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Cognitive Behavioral Therapy (cognitive + behavioral_therapy)
Selected AbstractsCognitive Behavioral Therapies for Trauma (2nd Edition) Edited by Victoria M. Follette and Joseph I. Ruzek.DEPRESSION AND ANXIETY, Issue 3 20092006., New York: The Guilford Press No abstract is available for this article. [source] Practitioner Review: Adolescent alcohol use disorders: assessment and treatment issuesTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2008Francheska Perepletchikova Background:, Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods:, A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state of the art knowledge of treatment of adolescent alcohol use disorders. Animal models of addiction are also briefly reviewed, and the value of translational research approaches, using findings from basic studies to guide the design of clinical investigations, is also highlighted. Results:, Comorbidity is the rule, not the exception in adolescent alcohol use disorders. Comprehensive assessment of psychiatric and other substance use disorders, trauma experiences, and suicidality is indicated in this population to optimize selection of appropriate clinical interventions. In terms of available investigated treatments for adolescents with alcohol use disorders, Multidimensional Family Therapy and group administered Cognitive Behavioral Therapies have received the most empirical support to date. There is a paucity of research on pharmacological interventions in this patient population, and no firm treatment recommendations can be made in this area. Conclusions:, Given the high rate of relapse after treatment, evaluation of combined psychosocial and pharmacological interventions, and the development of novel intervention strategies are indicated. [source] Review of the long-term effectiveness of cognitive behavioral therapy compared to medications in panic disorderDEPRESSION AND ANXIETY, Issue 2 2003Deepa 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] Improving Care for Minorities: Can Quality Improvement Interventions Improve Care and Outcomes For Depressed Minorities?HEALTH SERVICES RESEARCH, Issue 2 2003Controlled Trial, Results of a Randomized Objective. Ethnic minority patients often receive poorer quality care and have worse outcomes than white patients, yet practice-based approaches to reduce such disparities have not been identified. We determined whether practice-initiated quality improvement (QI) interventions for depressed primary care patients improve care across ethnic groups and reduce outcome disparities. Study Setting. The sample consists of 46 primary care practices in 6 U.S. managed care organizations; 181 clinicians; 398 Latinos, 93 African Americans, and 778 white patients with probable depressive disorder. Study Design. Matched practices were randomized to usual care or one of two QI programs that trained local experts to educate clinicians; nurses to educate, assess, and follow-up with patients; and psychotherapists to conduct Cognitive Behavioral Therapy. Patients and physicians selected treatments. Interventions featured modest accommodations for minority patients (e.g., translations, cultural training for clinicians). Data Extraction Methods. Multilevel logistic regression analyses assessed intervention effects within and among ethnic groups. Principal Findings. At baseline, all ethnic groups (Latino, African American, white) had low to moderate rates of appropriate care and the interventions significantly improved appropriate care at six months (by 8,20 percentage points) within each ethnic group, with no significant difference in response by ethnic group. The interventions significantly decreased the likelihood that Latinos and African Americans would report probable depression at months 6 and 12; the white intervention sample did not differ from controls in reported probable depression at either follow-up. While the intervention significantly improved the rate of employment for whites and not for minorities, precision was low for comparing intervention response on this outcome. It is important to note that minorities remained less likely to have appropriate care and more likely to be depressed than white patients. Conclusions. Implementation of quality improvement interventions that have modest accommodations for minority patients can improve quality of care for whites and underserved minorities alike, while minorities may be especially likely to benefit clinically. Further research needs to clarify whether employment benefits are limited to whites and if so, whether this represents a difference in opportunities. Quality improvement programs appear to improve quality of care without increasing disparities, and may offer an approach to reduce health disparities. [source] Variation in GABRA2 Predicts Drinking Behavior in Project MATCH SubjectsALCOHOLISM, Issue 11 2007Lance O. Bauer Background:, Previous studies demonstrated, and replicated, an association between single nucleotide polymorphisms (SNPs) within the GABRA2 gene and risk for alcohol dependence. The present study examines the association of a GABRA2 SNP with another definition of alcohol involvement and with the effects of psychosocial treatment. Methods:, European-American subjects (n = 812, 73.4% male) provided DNA samples for the analysis. All were participants in Project Matching Alcoholism Treatment to Client