Use Of Cognitive Behavioral Therapy Research Articles

Cognitive behavioural therapy in the treatment of social skills deficits and social phobia in a man with an autism spectrum disorder: a single-case study

AbstractAutism spectrum disorders (ASD) including high-functioning types such as Asperger's syndrome (AS) are diagnosed when there is evidence of a triad of qualitative impairments in social interaction, communication, and stereotyped/repetitive behaviours. It is not uncommon for these impairments to be accompanied by social anxiety. The present single-case study investigates the use of cognitive behavioural therapy (CBT) to treat a 47-year-old man who was assessed as having difficulties with social skills and social phobia in the context of a late diagnosis of AS. He received 20 h of CBT adapted for his AS in 15 sessions including a 1-month follow-up. Following a highly individualized formulation, treatment included modelling, role-playing, reinforcement, thought challenging, and behavioural experimentation. Results from five self-report measures showed continued improvements from the start of therapy to follow-up in social anxiety, global distress, depression and self-esteem. The client gave positive feedback about his experience of treatment. The case study is discussed with reference to limitations and some reflections for CBT in ASD.

Study of effectiveness of brief cognitive behavioral therapy for auditory hallucinations in schizophrenia

Introduction A growing body of evidence supports the use of cognitive behavioral therapy (CBT) for the treatment of schizophrenia. Auditory hallucinations are a common feature in schizophrenia that persists as a distressing symptom even after adequate pharmacotherapy regimen. Combining pharmacotherapy with brief CBT may reduce the severity of symptoms through decreasing the distress caused by the hallucinations. Aim The aim of this study was to evaluate the effectiveness of brief individual CBT for auditory hallucinations combined with treatment as usual (TAU) compared with TAU only in a sample of Egyptian schizophrenic patients referred to the Outpatient Clinic of El Hadara University Hospital. Patients and methods A total of 40 patients diagnosed with schizophrenia referred to the outpatient clinic of El Hadara University Hospital were randomly assigned into two groups: group I received brief CBT for auditory hallucinations combined with TAU, and group II received TAU only. Brief CBT for auditory hallucinations was delivered on eight sessions of 45 min each with a frequency of once per week. Positive and Negative Syndrome Scale (PANSS) was assessed before and after therapy in both groups and outcome was compared. Results On comparing the pre-assessment scores with the post-assessment scores of group I after 8 weeks of brief CBT for auditory hallucinations, a significant symptom reduction was observed for the PANSS positive (−18.31%, P < 0.001), negative (−16.67%, P < 0.001), general symptoms (−16.53%, P < 0.001), and total (−16.53%, P < 0.001) scores. Moreover, on comparing group I with group II after 8 weeks of brief CBT for auditory hallucinations, a significant symptom reduction was observed for the PANSS positive (P < 0.001), negative (P = 0.008), general symptoms (P < 0.001), and total (P < 0.001) scores. Conclusion Brief CBT for auditory hallucinations was found to be effective in reducing symptom severity in schizophrenia

Gay Poz Sex: A Sexual Health Promotion Intervention for HIV-Positive Gay and Bisexual Men

Despite the widespread use of cognitive-behavioral therapy and motivational interviewing techniques among behavioral clinicians, most mental health clinicians do not know how to use these techniques for HIV prevention and sexual health promotion. Even less information is available to clinicians on how to work with HIV-positive gay and bisexual men who are at risk for transmitting HIV due to condomless anal sex. The purpose of the present paper is to assist behavioral therapists who are treating HIV-positive gay and bisexual men who engage in sexual behavior that may place them at risk for transmitting HIV or for other sexually transmitted infections. Gay Poz Sex is a form of small group counseling that uses the Information-Motivation-Behavioral Skills model (e.g., Fisher & Fisher, 2000) as the theoretical basis, and a combination of psychoeducation, motivational interviewing, and cognitive-behavioral skills such as stimulus control and role-play exercises. The treatment has the goal of promoting a positive sense of sexual well-being and reducing sexual behavior associated with the transmission of HIV, such as condomless anal sex. This paper illustrates, using three case examples, the application of empirically supported therapy techniques to reduce condomless anal sex for HIV-positive gay and bisexual men.

