Cognitive Behavioral Therapy Practice Research Articles

Providing antiracist cognitive-behavioral therapy: Guidelines, tools, and tips

This article addresses gaps in cognitive-behavioral therapy (CBT) when it comes to integrating racial issues that affect racialized patients’ mental health. Traditional adaptations of CBT focused on social, religious, and linguistic challenges but neglected the critical aspects of interpersonal, institutional and systemic racism, internalized racism and complex racial trauma. This oversight has resulted in less effective outcomes for racialized individuals. The article proposes clear, applicable guidelines for clinicians to provide anti-racist CBT interventions. They cover clinical self-development, re-design the CBT triangular (thoughts, feelings, behaviors) theoretical framework, provide practical tools and tips to facilitate antiracist CBT interventions. Clinicians are encouraged to engage in self-assessment to understand their own racial biases and develop competencies to address racial issues and dynamics in therapy. CBT theoretical framework is re-envisioned to include environmental factors that impact the lives of racialized people, acknowledging the pervasive effects of racism on mental and physical health. The article also highlights the importance of creating a culturally safe therapeutic environment for racialized children, adolescents, and families, and emphasizes the need for specialized training to effectively serve these groups. The proposed guidelines aim to transform CBT practice, increase confidence of racialized individuals in mental health care, and ultimately decolonize CBT interventions.

Adapting cognitive behavioral therapy for anxiety in autistic children: A commentary

Cognitive Behavioral Therapy (CBT) is a widely recognized intervention for addressing anxiety in both non-autistic and autistic youth. This commentary explores the landscape of implementing CBT for anxiety disorders in autistic children, as investigated by Cervin and colleagues in their 2023 study. While the study provides valuable insights, our commentary aims to broaden the scope of CBT, such as the perspectives of those with lived experiences and consideration of strength-based practices. For this reason, we draw attention to unexplored facets and potential limitations, advocating for further adaptations of CBT practices aligning with the neurodiversity-affirming perspective as we aim to enhance the effectiveness and accessibility of CBT for autistic individuals.

"I can't escape my scars, even if I do get better": A qualitative exploration of how adolescents talk about their self-harm and self-harm scars during cognitive behavioural therapy for depression.

Emerging evidence indicates that perceptions of self-harm behaviours and self-harm scars may thwart recovery from depression, yet limited research has explored adolescent accounts of their self-harm and scars during therapy. This study sought to explore how adolescents describe their self-harm behaviours and scars during Cognitive Behavioural Therapy (CBT) and explore the sociocultural discourses that may influence these descriptions. The participants were six female adolescents (aged 14-17years old) with clinical depression, who were engaging in self-harm. All participants accessed CBT as part of clinical trial evaluating three psychological treatments for major depressive disorder in Child and Adolescent Mental Health Services. Audio-taped CBT sessions were analyzed using discourse analysis. Within CBT sessions, adolescents drew upon stigma discourses in talking about their self-harm. Adolescent also described their self-harm scars as shameful and stigmatizing, and as "proof" of the legitimacy of their depression. It is important for CBT practitioners to understand the context of sociocultural discourses around self-harm behaviours and self-harm scars, which are reflected in how adolescents with depression describe these within therapy and may serve to maintain distress. The study indicates that awareness of use of language and intersecting sociocultural discourses can inform CBT practice.

Efficacy of Cognitive Behavioral Therapy in Managing Anxiety Disorders among Adolescents: An In-Depth Analysis of Individual, Group, and Digital Approaches

