Distribution by Scientific Domains

Kinds of CBT

  • group cbt

  • Selected Abstracts

    A review of empirically supported psychological therapies for mood disorders in adults

    Steven D. Hollon Ph.D.
    Abstract Background: The mood disorders are prevalent and problematic. We review randomized controlled psychotherapy trials to find those that are empirically supported with respect to acute symptom reduction and the prevention of subsequent relapse and recurrence. Methods: We searched the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to identify appropriate articles. Results: One hundred twenty-five studies were found evaluating treatment efficacy for the various mood disorders. With respect to the treatment of major depressive disorder (MDD), interpersonal psychotherapy (IPT), cognitive behavior therapy (CBT), and behavior therapy (BT) are efficacious and specific and brief dynamic therapy (BDT) and emotion-focused therapy (EFT) are possibly efficacious. CBT is efficacious and specific, mindfulness-based cognitive therapy (MBCT) efficacious, and BDT and EFT possibly efficacious in the prevention of relapse/recurrence following treatment termination and IPT and CBT are each possibly efficacious in the prevention of relapse/recurrence if continued or maintained. IPT is possibly efficacious in the treatment of dysthymic disorder. With respect to bipolar disorder (BD), CBT and family-focused therapy (FFT) are efficacious and interpersonal social rhythm therapy (IPSRT) possibly efficacious as adjuncts to medication in the treatment of depression. Psychoeducation (PE) is efficacious in the prevention of mania/hypomania (and possibly depression) and FFT is efficacious and IPSRT and CBT possibly efficacious in preventing bipolar episodes. Conclusions: The newer psychological interventions are as efficacious as and more enduring than medications in the treatment of MDD and may enhance the efficacy of medications in the treatment of BD. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source]

    Successful medication withdrawal after cognitive-behavioral therapy in a treatment-resistant preadolescent male with obsessive-compulsive disorder

    Robert B. Goldstein M.D.
    Abstract There are no reports of a child taking a selective serotonin reuptake inhibitor and an atypical anti-psychotic being successfully tapered from these medications after completion of cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder. With this in mind, we report the case of an 8.5-year,old male who was taking risperidone 0.5,mg bid, sertraline 100,mg, and atomoxetine 25,mg at presentation. After a successful course of CBT, we describe how medications were systematically withdrawn. Implications of this case on practice parameters (e.g., CBT may be an effective augmenting agent for those non-responsive to initial pharmacological treatments) are highlighted. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source]

    Are there gender differences in catastrophic appraisals in panic disorder with agoraphobia?

    F.R.A.N.Z.C.P., Ph.D., Vladan Starcevic M.D.
    Abstract Our aim in this study was to compare panic-related catastrophic appraisals between women and men with panic disorder with agoraphobia (PDA). One hundred two outpatients with PDA (75 women and 27 men) participated. Two instruments for the assessment of catastrophic appraisals, Agoraphobic Cognitions Questionnaire and Panic Appraisal Inventory, were administered before and after cognitive-behavioral therapy (CBT) that also included pharmacotherapy in three-fourths of the patients. Female and male patients did not differ significantly in terms of their tendency to anticipate catastrophic consequences of panic, before or after CBT-based treatment. For both females and males, the tendency to make catastrophic appraisals decreased significantly with treatment. We conclude that among patients with PDA there are no gender differences in catastrophic appraisals of panic sensations and symptoms. The apparently higher risk of panic recurrence in women does not seem to be related to their panic-related catastrophic appraisals. These findings also support a notion that there is no gender difference in response to CBT-based treatment of PDA. Depression and Anxiety 24:545,552, 2007. © 2006 Wiley-Liss, Inc. [source]

    Does occasional cannabis use impact anxiety and depression treatment outcomes?: results from a randomized effectiveness trial