Stephanie L. Brooke and Charles E. Myers (Eds.): The Use of the Creative Therapies in Treating Depression

Depression is a beast that knows no boundaries. It does not discriminate based on age, gender, race, religion, or socioeconomic status. The World Health Organization estimates that 350 million people across the globe are affected by depression and it is the leading cause of disability worldwide. Author and blog writer Therese Borchard wrote, ‘‘I wish people knew that depression is complex, that it is a physiological condition with psychological and spiritual components, and therefore can’t be forced into any neat and tidy box, that healing needs to come from lots of kinds of sources and that every person’s recovery is different.’’ Indeed, the suffering depression imparts can be as diverse as the individuals affected by its’ wretched grasp. A holistic approach, tailored to the uniqueness of each individual, should always be considered as part of best clinical practice. The Use of Creative Therapies in Treating Depression provides an overview of how art, play, music, dance/movement, drama, and animals can be therapeutic modalities in clinical work with depression across the lifespan. In 18 of the 20 chapters, a creative therapy is introduced and its’ application with a particular patient population is reviewed. Each chapter provides a synopsis of the authors’ credentials in the both the practice and education of their creative field. The first chapter provides an overview of depression across the lifespan, while the final chapter addresses ethical considerations in the clinical application of these modalities. Dorothy Miraglia and Stephanie Brooke begin the book with a brief historical overview of depression. Chapter 1 also examines depression across the lifespan as well as the association between creativity and depression. Examples of famous figures throughout history and their creative achievements are highlighted, mainly within the context of Bipolar Disorder. Although these individual works are well known during the artists’ periods of mania, the authors are able to present how these works differed during periods of depression. This chapter concludes with an overview of the book. In Chapter 2, Deborah Elkis-Abuhoff addresses how adolescents with depression may be treated using art therapy. She discusses depressive disorders in adolescents and the use of cognitive-behavioral therapy (CBT) in the treatment of adolescent depression. She goes on to address how the addition of art therapy to this modality can enhance the therapeutic process. The use of collage, clay, self-reflection with mirrors, and altered books is discussed. Each art therapy approach is explained and research supporting the efficacy of these approaches is presented. The remainder of the chapter provides a comprehensive case illustration involving a 16-year-old female named Ashley. The author gives a detailed account of how each of these approaches was used in treatment and their impact throughout the therapy process. Photographs of Ashley’s collages, clay, reflection, and altered book give the reader a deeper appreciation of how these modalities are implemented. In Chapter 3, Lisa Hinz discusses the Expressive Therapies Continuum (ETC) and how it may be used in the assessment and treatment of depression. This conceptual model represents all levels of creative expression and functioning, ranging from the most basic kinesthetic/sensory level to the most complex cognitive/symbolic level. & Brandy Chaneb BrandyL.Chaneb@ky.gov

Use of Cognitive Behavioral Therapy and Token Economy to Alleviate Dysfunctional Behavior in Children with Attention-Deficit Hyperactivity Disorder.

Medication has proved highly efficacious as a means of alleviating general symptoms of attention-deficit hyperactivity disorder (ADHD). However, many patients remain functionally impaired by inappropriate behavior. The present study analyzed the use of cognitive behavioral therapy (CBT) with the Token-Economy (TE) technique to alleviate problem behavior for 25 participants with ADHD, all children (19 boys, mean age 10.11) on long-term methylphenidate medication, who were given 20 CBT sessions with 10 weeks of TE introduced as of session 5. Their ten most acute problem behaviors were selected and written records kept. On weekdays, parents recorded each inappropriate behavior and provided a suitable model for their actions. At weekly sessions, problem behaviors were counted and incident-free participants rewarded with a token. To analyze improvement (less frequent problem behavior), a list of 11 behavioral categories was rated: inattention, impulsivity, hyperactivity, disorganization, disobeying rules and routines, poor self-care, verbal/physical aggression, low frustration tolerance, compulsive behavior, antisocial behavior, lacking in initiative and distraction. Two CBT specialists categorized behaviors and an ADHD specialist ruled on discrepancies. Statistical analyses used were Generalized Estimating Equations with Poisson distribution and autoregressive order correlation structure. In the course of the sessions, problematic behaviors decreased significantly in seven categories: impulsiveness, hyperactivity, disorganization, disobeying rules and routine, poor self-care, low frustration tolerance, compulsive behaviors, and antisocial behaviors. Caregiver attitudes to children’s inappropriate behavior were discussed and reshaped. As functional improvement was observed on applying TE for 10 weeks, this type of intervention may be useful as an auxiliary strategy combined with medication.

Clinicians Need More Training on Value of Sleep, Statement Says

Clinicians Need More Training on Value of Sleep, Statement Says

Does using cognitive-behavioural therapy skills predict improvements in depression?

