examine differences between military veterans and service members with and without a psychiatric assistance dog (PAD) who were receiving cognitive behavioral therapy (CBT) for post-traumatic stress disorder (PTSD). Six hundred eighty-two military veterans presented at a 2-week intensive, outpatient CBT program for PTSD from February 2016 to February 2020. Self-reports of symptoms and rates of treatment completion by PAD ownership were assessed. Patients with PADs ( n = 93) reported higher scores on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( P = .04; Cohen's d = 0.23) and Neurobehavioral Symptom Inventory ( P &lt; .01; Cohen's d = 0.34) at baseline. PTSD symptom change was comparable between participants with and without PADs ( P &gt; .05). Dropout was higher among owners of PADs, but this difference was not significant ( P = .11). Among military populations, those with PADs may experience more severe PTSD and neuro-cognitive symptoms, but having a PAD was not associated with treatment outcome in intensive CBT. [ Psychiatr Ann . 2022;52(5):191–198.]

The Role of Intolerance of Uncertainty in Treatment for Pediatric Anxiety Disorders and Obsessive-Compulsive Disorder

ABSTRACT This study investigated the role of intolerance of uncertainty (IU) in an intensive group-based cognitive behavioral therapy (CBT) program with family involvement for children with anxiety disorders and obsessive-compulsive disorder (OCD). One hundred four children and adolescents, aged 8–19 years, who were patients in an intensive outpatient group-based treatment program and their parents participated in this intervention-based study. From both children’s and parents’ perspectives at admission, higher IU in children was associated with both higher levels of anxiety and functional impairment. Both children and parents reported significant reductions in children’s IU by discharge, and these reductions were associated with greater reductions in children’s anxiety and functional impairment. However, children who reported higher levels of IU at admission, reported fewer reductions in their anxiety and functional impairment. These findings demonstrate an association between IU and children’s anxiety and OCD intensive treatment outcomes. Those with higher levels of IU may benefit from more interventions that address tolerating uncertainty.

The effect of personalised versus non-personalised study invitations on recruitment within the ENGAGE feasibility trial: an embedded randomised controlled recruitment trial

BackgroundRecruitment into clinical trials is challenging and there is a lack of evidence on effective recruitment strategies. Personalisation of invitation letters is a potentially pragmatic and feasible way of increasing recruitment rates at a low-cost. However, there is a lack of evidence concerning the effect of personalising of study invitation letters on recruitment rates.MethodsWe undertook a Study Within A Trial (SWAT) to investigate the effect of personalised versus non-personalised study invitation letters on recruitment rates into the host feasibility trial ENGAGE, a feasibility study of an internet-administered, guided, Low Intensity Cognitive-Behavioural Therapy based self-help intervention for parents of children previously treated for cancer. An intervention group (n = 254) received a personalised study invitation letter and the control group (n = 255) received a non-personalised study invitation letter. The primary outcome was the proportion of participants in the intervention group and the control group enrolled into the ENGAGE host feasibility trial. Secondary outcomes relating to the recruitment and screening process, and retention were examined. Differences in proportions between groups for the primary and secondary outcomes were estimated using logistic regression.ResultsOf the 509 potential participants, 56 (11.0%) were enrolled into the ENGAGE host feasibility trial: personalised: 30/254 (11.8%) and non-personalised: 26/255 (10.2%). No statistically significant effect on personalisation of enrolment was found (OR 1.18, 95% CI 0.68–2.06). No statistically significant differences were found for any secondary outcome.ConclusionsPersonalisation of study invitations had no effect on recruitment. However, given the small study sample size in the present SWAT, and lack of similar embedded recruitment RCTs to enable a meta-analysis, additional SWATs to examine the personalisation of study invitation letters are warranted.Trial registrationISRCTN57233429; ISRCTN18404129; SWAT 112, Northern Ireland Hub for Trials Methodology Research SWAT repository (2018 OCT 1 1231) (https://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/FileStore/Filetoupload,939618,en.pdf).

Therapeutic competencies in reducing emotional and social distress after cognitive behavior therapy training program: Three years follow up

The aim of the study: This paper addresses the question: is a brief cognitive behavior therapy (CBT) training program enhances psychologist's skills as reflected in scores on Cognitive Therapy Skills scale and in helping students with emotional and social problems. Materials and Methods: Participants are 35 school psychologists (20 Female and 15 male) have received intensive CBT training for 6 days during two weeks followed by one to one supervision in school sittings for three months. Participants completed cognitive behavior therapy scale (CBTS). Individual and group counseling sessions delivered to male and female (age mean = 13.7 years) students known of emotional and social problems during the current school year. Supervisors wrote a report in the end of three months practice, students and parent's feedback had collected. Results show that differences between pre and post scores on CBTS scale are statistically significant (t= 4.92), supervisors reports and students feedback indicate improving therapeutic skills by the end of three months practice. Conclusion: CBT training program has positive influence in enhancing CBT skills in school psychologists that reflected in providing effective counseling for students with emotional and social problems. Supervision based training optimizing the therapeutic outcome in both individual and group therapy sessions. Follow up of 3 years revealed continuous effect of the training and continuous supervision in improving counseling skills of school psychologists.