This research article delves into the efficacy of Cognitive Behavioral Therapy (CBT) in addressing adolescent anxiety disorders. It explores various facets of CBT, including its theoretical underpinnings and mechanisms of change, highlighting its role in altering dysfunctional beliefs and thought patterns that contribute to anxiety. The article underscores the advantages of CBT, such as its structured approach, cost-effectiveness, and the provision of practical coping skills, making it a preferred choice for dealing with adolescent anxiety. The study then investigates the efficacy of different CBT approaches, including individual, group, and computerized CBT (cCBT) in details, specifically in the context of the COVID-19. It encompasses a range of research, from meta-analyses to controlled trials, evaluating the impact of these treatments on anxiety symptoms and their long-term efficacy. Research demonstrates CBT's high efficacy in treating youth anxiety, offering sustained symptom reduction and complementing psychopharmacological treatments backed by extensive studies and neuroimaging advancements. Group CBT for adolescents shows effectiveness in anxiety treatment, offering peer support and shared experiences in a communal setting, enhancing coping strategies and social skill development. The findings indicate cCBT's effectiveness in providing accessible mental health support to adolescents, aligning well with their tech-savvy tendencies. In conclusion, this research underlines CBT’s flexibility in addressing adolescent anxiety in both traditional and digital formats, with an emphasis on the promising potential of cCBT. It calls for future research to focus on standardizing CBT practices and validating the long-term effectiveness of cCBT.

Çocuk ve Ergenlerle Bilişsel Davranışçı Terapide Ebeveyn Katılımı: Bir Gözden Geçirme Çalışması

This research aims to evaluate the psycho-education and therapy programs prepared for children and adolescents with the Cognitive Behavioral Therapy approach and implemented between 2001-2021 in terms of parental involvement. This research, which was carried out in the descriptive model, is a review study. The articles covered in the research were accessed through Web of Science, ERIC, PubMed, Google Scholar, and ScienceDirect academic databases and were determined to be by the inclusion and exclusion criteria determined by the researchers, 10 of which were quasi-experimental with a control group and 7 in a randomized controlled study design. 17 articles were reviewed. Fifteen of the studies included child and adolescent sessions, while 2 included only children's sessions. According to the findings, it was determined that parent participation was used in all of the studies, the number of therapy sessions was between 8-30, and the session durations varied between 20 minutes and 1.5 hours in total, including the child/adolescent and parents It was stated that children and adolescents included in the treatment experienced various psychological disorders such as anxiety disorder, depression, obsessive-compulsive disorder, anger control disorder, attention deficit, and hyperactivity disorder, and eating disorder. These findings show that Cognitive Behavioral Therapy practices for different psychological disorders for children and adolescents benefit from parental involvement in 82% of the studies. The fact that the types of parental involvement and the presence of parental pathologies are not detailed in the studies constitute the shortcomings of parent involvement studies..

Awareness, Beliefs and Practice of Cognitive Behavioral Therapy (CBT) Strategies for Chronic Pain Management Among Physiotherapists

Purpose: To evaluate the awareness, practice and beliefs about CBT strategies for chronic pain management among Physiotherapists. Relevance: Chronic pain can be defined as pain that persists for 3 months or longer and, while not necessarily maladaptive, often leads to physical decline, limited functional ability and emotional distress. CBT has been increasingly used as an effective tool by psychologists in the management of chronic pain that is delivered through individual or group counselling sessions. Cognitive restructuring, relaxation techniques, activity pacing and good sleep hygiene are a few strategies of cognitive behavioral pain management therapies. There is also increasing evidence that supports the use of CBT strategies by Physiotherapists during their treatment for obtaining a positive outcome for chronic pain patients. Method and Analysis: A Google Form was formulated with relevant questions about awareness, practice and beliefs about CBT strategies for chronic pain. The questionnaire was face validated by 3 independent psychologists who practice CBT for chronic pain in their regular practice. This form was then distributed through various Physiotherapy groups in Bangalore via snowball sampling method. The data obtained from the responses were then complied, decoded and quantitatively analysed through content analysis using the SPSS-22. Result: The result showed strikingly contrasting responses from the Physiotherapists, as even though the majority of them were aware of CBT (34.1%), they applied it relatively less (15.3%). Of 63.5% Physiotherapists believed that pain perception is affected by automatic thoughts, while 52.9% agreed that negative thoughts need to be changed into positive coping thoughts. Around 49.4% of Physiotherapists believe in teaching relaxation techniques to their patients with chronic pain. Activity pacing and good sleep hygiene are important, as believed by 25.9% and 47.1% respectively. Physiotherapists (56.5%) accepted that patient needs to be mindful while exercising. Conclusion: Majority of Physiotherapists are aware and have positive beliefs about CBT strategies for chronic pain management. However, comparatively, we can see variations in the application of CBT strategies in their treatment plan. KEY WORDS: Cognitive Behavioral Therapy, chronic pain, Physiotherapy.

Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review.

Maladaptive therapist schemas are hypothesized to generate difficulties within cognitive behavioural therapy (CBT) practice, training and supervision. Without adequate identification and management, they negatively affect the cognitions and emotions of the therapist, leading them to behave in ways that risk ruptures or therapy and supervision being delivered in a suboptimal fashion. Consequently, there is a need to synthesize the research that has been undertaken to date on the content, prevalence, identification and management of maladaptive therapist schemas. A scoping review was undertaken of studies that have been published since 2001 on the impact of maladaptive therapist schemas (also referred to interchangeably as beliefs or cognitions) in CBT practice, training and supervision. Thirteen studies were identified in a literature search from four electronic databases, a reference list search of identified articles and hand searches. Three overall themes were identified in the research: (1) prevalence of therapist schemas, (2) specific therapist beliefs and (3) therapist characteristics associated with the delivery of suboptimal CBT or supervision. While there is little empirical support for therapist schemas, therapist resistance and beliefs relating to the fear of using exposure therapy were identified. Therapist intolerance of uncertainty and self-esteem were recurrent factors. There is no consensus on how to define, identify, formulate or respond to maladaptive therapist beliefs or schemas in clinical practice, training or supervision. Further research is needed to better understand their origins, maintaining factors and appropriate management of their impact.

School-Based Cognitive Behavioral Therapy Interventions for Internet and Gaming Addiction in Adolescents: A Systematic Review

Internet addiction has become an increasingly common problem, especially among children and adolescents. This problem has made school-based applications for internet addiction important. Different approaches are used in school-based interventions for the prevention and treatment of internet addiction. Cognitive behavioral therapy is one of the most preferred approaches. In this study, a systematic review of studies examining school-based cognitive behavioral therapy practices for internet and game addiction of adolescents in the literature was made. For this purpose, a comprehensive search was made in the databases of the Turkish National Thesis Center, Google Scholar, Science Direct, Springer, AKJournals and EBSCO. The studies reached as a result of the literature review were evaluated according to the PRISMA guide. The results obtained in this study are expected to guide future research and new school-based cognitive behavioral interventions.

Technological Advances in Cognitive-Behavioral Therapy and Clinical Practice: Challenges in an Evolving Field.

Technological innovations in cognitive-behavioral therapy (CBT) provide excellent opportunities for mental health clinicians to expand access to mental health treatment among culturally diverse and marginalized populations. This brief report highlights challenges that mental health clinicians encounter as they integrate technological innovations in CBT into their work with diverse clients and provides recommendations for addressing them. The authors identify five key challenges of using technology-driven CBT: development of the therapeutic alliance; potential fit for clients from culturally diverse backgrounds and marginalized groups; geographic and economic access; ethical and legal concerns; and competency in CBT practice, training, and supervision. Technological advances in CBT allow clinicians to treat more individuals from underserved communities. Existing challenges compel clinicians across disciplines to ensure that their practice is congruent with CBT practice values and ethics, policy, and research and that the best available CBT intervention can be integrated into all aspects of mental health practice.

CBT supervision behind closed doors: Supervisor and supervisee reflections on their expectations and use of clinical supervision

AbstractObjectivePrevious surveys examining the routine practice of cognitive behavioural therapy (CBT) supervision have consistently found that methods utilised by supervisors often drift from expert recommendations. Harmful or ineffective supervision are two potential consequences of practices which overlook one or more of the normative, formative or restorative functions. Given that most of the research to date in this area has used quantitative methods, it is important to gain a deeper understanding of the reasons why everyday supervision differs so greatly. One way of achieving this is through exploring the “lived experience” of supervisors and supervisees.MethodSemi‐structured interviews were conducted with (N = 10) supervisors and supervisees, and data were analysed using interpretative phenomenological analysis.ResultsThree superordinate themes were identified: “inconsistency of approaches,” “autonomy” and “the relationship.” The findings revealed that supervisors are practicing very differently from one another, despite awareness of expert guidance. There were some indications of supervisory drift, characterised by supervisor resistance to hierarchical structures and supervisee avoidance due to concerns about their safety within the relationship.ConclusionFurther research is needed to better understand how supervision dyads can identify and manage dysfunctional supervision practices.

