Short-term Cognitive Therapy Research Articles

The Effects of the Five-Session Cognitive Behavior Group Therapy for Panic Disorders: Ultra-Brief Treatment

Structuring short-term and group-based Cognitive Behavioral Therapy (CBT) will make an important contribution to cost-effectiveness. The aim of this study is to evaluate the effectiveness of our five-session CBGT protocol in reducing panic disorder symptoms and beliefs underlying this disorder in the perspective of cognitive theory. A protocol of five sessions was applied with forty-six patients who were diagnosed with panic disorder and volunteered for the study. A sociodemographic data form, the Panic Disorder Severity Scale (PDSS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Body Sensations Questionnaire (BSQ), Agoraphobic Cognition Scale (ACS), and Health Anxiety Scale (HAS) were administered to the patients by the study team. The scales were reapplied before the group process started, after the 2nd session, after the 5th session, and at the 6th month after the end of the therapy process. A significant change was observed between baseline and 6th-month controls in all measurements. In addition, there was no difference in PDSS, BDI, BSQ, and HAS scores between the end of therapy and 6th-month values. Our study will make a valuable contribution to the literature as it is the first CBGT study in our country and a short protocol such as five sessions is used.

COVID-19 health anxiety.

COVID-19 health anxiety.

Group psychotherapy's impact on trust in veterans with PTSD: a pilot study.

Interpersonal trust is fundamental for the recovery of trauma survivors and the effectiveness of group psychotherapy. Yet there is limited research on the relationship between interpersonal trust and group psychotherapy. Twenty-one male Vietnam combat veterans with posttraumatic stress disorder (PTSD) (6 in a long-term process group [LTP], 10 in a short-term cognitive processing therapy group [CPT], and 5 treatment-as-usual controls) were evaluated before and after group psychotherapy using the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and an in-vivo measure of interpersonal trust, the Iterated Trust Game. Three (14.3%) of the veterans were African American, 9 were Caucasian (42.9%), and 9 were Hispanic (42.9%); they averaged 61.9 years of age (SD = 1.8 years). Change in PCL-M scores differed by group (controls: -1.0 ± 3.7; CPT: -15.5 ± 6.8; LTP: -1.3 ± 12.2; p = .003). CPT group subjects improved more than controls (p < .001) and trended toward more improvement than the LTP group (p = .081). Members of the LTP group, compared to nonprocess group participants, showed greater initial (p = .042), and posttherapy trust (p = .003). Posttreatment, interpersonal trust was significantly higher in the LTP than the CPT group (p < .001). These results suggest that CPT treatment may be better than LTP treatment for improving PTSD symptoms, but LTP therapy may be better than CPT therapy for improving interpersonal trust in veterans with PTSD. They suggest important roles for both group treatments and point to the value of interpersonal trust in successful recovery from PTSD.

Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial

There is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects. To evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs). The participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067). For the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03). Continuing CST improves quality of life; and improves cognition for those taking AChEIs.

Predicting who benefits most from cognitive-behavioral therapy for anxiety and depression.

We examined core features of patient suitability for cognitive-behavioral therapy (CBT) and their ability to predict CBT outcomes. A sample of 256 outpatients diagnosed with depression and anxiety disorders were assessed using the Suitability for Short-Term Cognitive Therapy (SSCT) scale. Therapists rated patients' symptom severity using the Clinical Global Impression scale before and after therapy. A factor analysis of the SSCT scale yielded 2 factors: (a) Capacity for Participation in CBT Process and (b) Attitudes Relevant to the CBT Process. A multiple regression analysis revealed that only Capacity for Participation in CBT Process uniquely predicted improvement at termination. These findings highlight the importance of assessing the suitability of CBT for individual patients. Specifically, patients with greater capacity to identify and articulate thoughts and feelings and to share them in a nondefensive, focused way benefit most from CBT.

Experience of affects predicting sense of self and others in short-term dynamic and cognitive therapy.

The present study examined whether levels of activating affects (AA) and inhibitory affects (IA) were related to change toward more compassionate and realistic levels of sense of self (SoS) and sense of others (SoO). The sample included 47 patients diagnosed with cluster C personality disorders, who received 40 sessions of either cognitive therapy or short-term dynamic therapy (see the randomized controlled trial study, Svartberg, Stiles, & Seltzer, 2004). A total of 927 videotaped sessions were rated with the use of the observational instrument, Achievement of Therapeutic Objectives Scale. Longitudinal multilevel modeling enabled the examination of both between-person effects and within-person changes in level of AA and IA. Patients with better ability to experience AA at the start of therapy displayed significantly higher SoS and SoO across sessions compared with other patients. Patients who experienced higher levels of IA at the start of therapy displayed lower levels of SoS across sessions. A patient experiencing more AA than usual for him/her self within a session predicted an increased level of SoS and SoO at the next measuring point. There were no different change patterns in the 2 treatment groups. Results suggest that focus within therapy sessions on increasing patients' AA can help facilitate change in SoS and SoO toward more compassionate and realistic quality.