We examined symptoms and use of cognitive-behavioural therapy (CBT) skills during treatment for 60 outpatients receiving group CBT for depression. Depression symptoms decreased significantly and frequency of skills use increased significantly during treatment, and increases in skills use from pre-treatment to mid-treatment predicted changes in depression at post-treatment. Patients who report infrequent use of skills may be at risk for treatment non-response, which can provide an early warning sign for clinicians. Potential interventions include more psychoeducation about the treatment rationale to increase 'buy-in' or motivational interviewing to increase skills use.

Terapia cognitivo-comportamental em pacientes neurológicos: uma revisão sistemática

Pacientes neurológicos frequentemente apresentam alterações emocionais e comportamentais. O uso da terapia cognitivo-comportamental (TCC) tem sido sugerido para manejar sintomas de depressão e de ansiedade nessa população. O objetivo dessa revisão sistemática foi o de verificar a aplicabilidade da TCC em pacientes com AVC, TCE e epilepsia. Verificaram-se as bases de dados PUBMED, LILACS, Scielo Brasil, SCOPUS, PsycINFO e EMBASE. Analisaram-se artigos empíricos, redigidos em inglês, espanhol ou português, com população adulta e publicados entre os anos 2002 e 2013. Dentre os 1397 artigos encontrados, avaliaram-se 21 trabalhos. A população mais investigada foi a de TCE e o principal objetivo da TCC foi para promover melhora nos sintomas depressivos. De acordo com os resultados, a TCC em pacientes neurológicos sugere ser aplicável, porém necessita de investigações que forneçam evidências de efeito terapêutico mais confiáveis, protocolos mais estruturados, assim como estudos de follow up.

As terapias cognitivo-comportamentais no tratamento da bulimia nervosa: uma revisão

Objetivo Realizar uma revisão na literatura sobre a utilização da terapia cognitivo-comportamental (TCC) no tratamento da bulimia nervosa entre 2009 e 2013. Métodos Três bases de dados eletrônicas foram pesquisadas, considerando artigos em língua inglesa, espanhola e portuguesa. Resultados Após as análises e exclusão dos artigos, seguindo o método PRISMA, foram selecionados 20 artigos. Os artigos selecionados foram produzidos ou na Europa ou nos Estados Unidos, em língua inglesa. Os diagnósticos da amostra variaram de exclusivamente bulimia nervosa (60%) aos que incluíram pessoas com transtorno de compulsão alimentar (35%), além de diagnósticos mistos (5%). Os estudos foram, em sua maioria, realizados em mulheres adultas. A TCC, em sua abordagem clássica no consultório, foi utilizada em todos os artigos, ora utilizada individualmente, ora comparada com outras intervenções (internet, CD-ROM e autoajuda). Encontrou-se como resultado que a TCC diminui os sintomas de compulsão alimentar e de purgação, além de oferecer ganhos secundários aos participantes, como melhora de sintomas depressivos, de ansiedade e até mudanças na personalidade. As outras intervenções pesquisadas obtiveram bons resultados na modificação dos sintomas, demonstrando que há um novo caminho a ser galgado com essas novas formas de tratamento. Conclusão O tratamento da bulimia nervosa possui evidências suficientes para que seja realizado com a terapia cognitivo-comportamental. Além dela, intervenções psicoterápicas inovadoras baseadas na TCC clássica apresentam bons indicativos de eficácia. Futuras pesquisas sobre essas diferentes intervenções são necessárias.

Commentary on “The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review”

Purpose– The purpose of this paper is to provide a commentary on “The use of cognitive-behaviour therapy to treat depression in people with learning disabilities: a systematic review”.Design/methodology/approach– Drawing on the literature, as well as both clinical and research experience, some reasons are outlined for the lack of attention given to psychological therapies to treat depression amongst people with intellectual disabilities (IDs).Findings– More research is needed, but existing evidence is promising regarding the effectiveness of adapted cognitive-behaviour therapy for depression amongst people with IDs.Originality/value– The commentary draws attention to the scope for developing a range of effective cognitive, behavioural and cognitive-behavioural treatments.

The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review

Purpose – Cognitive behaviour therapy (CBT) is currently one of the recommended treatments for depression for the general population and guidance recommends that people with a learning disability should have access to the same treatments as people without a learning disability. The purpose of this paper is to identify, outline and evaluate current research on the effectiveness of CBT for depression for people with a learning disability. The clinical, service and research implications are considered. Design/methodology/approach – A systematic search was conducted and five relevant articles were identified for critical review. Findings – There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities. Research limitations/implications – The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms. Practical implications – Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression. Originality/value – This paper provides a comprehensive and up to date review of the current literature regarding the use of CBT for depression for people with a learning disability. This will be of value to clinicians working with people with a learning disability as well as those commissioning services.