    Jonathan B. Bricker Ph.D.
    Abstract This study investigated the extent to which occasional cannabis use moderated anxiety and depression outcomes in the Collaborative Care for Anxiety and Panic (CCAP) study, a combined cognitive-behavioral therapy (CBT) and pharmacotherapy randomized effectiveness trial. Participants were 232 adults from six university-based primary care outpatient clinics in three West Coast cities randomized to receive either the CCAP intervention or the usual care condition. Results showed significant (P<.01) evidence of an interaction between treatment group (CCAP vs. usual care) and cannabis use status (monthly vs. less than monthly) for depressive symptoms, but not for panic disorder or social phobia symptoms (all P>.05). Monthly cannabis users' depressive symptoms improved in the CCAP intervention just as much as those who used cannabis less than monthly, whereas monthly users receiving usual care had significantly more depressive symptoms than those using less than monthly. A combined CBT and medication treatment intervention may be a promising approach for the treatment of depression among occasional cannabis users. Depression and Anxiety 24:392,398, 2007. © 2006 Wiley-Liss, Inc. [source]

    Cognitive,behavioral therapy with childhood anxiety disorders: Functioning in adolescence

    Katharina Manassis M.D.
    Abstract We examined anxiety symptoms, anxiety-related impairment, and further treatment in adolescents who received cognitive behavioral therapy (CBT) for childhood anxiety disorders 6,7 years previously. Forty-three adolescents and their parents (14 boys, 29 girls; mean age 16.7 years) participated in structured telephone interviews. Participants (68% of initial sample of 63) did not differ in age, diagnostic profile, socioeconomic status, or initial severity from nonparticipants but more girls than boys participated. Indices based on child- and parent-reported symptoms and impairment were calculated, and within-sample comparisons by age, gender, diagnosis, and initial severity were done using t tests. Predictors of symptoms and impairment were also examined. On average, adolescents reported modest levels of anxiety-related impairment. Further treatment for anxiety had occurred in 30% (13 of 43) of patients. Stepwise regressions found female gender and diagnosis other than generalized anxiety disorder predictive of increased symptoms by parent report, and initial severity predicted adolescent-reported impairment. Adolescents showed limited internalizing symptomatology and impairment but almost one third had required further treatment. Studies comparing treated and untreated samples are needed to clarify whether CBT alters the natural history of childhood anxiety disorders and to replicate our findings regarding predictors of symptomatology and impairment. Depression and Anxiety 00:000,000, 2004. © 2004 Wiley-Liss, Inc. [source]

    Review of the long-term effectiveness of cognitive behavioral therapy compared to medications in panic disorder

    Deepa N. Nadiga M.D.
    Abstract Panic disorder is a recurrent and disabling illness. It is believed that Cognitive Behavioral Therapy (CBT) has a long-term protective effect for this disorder. This would offer CBT considerable advantage over medication management of panic disorder, as patients often relapse when they are tapered off their medications. This is a review of the literature about the long-term effectiveness of CBT. We searched for follow-up studies of panic disorder using CBT. Of the 78 citations produced in the initial search, most had major methodological flaws, including ignoring losses to follow-up, not accounting for interval treatment, and unclear reporting. Three papers met strict methodological criteria, and two of these demonstrated a modest protective effect of CBT in panic disorder patients. We make recommendations for well-designed studies involving comparisons of medications and cognitive behavior therapy. Depression and Anxiety 17:58,64, 2003. © 2003 Wiley-Liss, Inc. [source]

    A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder

    G.-J. Hendriks
    Hendriks G-J, Keijsers GPJ, Kampman M, Oude Voshaar RC, Verbraak MJPM, Broekman TG, Hoogduin CAL. A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder. Objective:, To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)). Method:, Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models. Results:, All outcome measures showed that the patients having received CBT and those treated with paroxetine had significantly better improvement compared with those in the waiting-list condition. With one patient (1/20, 5%) in the CBT and three (3/14, 17.6%) in the paroxetine condition dropping out, attrition rates were low. Conclusion:, Patients with late-life panic disorder respond well to both paroxetine and CBT. Although promising, the outcomes warrant replication in larger study groups. [source]

    A randomized study of massed three-week cognitive behavioural therapy schedule for panic disorder