Obsessive-Compulsive Disorder and Schizophrenia: Conceptualization, Assessment and Cognitive Behavioral Treatment.

There is little doubt that schizophrenia (SZ) and obsessive-compulsive disorder (OCD) are among the most severe disorders to impact humanity. They are both common, significantly disabling and have the tendency to strike during critical developmental periods in a young person's life. Schizophrenia affects approximately 1% of the global population and OCD has a lifetime prevalence of between 2% and 3% in the general population. The comorbidities in both SZ and OCD are common and frequently diagnosed, and research has generally found that comorbidities are associated with conditions that are more complex to diagnose and treat, and often result in less favorable prognoses. We review the research that has taken place regarding the co-occurrence of SZ and OCD, discuss it's theoretical conceptulization and clinical differentiation and diagnosis. We then propose recommendations for the best practice of cognitive behavioral therapy in this difficult population, as well as areas that need exploration for future research.

The philosophical assumptions across the ‘three waves’ of cognitive–behavioural therapy: how compatible are they?

SUMMARYUnderstanding the philosophical foundations of cognitive–behavioural therapy (CBT) is vital to drive theory and research forwards and to effectively conduct therapy using varied methods and techniques from different CBT models that may be rooted in distinct philosophical tenets. In the evolution of CBT as the most empirically validated form of psychotherapy, each of its three waves (behavioural therapy, cognitive therapy and acceptance-based therapies) has brought unique contributions to improve its effectiveness. Although some of the philosophical assumptions underlying the different CBT waves may be considerably dissimilar, in this clinical reflection I review the distinctive and cross-cutting features of such backgrounds, while suggesting a conciliation of epistemological perspectives that is capable of informing the practice of CBT in a consistent manner.

Nurses' Knowledge and Practicing Level of Cognitive Behavioral Pain Relief Methods in Public Hospitals of Eastern Ethiopia.

Despite the fact that cognitive behavioral therapy is regarded as a superior pain relief method and an alternative to drug therapy, little is known about its scope of application and determinant factors. As a result, the study sought to assess nurses' knowledge and practicing level of cognitive behavioral pain relief methods in public hospitals in eastern Ethiopia. To assess the knowledge and practicing level of cognitive behavioral pain relief among nurses working in public hospitals of eastern Ethiopia. A cross-sectional study was conducted among randomly selected 390 nurses. The data were collected using a self-administered questionnaire. The data were entered into Epi-data 3.1 and exported to SPSS 22 for analysis. Bivariate and multivariate logistic regression models were used to identify factors associated with cognitive behavioral therapy. In this study, more than half (54.1%) of the respondents had good cognitive behavioral methods practicing levels. Nearly two-thirds (58.8%) of the participants had adequate knowledge about pain relief methods. Having adequate knowledge (adjusted odds ratio [AOR] 2.664; 95% confidence interval [CI]: 1.75, 4.7), having training (AOR 1.7; 95% CI: 1.03, 3.01), and positive attitude (AOR 4.02; 95% CI: 4.5, 12.4) were significantly associated with cognitive behavioral therapy. In this study, more than half of nurses had good cognitive behavioral methods practicing levels. Having a positive attitude, being knowledgeable, and having training were determinant factors in the practice of cognitive behavioral therapy. Continuing education and training should be considered for nurses to enhance their cognitive behavioral therapy practice.

Fundamentals and Issues of Cognitive Behavioral Therapy Practice in Telepsychology

Fundamentals and Issues of Cognitive Behavioral Therapy Practice in Telepsychology

A clinical approach to nightmares and bad dreams in cognitive–behavioural therapy

SUMMARYClinicians trained in cognitive–behavioural therapy (CBT) are frequently not trained to work with dreams. Given the high prevalence and impact of nightmares and bad dreams, empowering CBT therapists to effectively work with these sleep phenomena is crucial to improve therapeutic outcomes. This article briefly outlines a cognitive–behavioural model of dreams and reviews some clinical guidelines for directly and indirectly addressing nightmares and bad dreams in CBT practice.