Growth in sense of self and sense of others predicts reduction in interpersonal problems in short-term dynamic but not in cognitive therapy

Objectives: We investigated relationships between sense of self (SoS) and sense of others (SoO) and specific interpersonal problems in short-term dynamic and cognitive therapy. Method: 40 patients with Cluster C personality disorders from a RCT were included. The Achievement of Therapeutic Objective Scales (ATOS) was used to perform ratings of videotaped sessions. The Inventory of Interpersonal Problems Circumplex version was used as the outcome measure. Results: There were significant relationships between growth in SoS and SoO and reductions of hostile-dominant and hostile-submissive behaviors, as well as cold, social-avoidant and vindictive behaviors. Increase in SoO was also related to reductions in non-assertive and domineering behaviors. However, the results were only present in the STDP treatment group.

Change in Defense Mechanisms During Short-Term Dynamic and cognitive Therapy in Patients With Cluster C Personality Disorders

Change in Defense Mechanisms During Short-Term Dynamic and cognitive Therapy in Patients With Cluster C Personality Disorders

Assessing Suitability for Short-Term Cognitive-Behavioral Therapy in Psychiatric Outpatients with Psychosis

The Suitability for Short-Term Cognitive Therapy (SSCT) rating procedure has predicted outcome in depressed and anxious patients. This study examines its relevance in assessing patients with psychosis. Outpatients with psychosis (n=56), depression (n=93), and anxiety (n=264) received cognitive- behavioral therapy in a university hospital teaching unit (mean number of sessions=16, SD=11). Demographic, clinical, and suitability variables were assessed as potential predictors of dropout and success as measured by the Reliable Change Index. Despite lower suitability scores in the psychosis group, dropout and success rates were similar across groups, although the magnitude of symptom reduction was less in the psychosis group. Across diagnoses, dropout was predicted by unemployment and by reluctance to take personal responsibility for change. In the psychosis group only, dropout was predicted by hostility. Success of completed therapy was predicted by higher baseline agoraphobic anxiety and "responsibility for change" scores. Attention to hostility early in therapy may reduce dropout in psychotic patients. Fostering acceptance of responsibility for change may improve both treatment retention and success across diagnoses. Agoraphobic fear is associated with success, possibly reflecting the effectiveness of behavioral interventions in psychosis and anxiety alike.

Change in Defense Mechanisms During Short-Term Dynamic and Cognitive Therapy in Patients With Cluster C Personality Disorders

The aims of this study were to examine whether a change in overall defensive functioning during treatment a) would predict change in symptom distress during the course of treatment and follow-up and b) would be greater in short-term dynamic therapy than in cognitive therapy. Patients (N = 50) who met criteria for cluster C personality disorders were randomized to 40 weekly sessions of short-term dynamic therapy or cognitive therapy. Video recordings of a pretreatment interview and therapy session 36 were evaluated using the Defense Mechanisms Rating Scales. Symptom distress was measured using the revised version of Symptom Checklist-90. Change in overall defensive functioning during treatment predicted change in symptom distress from pretreatment to 2 years after treatment. Both treatment groups showed significant changes in defensive functioning toward greater adaptability but without any significant differences between the short-term dynamic therapy and cognitive therapy groups in a sample of patients with cluster C personality disorders.

Suitability for Short-Term Cognitive-Behavioral Therapy

The Suitability for Short-Term Cognitive Therapy Rating Scale (SRS) defines 10 criteria to assess suitability for short-term cognitive-behavioral therapy (CBT). This study examines the relationships between pretreatment SRS scores and outcome of 113 patients treated with short-term CBT for a wide range of disorders. Using the reliable change index (RCI) as a measure of outcome, 65 individuals (57.5%) of the sample experienced statistically reliable improvement. Married status, employed status, female gender, and anxiety disorder as a primary diagnosis were positively correlated with posttreatment RCI. Awareness of emotion and security operations were the SRS items most strongly correlated with outcome. Also correlated were the two alliance potential items (in-session and out-of-session evidence) and the acceptance of personal responsibility for change. Hierarchical multiple linear regression analysis resulted in a three-variable model where married status, primary anxiety disorder, and mean SRS score accounted for 20% of the variance in RCI scores. We conclude that the SRS adds predictive value to the assessment of potential to succeed in CBT.