    M. K. Bohni
    Objective:, To compare the efficacy of massed vs. spaced group cognitive behavioural therapy (CBT) for patients with panic disorder with or without agoraphobia (PD). Method:, Thirty-nine PD patients were randomly assigned to massed group CBT (daily 4-h sessions in week 1, two 2-h sessions in week 2 and one 2-h session in week 3) or traditional spaced weekly group CBT (13 consecutive, weekly 2-h sessions). The content and number of hours in the two treatment schedules were identical. Outcome was assessed after treatment, and at 3, 6 and 18 months of follow-up. Results:, Both treatment groups achieved significant improvement on all measures with large pre- to post-treatment and pre-treatment to follow-up effect sizes. No between-group differences were registered. Adherence and patient satisfaction did not differ between groups. Conclusion:, The massed, 3-week group CBT schedule proved to be effective and feasible for PD patients with outcomes comparable with that of standard, spaced group CBT. [source]

    Group cognitive behavioural therapy for obsessive,compulsive disorder: a systematic review and meta-analysis

    H. Jónsson
    Objective:, Behaviour therapy with exposure and response prevention (ERP) or cognitive behavioural therapy (CBT) including ERP are considered the psychological treatments of choice for obsessive,compulsive disorder (OCD), but group CBT/ERP has received relatively little research attention in the treatment of OCD. The aim of this study was to provide a meta-analysis of the effectiveness of group CBT/ERP for OCD. Method:, A systematic literature search was conducted and studies were meta-analysed by means of the Cochrane Review Manager Program with measures of i) pre- to post-effect sizes (ES) and ii) between-group ES in comparison with different control conditions. Outcome was primarily measured on the Y-BOCS and ES was calculated in the form of Cohens d. Results:, Thirteen trials were included in the meta-analysis. The overall pre,post-ES of these trials of 1.18 and a between-group ES of 1.12 compared with waiting list control in three randomized controlled studies indicate that group CBT/ERP is an effective treatment for OCD. Group CBT achieved better results than pharmacological treatment in two studies. One study found no significant differences between individual and group CBT. Conclusion:, Group CBT is an effective treatment for OCD, but more studies are needed to compare the effectiveness of group and individual treatment formats. [source]

    Cognitive-behavioural therapy for late-life anxiety disorders: a systematic review and meta-analysis

    G. J. Hendriks
    Objective:, To examine and estimate the efficacy of cognitive-behavioural therapy (CBT) for late-life anxiety disorders. Method:, A systematic review and meta-analysis of randomized controlled trials comparing CBT with i) a waiting-list control condition and ii) an active control condition controlling for non-specific effects in patients aged over 60 years and suffering from an anxiety disorder. The main outcome parameter of individual studies, i.e. effect on anxiety, was pooled using the standardized mean difference (SMD). Results:, Seven papers fulfilled the inclusion criteria, including nine randomized controlled comparisons for 297 patients. Anxiety symptoms were significantly more reduced following CBT than after either a waiting-list control condition [SMD = ,0.44 (95 CI: ,0.84 ,0.04), P = 0.03] or an active control condition [SMD = ,0.51 (95 CI: ,0.81, ,0.21), P<0.001]. Additionally, CBT significantly alleviated accompanying symptoms of worrying and depression. Conclusion:, Cognitive-behavioural therapy is efficacious for the treatment of late-life anxiety disorders. [source]

    Cognitive behaviour therapy with coping training for persistent auditory hallucinations in schizophrenia: a naturalistic follow-up study of the durability of effects

    D. Wiersma
    Objective: To investigate the durability of positive effects of cognitive behaviour therapy (CBT) with coping training on psychotic symptoms and social functioning. Method: Forty patients with schizophrenia or related psychotic disorders and refractory auditory hallucinations were given CBT and coping training in an integrated single family treatment programme. In a naturalistic study patients were followed after 2 and 4 years since the start of treatment. Results: The treatment improved overall burden of ,hearing voices', with a generalization into daily functioning. Improvement with regard to fear, loss of control, disturbance of thought and interference with thinking was sustained by 60% of the patients while one-third improved further. Complete disappearance of hallucinations occurred in 18% of the patients. Conclusion: CBT with coping training can improve both overall symptomatology and quality of life, even over longer periods of time, but a status of persistent disablement indicates a continuing need for mental health care. [source]

    Randomized controlled multicentre trial of cognitive behaviour therapy in the early initial prodromal state: effects on social adjustment post treatment