The Future of Cognitive Behavioral Therapy

Aaron T. Beck, the founder of this journal and the father of cognitive behavioral therapy (CBT), is turning 100 on June 18th, 2021. This special issue on the Future of CBT provides a glimpse into the next frontier of CBT research and practice. Some of the leading CBT scholars and researchers, including Dr. Beck himself, will explore new CBT approaches for schizophrenia, OCD, depression, and envy.

ممارسة العلاج المعرفی السلوکی فی خدمة الفرد فی إکساب الوعی التنموی للمرأة غیر العاملة

ملخص البحث هدفت هذه الدراسة إلى محاولة التحقق من مدى فاعلية برنامج للتدخل المهني في اطار العلاج المعرفي السلوکي في خدمة الفرد في إکساب الوعي التنموي للمرأة غير العاملة ، والدراسة من النوع التجريبي وذلک عن طريق التجربة القبلية ـ البعدية بإستخدام مجموعتين احداهما تجريبية والأخرى ضابطة تشمل کل مجموعة (15) مفردات من الذين تنطبق عليهم شروط العينة من السيدات غير العاملات بنادي المرأة بمرکز شباب المنصورة. واعتمدت الدراسة على مقياسالوعي التنموي للمرأة غير الذي أعده الباحث والمقابلات الفردية والجماعية مع أعضاء المجموعة التجربية. وتوصلت نتائج الدراسة الي أن هناک فروق معنوية ذات دلالة إحصائية بين متوسطات درجات التطبيقين القبلي والبعدي لمقياس الوعي التنموي للمرأة غير العاملة عند مستوى معنوية (0.01) لصالح التطبيق البعدي. مما يشير إلى التأثير الإيجابي لبرنامج التدخل المهني في اطار العلاج المعرفي السلوکي في خدمة الفرد في إکساب الوعي التنموي للمرأة غير العاملة . الکلمات المفتاحية : العلاج المعرفي السلوکي- الوعي التنموي- المرأة Abstract The practice of cognitive-behavioral therapy in case work for developmental awareness to non-working women This study aimed to try to verify the effectiveness of a professional intervention program within The practice of cognitive-behavioral therapy in case work for developmental awareness to non-working women. The study is of the experimental type through the pre-post experiment using two groups, one experimental and the other a control that includes each group (15 Vocabulary of those who meet the conditions of the sample of non-working women in the Women's Club of Mansoura Youth Center. The study relied on a measure of developmental awareness of women other than that prepared by the researcher and individual and group interviews with members of the experimental group. The results of the study concluded that there are statistically significant significant differences between the averages of the scores for the pre and post application of the non-working woman's development awareness scale at a significant level (0.01) in favor of the post application. This indicates the positive impact of the professional intervention program within The practice of cognitive-behavioral therapy in case work for developmental awareness to non-working women. Key words : cognitive-behavioral therapy- developmental awareness- women.

Cultural adaptations of cognitive behaviour therapy for the Orthodox Jewish community: a qualitative study of therapists’ perspectives

Abstract Cultural factors are influential in the prevalence, diagnosis and treatment efficacy of mental health conditions. Although the literature has advanced substantially towards the development of cultural adaptations of cognitive behavioural therapy (CBT) for various minority cultural groups, research into cultural adaptations of CBT for the Orthodox Jewish community has been scarce. This qualitative study interviewed five CBT therapists about their experiences working with clients from the London Orthodox Jewish community and uncovered several key practical implications for the clinical practice of CBT with this client group. This study indicates that CBT is a culturally appropriate psychological treatment for this client group that accords with Orthodox Jewish teachings and religious beliefs. CBT therapists are encouraged to become familiar with Orthodox Jewish cultural practices and beliefs and adopt a culturally sensitive approach to treatment. Despite the reduced mental health stigma within the community, this study recommends that CBT therapists normalise mental health conditions and therapy with Orthodox Jewish clients. Due to the close-knit nature of the community, it is suggested that CBT therapists display heightened confidentiality with this client group. To overcome the mistrust of their Orthodox Jewish clients, CBT therapists are advised to display cultural sensitivity and genuine respect for the Orthodox Jewish way of life, in addition to building a strong therapeutic alliance. Further qualitative research exploring different perspectives is necessary to produce evidence-based guidelines for the cultural adaptation of CBT for the Orthodox Jewish community. Key learning aims (1) To explore how CBT therapists work with the religious beliefs and practices of Orthodox Jewish clients. (2) To discover the challenges faced by Orthodox Jewish clients when accessing psychological treatment. (3) To consider the ways in which CBT can be culturally adapted to meet the needs of the Orthodox Jewish community.