İnternet Bağımlılığı ile Başa Çıkmada Bilişsel Davranışçı Yaklaşımın Kullanılması: Bir Olgu Sunumu

İnternet Bağımlılığı ile Başa Çıkmada Bilişsel Davranışçı Yaklaşımın Kullanılması: Bir Olgu Sunumu

A Healing Herd: Benefits of a Psychodynamic Group Approach in Treating Body-Focused Repetitive Behaviors

Body-focused repetitive behaviors, such as trichotillomania and skin-picking, are not well understood in clinical communities. Research and practice with a population exhibiting these behaviors have focused almost exclusively on the usefulness of cognitive-behavioral therapy in symptom reduction. The author specializes in treating patients with body-focused repetitive behaviors and suggests that a holistic, psychodynamic model of treatment for this population creates possibilities for deeper change. Group therapy can be an important component of this work, helping clients to overcome resistance to change, ameliorate shame, work through dissociation, and regulate emotions. This process is explored in an examination of a psychodynamic therapy group with pickers and pullers.

Development and evaluation of a behavioral pain management treatment program in a Veterans Affairs Medical Center.

Chronic pain complaints are highly prevalent among Veterans seeking Veterans Affairs health care, and the implementation of effective behavioral health interventions is vital to meet patient needs. Research supports the use of cognitive behavioral therapy for the treatment of chronic pain; however, varying guidelines regarding length of treatment and modality (i.e., group vs. individual) complicate clinical planning and program development. This study aimed to evaluate treatment outcomes and equivalence of 3 variations (12, 10, and 6 weeks of group treatment) of cognitive behavioral therapy for chronic pain using clinical program data collected from Veterans enrolled in Veterans Affairs health services in a large tertiary care setting. Across groups, Veterans showed improvements in negative pain-related thinking and decreases in pain-related disability and distress. In general, patient outcomes regarding pain-related distress and disability for the 6-week group were equivalent or better than the 12- and 10-week groups. Preliminary results support the effectiveness of brief behavioral interventions for chronic pain. The findings have important practical implications, as briefer treatments may offer comparable therapeutic impact as longer, more time-intensive treatment protocols. This study offers a unique examination of treatment development and evaluation processes informed by real-world clinical needs and patient feedback.

Is Enhanced Cognitive Behavioral Therapy an Effective Intervention in Eating Disorders? A Review

In this study the author reviews the current empirical research regarding Enhanced Cognitive Behavioral Therapy (CBT-E) in the treatment of the full range of eating disorders (EDs): anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified. All peer-reviewed outcome studies identified through electronic bibliographic databases and manual searches of article reference lists are reviewed. A total of six studies (n = 6) were found. The author reports the results of these studies consisting of open-trials of CBT-E applied to different ED diagnoses, comparing two forms of CBT-E (focused and broad) to waitlist, and comparing CBT-E plus Motivation Focused Therapy. There is evidence to support the use of CBT-E for the treatment of EDs; however, this evidence is tentative as CBT-E is still in its early phases of empirical testing. No trials found CBT-E to be ineffective. Although these research designs are not randomized control trials, these results are promising for ED research. There are few efficacious treatments for EDs, especially for those with “chronic” EDs and adults with anorexia nervosa. CBT-E is one of the first interventions that focuses on particular symptomatic behaviors of EDs manifested in individual clients rather than treating ED diagnoses generically.

Sociological Conceptions of Happiness and its Implications for Psychotherapy and Public Policy

This paper critiques the usefulness of cognitive-behavioural therapy, which is often seen as a means of redressing the loss of community and friendship networks within society. Therapy in this context they runs the danger of becoming an Iatrogenesis at worst and just another `technology of mood’ at best. In this paper we develop the critiques made elsewhere and provide a more nuanced argument that considers a wider range of psychological therapies. While all psychological therapies operate at an individual level, there are wide differences in the epistemological stances taken by differing therapeutic schools. Cognitive-behavioural therapy focuses on the idea of dysfunctional thinking within the individual, psychoanalytic therapy focuses upon developmental legacies, whereas person-centred therapy focuses on currently active social influences. In this form one to one therapy can be a route to change which is compatible with our sociological critique. However, the broader criticism that psychological therapies attempt to compensate for breakdowns in friendship and social networks remains. Furthermore reviews of psychotherapeutic outcome data and qualitative enquiry both point to the experience of authentic relationship rather than psychotherapeutic technique as the major determinant of outcome. Preventing social dislocation rather than trying to repair it post hoc should be the goal. This would beg a wider range of questions such as; what does social isolation actually mean in contemporary western society and what does this mean for people with mental health problems in particular? What are the various ways in which social networks provide support functions and what may be missing in an individual’s life and then what can be done to try and compensate for that lack?