Inpact of a ten week mind-body medicine intervention on peristent fatigue following breast cancer treatment: 6 month follow- up

9062 Background: Persistent fatigue following breast cancer treatment, which affects up to 40% of breast cancer patients, is the result of diverse patient and treatment factors. The multi-dimensional underlying etiology of fatigue calls for broad based interventions aimed at managing stress, improving diet and exercise patterns and short term cognitive therapy supporting attitudinal and behavioral changes. A pilot study was conducted to obtain preliminary efficacy information for a ten week group-based mind body intervention to treat persistent fatigue among breast cancer survivors. Methods: The quasi-experimental study design used a before/after evaluation of fatigue scores. Subjects were women who were between six months and five years post-completion of adjuvant chemotherapy and/or radiation therapy for breast cancer and who had a baseline fatigue score of ≤ 50 as measured by the vitality subscale of the SF-36 Health Survey. Twenty- one women entered the study. Three participants dropped out after attending only two of the ten weekly sessions and are excluded from the analysis. Main outcome measures were change in severity of fatigue as measured by the Piper Fatigue Scale and vitality subscale score of the SF-36. Results: At baseline, the mean age of participants was 52.7 years; 66.7% were Caucasian and 23.7% were African-American. Median time since breast cancer diagnosis was 2.9 years. The mean Piper fatigue score improved from 6.0 (SD 1.5) at baseline to 4.0 (SD 2.1) at the end of the ten week intervention (p&lt; 0.001). Fatigue scores at two and six months post-intervention were 3.2 (SD 2.9; p= 0.001) and 4.1 (SD 2.1; p= 0.02), respectively. Similarly the SF-36 vitality subscale score improved following the intervention with persistent improvement at 6 months (p=0.02). Conclusion: A holistic integrated mind body medicine intervention holds promise for long-term impact on reducing fatigue following breast cancer treatment. Sponsored by Susan G. Komen Breast Cancer Foundation No significant financial relationships to disclose.

The relationship between patient suitability, therapeutic alliance, homework compliance and outcome in cognitive therapy for psychosis

Objective. This paper examines the relationships between patient suitability, therapeutic alliance, homework compliance and outcome in cognitive–behaviour therapy (CBT) for psychosis. Method. 29 patient and therapist dyads completed patient and therapist versions of the California Psychotherapeutic Alliance Scale (CALPAS) at session 3 and 21 at session 9. The level of patient homework compliance was rated by therapist and patient, using visual analogue scales, at therapy sessions 3 (29 dyads) and 9 (20 dyads). The Positive and Negative Symptoms of Schizophrenia (PANSS) scale was used to measure psychotic symptoms pre- and post-treatment. Patient suitability for the treatment was measured at session 3, using the Suitability for Short-Term Cognitive Therapy Scale. Results. Only two of the specific hypotheses were supported. There was no significant agreement between patients and therapists on the quality of the therapeutic alliance at session 3, but by session 9 two (patient commitment and working strategy consensus) of the four sub-scales were significantly associated, although there was little evidence that the quality improved over time. Lower patient suitability and insight at session three predicted a lower therapeutic alliance. Therapeutic alliance predicted level of homework compliance. The only significant predictor of outcome was the PANSS positive symptoms sub-scale pre-treatment score. Conclusions. These results suggest that patients who experience psychotic symptoms can be successfully engaged early in therapy as can those with affective disorders but that therapeutic alliance may not have a direct effect on outcome. Copyright © 2006 John Wiley & Sons, Ltd.

Evaluating alliance-focused intervention for potential treatment failures: A feasibility study and descriptive analysis.

This article describes a pilot study evaluating the feasibility of an approach developed to test the efficacy of a therapeutic intervention (brief relational therapy) for patients with whom it is difficult to establish a therapeutic alliance. In the first phase of the study, 60 patients were randomly assigned to either short-term dynamic therapy (STDP) or short-term cognitive therapy (CBT), and their progress in the first eight sessions of treatment was monitored. On the basis of a number of empirically derived criteria, 18 potential treatment failures were identified. In the second phase of the study, these identified patients were offered the option of being reassigned to another treatment. The 10 patients who agreed to switch treatments were reassigned either to the alliance-focused treatment, referred to as brief relational therapy (BRT), or a control condition. For patients coming from CBT, the control condition was STDP. For patients coming from STDP, the control condition was CBT. The results provide preliminary evidence supporting the potential value of BRT as an intervention that is useful in the context of alliance ruptures.

Moderators of trainee therapists' competence in cognitive therapy.