Efficacy of intensive CBT telehealth for obsessive-compulsive disorder during the COVID-19 pandemic

Despite evidence for the effectiveness of cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD), many individuals with OCD lack access to needed behavioral health treatment. Although some literature suggests that virtual modes of treatment for OCD are effective, it remains unclear whether intensive programs like partial hospitalization and intensive outpatient programs (PHP and IOPs) can be delivered effectively over telehealth (TH) and within the context of a global pandemic. Limited extant research suggests that clinicians perceive attenuated treatment response during the pandemic. The trajectory and outcomes of two matched samples were compared using linear mixed modeling: a pre-COVID in-person (IP) sample (n = 239) and COVID TH sample (n = 239). Findings suggested that both modalities are effective at treating OCD and depressive symptoms, although the pandemic TH group required an additional 2.6 treatment days. The current study provides evidence that PHP and IOP treatment delivered via TH during the COVID-19 pandemic is approximately as effective as pre-pandemic IP treatment and provides promising findings for the future that individuals with complicated OCD who do not have access to IP treatment can still experience significant improvement in symptoms through TH PHP and IOP treatment during and potentially after the pandemic.

Effectiveness and feasibility of intensive versus regular cognitive behaviour therapy in patients with anxiety and obsessive-compulsive disorders: A meta-analysis

• Relative effectiveness of intensive CBT formats is an understudied area of research. • Intensive CBT did not differ from regular CBT in reducing anxiety and obsessive-compulsive symptoms. • Intensive CBT was better than regular CBT in reducing comorbid depressive symptoms. • Dropout was understudied but is significant to gain insight into feasibility. • Intensive CBT achieves faster results due to shorter lead time and is promising. Since the introduction of cognitive behaviour therapy (CBT), researchers are searching for the optimum schedule of sessions to maximize the effectiveness. In the last decades, intensive treatments - multiple long sessions in a few weeks - became popular in patients with anxiety disorders and obsessive-compulsive disorder (OCD). However, it is still unknown whether intensive CBT is superior to regular CBT (short weekly sessions for several months). This meta-analysis examined whether intensive CBT is superior to regular CBT in patients with anxiety disorders and OCD in reducing anxiety, obsessive-compulsive (OC) and comorbid depressive symptoms, and in reducing dropout. A systematic literature search was performed in PubMed, PsycINFO and Embase in which words indicative of an anxiety disorder or OCD were combined with intensive treatment and CBT. We identified 5012 unique studies. Two randomised controlled trials (RCTs) and four non-RCTs were included, pertaining to 393 subjects. Intensive CBT and regular CBT did not statistically differ in reducing anxiety or OC symptoms from pre- to post-treatment and from post-treatment to follow-up. However, intensive CBT was significantly better in reducing depressive symptoms from pre- to post-treatment ( g = 0.25; 95% CI: (0.04, 0.45)). Dropout was only reported in two studies and could thus not be meta-analysed. The included studies were limited in number and quality. High-quality RCTs are needed to assess both effectivity and feasibility of intensive CBT. Meanwhile, intensive CBT might be preferable for patients with comorbid depression or for those needing fast improvement, due to its shorter lead time.

Feasibility of an Intensive, Disorder-Specific, Group-Based Cognitive Behavioural Therapy Intervention for Adolescents with Social Anxiety Disorder.

This study examined the preliminary acceptability and efficacy of an intensive, group-based, disorder-specific cognitive behavioural therapy (CBT) intervention for adolescents with social anxiety disorder (SAD). Fourteen Australian adolescents with SAD (78.6% female, M age = 13.93 years) and their parents completed the program plus measures of treatment satisfaction, and provided feedback. Clinical interviews and surveys were administered pre-treatment, post-treatment, and at 6-month follow-up to determine diagnostic status and assess related variables. Post-treatment satisfaction scores were very high for adolescents and parents. Post-treatment, 32.3% of participants no longer met criteria for SAD diagnosis, increasing to 42.9% at follow-up. Participants showed sizeable reductions in comorbid diagnoses, significant improvements in global functioning, social anxiety symptoms, and internalising symptoms from pre- to post-treatment (maintained at follow-up), and significant improvements in social skills and social competence from pre-treatment to follow-up. This study supports the use of an intensive CBT program for adolescents with SAD.