    Andreas Bechdolf
    Abstract Aim:, Improvement of social adjustment is a major aim of indicated prevention in young people at risk of developing psychosis. The present study explores the effect of specific cognitive behaviour therapy (CBT) as compared with supportive counselling (SC) on social adjustment in people in a potential early initial prodromal state of psychosis (EIPS) primarily defined by self-experienced cognitive thought and perception deficits (basic symptoms). Methods:, A total of 128 help-seeking outpatients in the EIPS were randomized to receive either specific CBT or SC for 12 months. Social adjustment was assessed with the Social Adjustment Scale II (SAS II) at baseline, time of transition or post treatment Results:, From 113 patients, who completed the SAS II at intake, 67 (59.3%) completed the SAS assessments at time of transition or post treatment. Both specific CBT and SC resulted in improvements in scales of SAS II, with no significant between-group differences post treatment. Conclusions:, Although treatment in specially designed early detection and intervention centres improves functioning of people in the EIPS, specific CBT was not superior to SC. One could hypothesize that additional vocational rehabilitation, case management and involvement of multidisciplinary teams are needed to further improve short-term outcome of specific interventions on this dimension. [source]

    Failure to improve cigarette smoking abstinence with transdermal selegiline + cognitive behavior therapy

    ADDICTION, Issue 9 2010
    Joel D. Killen
    ABSTRACT Aims To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence. Design Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks. Setting Community smoking cessation clinic. Participants 243 adult smokers (,18 years of age; ,10 cigarettes/day). Measures Expired-air carbon monoxide confirmed 7-day point prevalence abstinence. Findings STS was not superior to placebo. More women than men were abstinent at 52 week follow-up (28% vs 16%, P < 0.05). Behavioral activation (BAS) moderated treatment response (P = 0.01). The survival rate through week 52 for those with high ,drive' scores on the BAS was 47% if assigned to selegiline and 34% if assigned to placebo. The survival rate for those with low ,drive scores' on the BAS was 35% if assigned to selegiline compared to 53% if assigned to placebo. Conclusion Transdermal selegiline does not appear generally effective in aiding smoking cessation though there may be a selective effect in those smokers with low ,behavioral activation'. [source]

    Matching motivation enhancement treatment to client motivation: re-examining the Project MATCH motivation matching hypothesis

    ADDICTION, Issue 8 2010
    Katie Witkiewitz
    ABSTRACT Aims The current study was designed to re-examine the motivation matching hypothesis from Project MATCH using growth mixture modeling, an analytical technique that models variation in individual drinking patterns. Design, setting and participants Secondary data analyses of data from Project MATCH (n = 1726), a large multi-site alcoholism treatment-matching study. Measurements Percentage of drinking days was the primary outcome measure, assessed from 1 month to 12 months following treatment. Treatment assignment, alcohol dependence symptoms and baseline percentage of drinking days were included as covariates. Findings The results provided support for the motivation matching hypothesis in the out-patient sample and among females in the aftercare sample: the majority of individuals with lower baseline motivation had better outcomes if assigned to motivation enhancement treatment (MET) compared to those assigned to cognitive behavioral treatment (CBT). In the aftercare sample there was a moderating effect of gender and alcohol dependence severity, whereby males with lower baseline motivation and greater alcohol dependence drank more frequently if assigned to MET compared to those assigned to CBT. Conclusions Results from the current study lend partial support to the motivation-matching hypothesis and also demonstrated the importance of moderating influences on treatment matching effectiveness. Based upon these findings, individuals with low baseline motivation in out-patient settings and males with low levels of alcohol dependence or females in aftercare settings may benefit more from motivational enhancement techniques than from cognitive,behavioral techniques. [source]

    Individualized assessment and treatment program for alcohol dependence: results of an initial study to train coping skills