COGNITIVE BEHAVIORAL THERAPY FOR SCHIZOPHRENIA

Schizophrenia is a heterogeneous disorder that affects behavioral, affective, and cognitive domains and consists of positive and negative psychotic symptoms. Antipsychotic therapy is the first-line treatment for schizophrenia. However, treatment adherence levels are low. Even if there is good treatment compliance, residual symptoms and treatment resistance can be seen. As a result, recent schizophrenia treatment guidelines suggest Cognitive Behavioral Therapy (CBT) as adjunctive to antipsychotic therapy. CBT is known effective, especially on positive symptoms. This paper aims to review CBT practices and their effectiveness in schizophrenia.

A Mobile Phone-Based App for Use During Cognitive Behavioral Therapy for Adolescents With Anxiety (MindClimb): User-Centered Design and Usability Study.

BackgroundMobile device–based tools to help adolescents practice skills outside of cognitive behavioral therapy (CBT) sessions for treating an anxiety disorder may lead to greater treatment gains.ObjectiveThis study aimed to develop, design, and test the acceptability, learnability, heuristics, and usability of MindClimb, a smartphone-based app for adolescents with anxiety to use between CBT sessions to plan and complete exposure activities using skills (cognitive, relaxation, exposure practice, and reward) learned in treatment.MethodsThis 3-phase study took place from August 2015 to December 2018. In phase 1, the app was designed and developed in consultation with young people and CBT therapists to identify desired functions and content. Feedback was subjected to thematic analysis using a general inductive approach. In phase 2, we conducted 2 high-fidelity testing sessions using the think-aloud approach (acceptability, learnability, usability) and 10-item System Usability Scale with 10 adolescents receiving CBT. The high-fidelity MindClimb app was evaluated by 5 app developers based on Nielsen’s usability heuristics and 5-point severity ranking scale. In phase 3, a total of 8 adolescents and 3 therapists assessed the usability of MindClimb during CBT sessions by recording the frequency of skills practice, use of MindClimb features, satisfaction with the app, and barriers and facilitators to app use during treatment.ResultsFeedback from phase 1 consultations indicated that the app should (1) be responsive to user needs and preferences, (2) be easy to use and navigate, (3) have relevant content to the practice of CBT for anxiety, and (4) be aesthetically appealing. Using this feedback as a guide, a fully functional app prototype for usability testing and heuristic evaluation was developed. In phase 2, think-aloud and usability data resulted in minor revisions to the app, including refinement of exposure activities. The average system usability score was 77 in both testing cycles, indicating acceptable usability. The heuristic evaluation by app developers identified only minor errors (eg, loading speed of app content, with a score of 1 on the severity ranking scale). In phase 3, adolescents considered app features for completing exposure (6.2/10) and relaxation (6.4/10) modestly helpful. Both adolescents (average score 11.3/15, SD 1.6) and therapists (average score 10.0/12, 2.6 SD) reported being satisfied with the app.ConclusionsThe user-centered approach to developing and testing MindClimb resulted in a mobile health app that can be used by adolescents during CBT for anxiety. Evaluation of the use of this app in a clinical practice setting demonstrated that adolescents and therapists generally felt it was helpful for CBT practice outside of therapy sessions. Implementation studies with larger youth samples are necessary to evaluate how to optimize the use of technology in clinical care and examine the impact of the app plus CBT on clinical care processes and patient outcomes.