A revised version of the Cognitive Therapy Scale (CTS-R) was developed and used in an ecologically valid study designed to examine the acquisition of competence in cognitive therapy (CT). The relationship of therapist and patient variables to changes in competence was examined. Unlike most previous research, this study defines effectiveness of training in terms of therapist competence rather than patient outcome. A longitudinal design was employed within a naturalistic setting. Trainees' competence (the dependent variable) was sampled on three occasions during a training course. Twenty screened out-patients, who had been routinely referred to the Newcastle Cognitive Therapy Centre, were assigned to 20 postgraduate trainees receiving training in CT. Expert raters assessed trainees' competence at three points over the first 12 sessions of treatment using the CTS-R. The relationship of therapist and patient variables to changes in competence was examined. The patient measures used were the Beck Depression Inventory (BDI) and the Suitability for Short-Term Cognitive Therapy (SSCT). Three therapist factors were found to be related to competence: time (trainee therapists improving over the training period), previous experience with CT (those with most experience were most competent), and gender of the therapist (males improving at a greater rate than females). Therapist competence was also related to patients' suitability. These findings suggest that previous CT experience is an advantage prior to attending an advanced training course, and also that careful patient selection helps trainees to demonstrate therapeutic competence.

The Relationship Between Patient Pretreatment Interpersonal Schemas and Therapeutic Alliance in Short-Term Cognitive Therapy

This pilot study examined the relationship between interpersonal schemas (as measured by the Interpersonal Schema Questionnaire) and the therapeutic alliance (as measured early in treatment by a patient self-report version of the Working Alliance Inventory) in short-term cognitive therapy. Twenty-six (15 men, 11 women) patients participated in this study. Findings revealed that the complementarity of expected responses in submissive situations was positively associated with therapeutic alliance, whereas the complementarity of expected responses in dominant situations and the desirability of these responses were negatively related to therapeutic alliance.

The Therapeutic Alliance in Brief Psychotherapy

Introduction - Negotiating the Therapeutic Alliance in Brief Psychotherapy Therapeutic Alliance in Brief Psychoanalytic Psychotherapy - a Drive/Conflict Perspective Therapeutic Alliance in the Relational Models of Time Limited Dynamic Psychotherapy Functional Analytic Psychotherapy, the Therapeutic Alliance and Brief Psychotherapy The Therapeutic Relationship in Short-Term Cognitive Therapy The Therapeutic Alliance in Human and Experiential Therapies The Alliance in Time-Limited Group Psychotherapy The Therapeutic Alliance in Strategic Therapy The Therapeutic Alliance in Couples and Family Therapy Theory in Practice Common Ground and Shared Principles.

Presentation of Depression and Response to Group Cognitive Therapy with Older Patients

Concerned with response prediction, this research examines the relationships between pre-treatment components of depressive symptomatology and outcome of short-term group cognitive therapy for depression with older adults. Aspects of depressive symptomatology under examination were initial intensity of self-reported depressive symptomatology, profile of melancholic depression, perceived health status, perceived social support, and intensity of negative view of self. Findings indicate that perceived social support is not related to outcome but that a more intense depressive symptomatology, a more negative health evaluation, and a more negative view of self are variables associated with a less favorable outcome. Despite showing a sizable decrease in depressive symptoms over the course of intervention, severely depressed subjects still presented residual depressive symptoms at the conclusion of intervention. There was a tendency for subjects with a melancholic profile to show a poorer response to this intervention.

An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression.

An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression.

Is cognitive therapy suitable for treating individuals with personality dysfunction

In this study, the impact of personality dysfunction on suitability for cognitive therapy was examined empirically. Thirty-six (36) mental health outpatients were evaluated with regard to the extent of personality dysfunction and suitability for short-term cognitive therapy. All participants were interviewed by a psychiatrist using the Personality Disorders Examination (PDE) to assess personality dysfunction, and by a psychologist using the Suitability for Short-Term Cognitive Therapy Scale (SSCT) to assess cognitive therapy suitability. Participants also completed the Millon Clinical Multiaxial Inventory–Revised (MCMI-II) to provide a multimethod assessment of personality dysfunction. Analysis of the correlations between suitability for cognitive therapy and personality dysfunction for both the independent-interviewer rated method (the PDE) and the self-report method (MCMI-II) indicated that greater dysfunction was significantly associated with poorer suitability for cognitive therapy. Results were most clear for the general therapy subscale of the SSCT relative to the cognitive therapy specific subscale. A tentative item analysis of the SSCT scale indicated that alliance potential (both in-session and out-of-session ratings), security operations, chronicity, personal responsibility for change, and compatibility with the cognitive therapy rationale were most strongly affected (negatively) by personality dysfunction. These data suggest that, although personality dysfunction has an impact on suitability, cognitive therapy may not be any more contraindicated than any other form of psychotherapy. Theoretical developments within cognitive therapy to address personality dysfunction specifically also support the use of cognitive therapy with this population. Suggestions for specific process and procedural modifications to cognitive therapy when working with personality dysfunction that address the factors that contribute to poor suitability are outlined.