    ADDICTION, Issue 11 2009
    Mark D. Litt
    ABSTRACT Aims Cognitive,behavioral treatments (CBT) are among the most popular interventions offered for alcohol and other substance use disorders, but it is not clear how they achieve their effects. CBT is purported to exert its beneficial effects by altering coping skills, but data supporting coping changes as the mechanism of action are mixed. The purpose of this pilot study was to test a treatment in which coping skills were trained in a highly individualized way, allowing us to determine if such training would result in an effective treatment. Design Participants were assigned randomly to a comprehensive packaged CBT program (PCBT), or to an individualized assessment and treatment program (IATP). The IATP program employed experience sampling via cellphone to assess coping skills prior to treatment, and provided therapists with a detailed understanding of patients' coping strengths and deficits. Setting Out-patient treatment. Participants A total of 110 alcohol-dependent men and women. Measurements Participants in both conditions completed experience sampling of situations, drinking and coping efforts prior to, and following, 12 weeks of treatment. Time-line follow-back procedures were also used to record drinking at baseline and post-treatment. Findings IATP yielded higher proportion of days abstinent (PDA) at post-treatment (P < 0.05) than did PCBT, and equivalent heavy drinking days. IATP also elicited more momentary coping responses and less drinking in high-risk situations, as recorded by experience sampling at post-treatment. Post-treatment coping response rates were associated with decreases in drinking. Conclusions The IATP approach was more successful than PCBT at training adaptive coping responses for use in situations presenting a high risk for drinking. The highly individualized IATP approach may prove to be an effective treatment strategy for alcohol-dependent patients. [source]

    Brief motivational interventions for college student problem gamblers

    ADDICTION, Issue 9 2009
    Nancy M. Petry
    ABSTRACT Aims College students experience high rates of problem and pathological gambling, yet little research has investigated methods for reducing gambling in this population. This study sought to examine the efficacy of brief intervention strategies. Design Randomized trial. Setting College campuses. Participants A total of 117 college student problem and pathological gamblers. Interventions Students were assigned randomly to: an assessment-only control, 10 minutes of brief advice, one session of motivational enhancement therapy (MET) or one session of MET, plus three sessions of cognitive,behavioral therapy (CBT). The three interventions were designed to reduce gambling. Measurements Gambling was assessed at baseline, week 6 and month 9 using the Addiction Severity Index,gambling (ASI-G) module, which also assesses days and dollars wagered. Findings Compared to the assessment-only condition, those receiving any intervention had significant decreases in ASI-G scores and days and dollars wagered over time. The MET condition decreased significantly ASI-G scores and dollars wagered over time, and increased the odds of a clinically significant reduction in gambling at the 9-month follow-up relative to the assessment-only condition, even after controlling for baseline indices that could impact outcomes. The Brief Advice and MET+CBT conditions had benefits on some, but not all, indices of gambling. None of the interventions differed significantly from one another. Conclusions These results suggest the efficacy of brief interventions for reducing gambling problems in college students. [source]

    Extended treatment of older cigarette smokers

    ADDICTION, Issue 6 2009
    Sharon M. Hall
    ABSTRACT Aims Tobacco dependence treatments achieve abstinence rates of 25,30% at 1 year. Low rates may reflect failure to conceptualize tobacco dependence as a chronic disorder. The aims of the present study were to determine the efficacy of extended cognitive behavioral and pharmacological interventions in smokers , 50 years of age, and to determine if gender differences in efficacy existed. Design Open randomized clinical trial. Setting A free-standing, smoking treatment research clinic. Participants A total of 402 smokers of , 10 cigarettes per day, all 50 years of age or older. Intervention Participants completed a 12-week treatment that included group counseling, nicotine replacement therapy (NRT) and bupropion. Participants, independent of smoking status, were then assigned randomly to follow-up conditions: (i) standard treatment (ST; no further treatment); (ii) extended NRT (E-NRT; 40 weeks of nicotine gum availability); (iii) extended cognitive behavioral therapy (E-CBT; 11 cognitive behavioral sessions over a 40-week period); or (iv) E-CBT plus E-NRT (E-combined; 11 cognitive behavioral sessions plus 40 weeks nicotine gum availability). Measurements Primary outcome variable was 7-day point prevalence cigarette abstinence verified biochemically at weeks 24, 52, 64 and 104. Findings The most clinically important findings were significant main effects for treatment condition, time and the treatment × time interaction. The E-CBT condition produced high cigarette abstinence rates that were maintained throughout the 2-year study period [(week 24 (58%), 52 (55%), 64 (55%) and 104 (55%)], and was significantly more effective than E-NRT and ST across that period. No other treatment condition was significantly different to ST. No effects for gender were found. Conclusions Extended cognitive behavioral treatments can produce high and stable cigarette abstinence rates for both men and women. NRT does not add to the efficacy of extended CBT, and may hamper its efficacy. Research is needed to determine if these results can be replicated in a sample with a greater range of ages, and improved upon with the addition of medications other than NRT. [source]