Meeting the complex needs of individuals living with HIV: a case study approach.

This article critically discusses the nursing care and management of a person living with the human immunodeficiency virus (HIV) infection as a long-term condition, requiring highly complex HIV care. Complex HIV care is managed in the secondary care setting. However, recent legislation has motivated shifts in HIV care to the community care setting. This article aims to enhance health professionals' understanding in order to equip practice and district nurses to deliver HIV care provision. Antiretroviral adherence is a prerequisite for disease survival as well as an essential component of complete HIV self-care management. It is therefore imperative that nurses tailor adherence strategies according to each patient's requirements. Case management strategies such as the use of cognitive behavioural therapy to alleviate depressive symptoms will be considered. Furthermore, the use of motivational interviewing for antiretroviral adherence is highlighted as a potential intervention to help patients overcome the physical, psychological and physiological challenges of living with HIV-associated comorbidities. The delivery of integrated HIV care is pivotal for the management of the person living with HIV, as is the facilitation of a self-caring behaviour.

Psychometric properties of translated outcome measures of cognitive behavioural therapy for psychosis in the Chinese context

ObjectivesGrowing evidence supporting the use of Cognitive Behavioural Therapy (CBT) to improve outcomes in patients with psychosis has largely originated from American and European countries, its applicability and effectiveness in Chinese patients with psychosis is still under-explored. However, the lack of stable and reliable outcome measures to evaluate the effectiveness of CBT for patients with psychosis hinders further development of psychological intervention in patients with psychosis in the Chinese context. The present study therefore aims to translate selected outcomes measures developed in American and European countries to measure the effectiveness of CBT for psychosis into Chinese and evaluate their psychometric properties. MethodsThirty-three patients with residual psychotic symptoms were recruited in the Department of Psychiatry, Kowloon Hospital, Hong Kong. Participants were asked to complete a set of self-reported questionnaires twice with an interval of a week, including Beliefs About Voices Questionnaire-Revised (BAVQ-R), Beck Cognitive Insight Scale (BCIS) and Southampton Mindfulness Questionnaire (SMQ). ResultsThe results found that the Chinese versions of BAVQ-R, BCIS and SMQ had excellent test-retest reliability with good to acceptable internal reliability. ConclusionsGenerally, all three translated outcome measures were found to be stable and reliable, and were ready for evaluating the effectiveness of cognitive therapy for psychosis in the Chinese population. Further discussions on scoring and interpretations of the Chinese version of SMQ were made.

Personality profile of obese children and adolescents

Personality traits can affect eating behaviors, the development of obesity, and obesity treatment failure. Because of the scarcity of research on the relationship between personality traits and childhood obesity and its importance in obesity treatment outcome, the current study aimed to assess the personality profile of obese children and adolescents, investigate the relationship between patterns of temperament and character as well as psychopathology in obese youths and explore the relationship between personality traits and severity of childhood obesity and its metabolic complications independent of the impact of psychopathology. After exclusion of children with comorbid psychiatric disorders, 40 obese children were enrolled from the Pediatrics Obesity Clinic, Ain Shams University. They were compared with a matched control group of nonobese children (n=20). The Junior Temperament and Character Inventory was used to assess the personality profile, and Child Behavioral Checklist was used to assess psychopathology. Obese children were found to have significantly higher novelty seeking and harm avoidance behavior compared with nonobese controls. Among obese children, high novelty seeking was associated with externalizing problems, and low self-transcendence was associated with internalizing problems. Higher BMI was associated with higher novelty seeking and lower persistence. Personality traits related to metabolic complications of obesity were persistence, self-transcendence, and self-directedness. Personality traits may contribute to health outcome through their association with obesity and its progression. These data underscore the future potential usefulness of personality assessment in obesity management and suggest the use of cognitive behavioral therapy targeting these personality traits to achieve better treatment outcome.

In people with tinnitus, is there randomized controlled trial evidence to support the use of cognitive behavioral therapy?

In people with tinnitus, is there randomized controlled trial evidence to support the use of cognitive behavioral therapy?