    Extended cognitive behavior therapy for cigarette smoking cessation

    ADDICTION, Issue 8 2008
    Joel D. Killen
    ABSTRACT Primary aim Examine the effectiveness of extended cognitive behavior therapy (CBT) in promoting longer-term smoking abstinence. Design Open-label treatment phase followed by extended treatment phase. Randomization conducted prior to entry into open-label treatment phase; analysis based on intention-to-treat to avoid threat of selection bias. Setting Community smoking cessation clinic. Participants A total of 304 adult smokers (,18 years of age; ,10 cigarettes/day). Intervention Open-label (8 weeks): all participants received bupropion SR, nicotine patch, CBT. Extended treatment (12 weeks): participants received either CBT + voicemail monitoring and telephone counseling or telephone-based general support. Measurements Seven-day point prevalence abstinence, expired-air carbon monoxide. Results At week 20 follow-up, CBT produced a higher 7-day point prevalence abstinence rate: 45% versus 29%, P = 0.006; at 52 weeks the difference in abstinence rates (31% versus 27%) was not significant. History of depression was a moderator of treatment. Those with a positive history had a better treatment response at 20 weeks when assigned to the less intensive telephone support therapy (P < 0.05). Conclusion The superiority of CBT to 20 weeks suggests that continued emphasis on the development of cognitive and behavioral strategies for maintaining non-smoking during an extended treatment phase may help smokers to maintain abstinence in the longer term. At present, the minimum duration of therapy is unknown. [source]

    Cognitive-behavioural therapy for individuals with bulimia nervosa and a co-occurring substance use disorder

    Robyn Sysko
    Abstract A significant percentage of individuals with bulimia nervosa (BN) also can be diagnosed with a co-occurring substance use disorder (SUD). Although studies have addressed the frequency of overlap between the disorders, etiology and shared personality traits, limited research is available about the treatment of these comorbid patients. Adapting cognitive-behaviour therapy (CBT) to serve as an integrated treatment for patients with both BN and a SUD is a viable option, as studies of CBT suggest that this form of treatment is efficacious for both disorders independently. The shared strategies in CBT for BN and SUDs facilitate the development of a combined treatment for individuals with both disorders with the addition of modules designed to address some common features of these disorders, such as motivation, difficulty with interpersonal relationships, reward sensitivity and impulsivity. Future research should begin to evaluate the efficacy of an integrated CBT in treating individuals with BN and a SUD. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Feasibility and acceptability of CD-ROM-based cognitive-behavioural treatment for binge-eating disorder

    Jennifer R. Shapiro
    Abstract We compared preliminary feasibility and acceptability of CD-ROM-delivered CBT for overweight individuals with binge-eating disorder (BED) to 10 weekly group CBT sessions (Group) and to a waiting list control (WL). Attrition was numerically greater in the Group than the CD-ROM condition; although only Group differed significantly from WL in dropout rates. Those in the CD-ROM condition reported continued use of their CD-ROM after treatment. Also, the majority of WL participants elected to receive CD-ROM over Group treatment at the end of the waiting period. Preliminarily, no significant differences emerged across the active treatment groups on most outcome measures. However, there was a significantly greater decline in binge days in the two active groups relative to WL. CD-ROM appears to be an acceptable and at least initially preferred method of CBT delivery for overweight individuals with BED. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Cognitive-behavioural therapy for adolescents with bulimia nervosa,

    G. Terence Wilson
    Abstract Psychological and pharmacological treatments for bulimia nervosa (BN) have been studied extensively in adults, but there are no published controlled treatment studies of adolescents with BN. One option for treating adolescents with BN is to adapt cognitive-behavioural therapy (CBT) for younger individuals. The rationale for developing CBT for adolescents with BN is three-fold: the efficacy of CBT for adult patients with BN, the efficacy of CBT in treating adolescents with other clinical disorders, and the conceptual fit between CBT and adolescent eating disorders. CBT should be tailored to the treatment of adolescents, with particular focus on domains of development, including: motivation, cognitive processing, interpersonal functioning, and family involvement. A recently described new version of CBT for BN (Fairburn, Cooper, & Shafran, 2003) is well-suited for adapting manual-based CBT from adults to adolescents. Future research should evaluate the efficacy of CBT for the treatment of adolescents with BN and related eating disorders. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Cognitive remediation therapy as an intervention for acute anorexia nervosa: a case report

    Helen Davies
    Abstract The aim of this case report is to illustrate how cognitive remediation therapy (CRT) can be used as part of the treatment programme in acute anorexia nervosa (AN) to stimulate mental activities and improve thinking skills and information-processing systems when other therapies, for example cognitive behavioural therapy (CBT), may be too complex and intense for the patient to engage in. Furthermore, we hypothesize that CRT may be an effective tool in improving flexibility of thinking in AN, as previous neuropsychological findings have proved that rigidity is one of the maintaining factors in AN. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosa

    S. G. Gowers
    Abstract This study was a pilot for a larger study to evaluate a time-limited outpatient programme for adolescent anorexia nervosa, to explore the ability of an assessment interview to change self-reported motivation and ascertain the extent to which this predicted engagement with treatment and early behavioural change. Forty-two adolescents with anorexia nervosa rated their motivation for change before and after attending a new-style assessment interview. Initial (6 week) effectiveness of the programme was evaluated by measuring engagement with treatment, weight change, clinician (HoNOSCA) and self-rated (EDI, MFQ, HoNOSCA-SR) outcome measures, overall and in relation to motivational status. The assessment interview significantly improved motivation. Motivational category after interview was unrelated to physical status, cognition or general functioning but predicted engagement with treatment. Whilst for the whole sample, treatment produced physical, cognitive and general improvements at 6 weeks, motivational status was a powerful predictor of weight gain. A client-centred assessment interview engaged 80% in an outpatient programme based on CBT. Motivational enhancement may improve engagement and specifically result in behavioural change and early weight gain. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Does ecological momentary assessment improve cognitive behavioural therapy for binge eating disorder?

    A pilot study
    Abstract The purpose of this pilot study was to test whether self-monitoring in CBT could be enhanced in order to improve the identification of proximal antecedents of binge eating in binge eating disorder (BED). CBT was modified by asking participants to monitor all eating intensively through ecological momentary assessment (EMA). A total of 41 females (mean BMI,=,37.9; SD,=,8.2) meeting DSM-IV criteria for BED were randomly assigned to one of two group treatments; CBT (n,=,22) or CBT with EMA (n,=,19). CBT with EMA differed from CBT in that for the first 2 weeks of treatment, participants completed detailed pocket diaries about mood, events, etc., when signalled at random by programmable wristwatches, as well as at all times when eating. All participants completed measures of eating (EDE-Q, TFEQ, EES) and general psychopathology (BDI, RSE) before treatment, at the end of treatment, and at 1-year follow-up. While both treatment groups showed improvement on the outcome variables of interest, the individual data gained via EMA did not significantly enhance standard CBT. Therefore, it is unlikely that further research incorporating EMA as a therapeutic technique within CBT for BED will be compelling. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Cognitive,behavioral treatment for alcohol dependence: a review of evidence for its hypothesized mechanisms of action

    ADDICTION, Issue 10 2000
    Jon Morgenstern
    Objective. This review examined support for the hypothesis that cognitive-behavioral treatment (CBT) for alcohol dependence works through increasing cognitive and behavioral coping skills. Method. Ten studies were identified that examined the hypothesized mechanisms of action of CBT. These studies involved random assignment (or its near equivalent) of participants to CBT and at least one comparison condition. Results. Although numerous analyses of the possible causal links have been conducted to evaluate whether CBT works through increasing coping, the results indicate little support for the hypothesized mechanisms of action of CBT. Conclusions. Research has not yet established why CBT is an effective treatment for alcohol dependence. Negative findings may reflect methodological flaws of prior studies. Alternatively, findings may indicate one or more conceptual assumptions underlying CBT require revision. [source]

    RESEARCH REPORT Alcoholism treatment and medical care costs from Project MATCH

    ADDICTION, Issue 7 2000
    Harold D. Holder
    Aims. This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Design Longitudinal study with pre- and post-treatment initiation. Measurements. The total medical care costs for inpatient and outpatient treatment for patients participating over a span of 3 years post-treatment. Setting. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Participants. Two hundred and seventy-nine patients. Intervention. Patients were randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Findings. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF., Conclusions. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment. [source]

    Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity

    Michelle A. Ommerborn
    The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects. [source]

    Maternal medication use and the risk of brain tumors in the offspring: The SEARCH international case-control study

    Amanda H. Cardy
    Abstract N -nitroso compounds (NOC) have been associated with carcinogenesis in a wide range of species, including humans. There is strong experimental data showing that nitrosamides (R1NNO·COR2), a type of NOC, are potent neuro-carcinogens when administered transplacentally. Some medications are a concentrated source of amides or amines, which in the presence of nitrites under normal acidic conditions of the stomach can form NOC. Therefore, these compounds, when ingested by women during pregnancy, may be important risk factors for tumors of the central nervous system in the offspring. The aim of the present study was to test the association between maternal use of medications that contain nitrosatable amines or amides and risk of primary childhood brain tumors (CBT). A case-control study was conducted, which included 1,218 cases and 2,223 population controls, recruited from 9 centers across North America, Europe and Australia. Analysis was conducted for all participants combined, by tumor type (astroglial, primitive neuroectodermal tumors and other glioma), and by age at diagnosis (,5 years; >5 years). There were no significant associations between maternal intake of medication containing nitrosatable amines or amides and CBT, for all participants combined and after stratification by age at diagnosis and histological subtype. This is the largest case-control study of CBT and maternal medications to date. Our data provide little support for an association between maternal use of medications that may form NOC and subsequent development of CBT in the offspring. © 2005 Wiley-Liss, Inc. [source]

    A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorder

    Simone Munsch PhD
    Abstract Objectives: The aim of this study was to determine the efficacy of cognitive-behavioral therapy (CBT) and behavioral weight loss treatment (BWLT) for overweight patients with binge eating disorder (BED). Method: Eighty obese patients meeting criteria of BED according to DSM-IV-TR were randomly assigned to either CBT or BWLT consisting of 16 weekly treatments and 6 monthly follow-up sessions. Binge eating, general psychopathology, and body mass index (BMI) were assessed before, during, and after treatment, and at 12-month follow-up. Results: At posttreatment results favored CBT as the more effective treatment. Analysis of the course of treatments pointed to a faster improvement of binge eating in CBT based on the number of self-reported weekly binges, but faster reduction of BMI in BWLT. At 12-month follow-up, no substantial differences between the two treatment conditions existed. Conclusion: CBT was somewhat more efficacious than BWLT in treating binge eating but this superior effect was barely maintained in the long term. Further research into cost effectiveness is needed to assess which treatment should be considered the treatment of choice. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006 [source]

    An integration of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa: A case study using the case formulation method

    Peter S. Hendricks MA
    Abstract Objective The current study provides an illustration of an integration of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for the treatment of bulimia nervosa (BN), based on the case formulation strategy. Method A 25-year-old Hispanic female referred herself for the treatment of eating difficulties and depressed mood. Diagnostic criteria were met for BN, major depressive episode, and alcohol abuse. Components of both CBT and IPT were utilized throughout the course of treatment. Results CBT techniques appeared to be most effective in eliminating binge eating and binge drinking behavior, whereas IPT techniques seemed to be most effective in reducing purging behavior. Results revealed that the client was no longer experiencing clinically significant symptoms of BN, depression, or alcohol abuse at end of treatment and follow-up (18 months after treatment onset). Discussion Findings support the integration of CBT and IPT for the treatment of BN and, potentially, other eating disorders. © 2005 by Wiley Periodicals, Inc. [source]