Heterogeneity (MATCH), a multi-center randomized clinical trial evaluating the efficacy of 3 types of psychosocial treatment for alcoholism: Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), or twelve-step facilitation (TSF). The daily probabilities of drinking and heavy drinking were estimated during the 12-week treatment and 12-month post-treatment periods. Results:, Subjects homozygous for the allele associated with low risk for alcohol dependence in previous studies had lower daily probabilities of drinking and heavy drinking in the present study. This low-risk allele was also associated with a greater difference in drinking outcomes between the treatments. In addition, it enhanced the relative superiority of TSF over CBT and MET. Population stratification was excluded as a confound using ancestry informative marker analysis. Conclusions:, The assessment of genetic vulnerability may be relevant to studies of the efficacy of psychosocial treatment: GABRA2 genotype modifies the variance in drinking and can therefore moderate power for resolving differences between treatments. [source] Climbing Our Hills: A Beginning Conversation on the Comparison of Acceptance and Commitment Therapy and Traditional Cognitive Behavioral TherapyCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2008Steven C. Hayes The history and developmental program of acceptance and commitment therapy (ACT) and relational frame theory (RFT) is described, and against that backdrop the target article is considered. In the authors' comparison of ACT and traditional cognitive behavioral therapy (CBT), traditional CBT does not refer to specific processes, principles, or theories but to a tribal tradition. Framed in that way, comparisons of ACT and CBT cannot succeed intellectually, because CBT cannot be pinned down. At the level of theory, change processes, and outcomes, ACT/RFT seems to be progressing as measured against its own goals. [source] What Allows Cognitive Behavioral Therapy to Be Brief: Overview, Efficacy, and Crucial Factors Facilitating Brief TreatmentCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2001Lata K. McGinn Cognitive behavior therapy (CBT) has been traditionally used as a short-term treatment for a wide range of emotional disorders and problems. In the present paper, we review aspects of CBT that allow it to be time efficient. Specifically, CBT maximizes efficiency because it uses manual-based, empirically supported treatment strategies and defines specific, measurable, and achievable target goals. A focused assessment process and a relatively structured session format facilitate the implementation of treatment strategies without delay and allow the therapist to make efficient use of session time. Once treatment is implemented, a periodic review of treatment progress using objective criteria enables the therapist and client to make informed decisions about the direction of treatment. CBT uses strategies to enhance generalization and prevent relapse and empowers patients by providing them with skills they can use outside therapy sessions. Finally, the therapist's active, directive stance plays a critical role in making CBT time-efficient. [source] Anorexia nervosa treatment: A systematic review of randomized controlled trials,INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2007Cynthia M. Bulik PhD Abstract Objective: The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), harms associated with treatments, factors associated with treatment efficacy, and differential outcome by sociodemographic characteristics. Method: We searched six major databases for studies on the treatment of AN from 1980 to September 2005, in all languages against a priori inclusion/exclusion criteria focusing on eating, psychiatric or psychological, or biomarker outcomes. Results: Thirty-two treatment studies involved only medications, only behavioral interventions, and medication plus behavioral interventions for adults or adolescents. The literature on medication treatments and behavioral treatments for adults with AN is sparse and inconclusive. Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration, although its efficacy in the underweight state remains unknown. Variants of family therapy are efficacious in adolescents, but not in adults. Conclusion: Evidence for AN treatment is weak; evidence for treatment-related harms and factors associated with efficacy of treatment are weak; and evidence for differential outcome by sociodemographic factors is nonexistent. Attention to sample size and statistical power, standardization of outcome measures, retention of patients in clinical trials, and developmental differences in treatment appropriateness and outcome is required. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [source] Cognitive behavioral therapy of negative symptomsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2009Dimitri Perivoliotis Abstract Negative symptoms account for much of the functional disability associated with schizophrenia and often persist despite pharmacological treatment. Cognitive behavioral therapy (CBT) is a promising adjunctive psychotherapy for negative symptoms. The treatment is based on a cognitive formulation in which negative symptoms arise and are maintained by dysfunctional beliefs that are a reaction to the neurocognitive impairment and discouraging life events frequently experienced by individuals with schizophrenia. This article outlines recent innovations in tailoring CBT for negative symptoms and functioning, including the use of a strong goal-oriented recovery approach, in-session exercises designed to disconfirm dysfunctional beliefs, and adaptations to circumvent neurocognitive and engagement difficulties. A case illustration is provided. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1,16, 2009. [source] Cognitive,behavioral therapy with childhood anxiety disorders: Functioning in adolescenceDEPRESSION AND ANXIETY, Issue 4 2004Katharina 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 disorderDEPRESSION AND ANXIETY, Issue 2 2003Deepa 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] Extended treatment of older cigarette smokersADDICTION, Issue 6 2009Sharon 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] RESEARCH REPORT Alcoholism treatment and medical care costs from Project MATCHADDICTION, Issue 7 2000Harold 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] Behavioral Sleep Modification May Revert Transformed Migraine to Episodic MigraineHEADACHE, Issue 8 2007Anne H. Calhoun MD Background.,Sleep problems have been linked with headaches for more than a century, but whether the headaches are the cause or the result of the disrupted sleep is unknown. Objectives.,We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine (TM). Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene, we designed a randomized, placebo-controlled study to assess the impact of such treatment on TM. We hypothesized that behavioral sleep modification (BSM) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine. Methods.,Subjects were 43 women with TM referred to an academic headache center. After obtaining informed consent, patients were randomized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care. Subjects recorded headaches in standardized diaries. The first postintervention visit was scheduled at 6 weeks. At that visit, the blind was broken and all subjects received BSM instructions. A final visit was scheduled 6 weeks later. Results.,Compared to the placebo behavioral group, the BSM group reported statistically significant reduction in headache frequency [F (1, 33 = 12.42, P=.001)] and headache intensity [F(1, 33 = 14.39, P= .01)]. They were more likely to revert to episodic migraine ,2 (2, n = 43) = 7.06, P= .029. No member of the control group reverted to episodic migraine by the first postintervention visit. By the final visit, 48.5% of those who had received BSM instructions had reverted to episodic migraine. Conclusions.,In this pilot study of women with TM, we found that a targeted behavioral sleep invention was associated with improvement in headache frequency, headache index, and with reversion to episodic migraine. [source] A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorderINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2007Simone 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] Internet-based cognitive behavioral therapy for tinnitusJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2004Gerhard Andersson Tinnitus is a common otological problem that is often resistant to surgical or medical interventions. In common with chronic pain, cognitive-behavioral treatment has been found to alleviate the distress and improve the functioning of tinnitus patients. Recently, a self-help treatment has been developed for use via the Internet. In this article, we describe the self-help program and apply it to a middle-aged woman with tinnitus. We report the case formulation, which was done in a structured interview, and the treatment interactions, which were conducted via e-mail. The self-help program was presented on Web pages, and weekly diaries were submitted to follow progress and give feedback. The treatment was successful with reductions of tinnitus-related annoyance and anxious and depressive mood. Implications for Internet administration of self-help treatment are discussed. © 2003 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] A Randomized, Double-Blind, Placebo-Controlled Pilot Study of Naltrexone in Outpatients With Bipolar Disorder and Alcohol DependenceALCOHOLISM, Issue 11 2009E. Sherwood Brown Background:, Alcohol dependence is extremely common in patients with bipolar disorder and is associated with unfavorable outcomes including treatment nonadherence, violence, increased hospitalization, and decreased quality of life. While naltrexone is a standard treatment for alcohol dependence, no controlled trials have examined its use in patients with co-morbid bipolar disorder and alcohol dependence. In this pilot study, the efficacy of naltrexone in reducing alcohol use and on mood symptoms was assessed in bipolar disorder and alcohol dependence. Methods:, Fifty adult outpatients with bipolar I or II disorders and current alcohol dependence with active alcohol use were randomized to 12 weeks of naltrexone (50 mg/d) add-on therapy or placebo. Both groups received manual-driven cognitive behavioral therapy designed for patients with bipolar disorder and substance-use disorders. Drinking days and heavy drinking days, alcohol craving, liver enzymes, and manic and depressed mood symptoms were assessed. Results:, The 2 groups were similar in baseline and demographic characteristics. Naltrexone showed trends (p < 0.10) toward a greater decrease in drinking days (binary outcome), alcohol craving, and some liver enzyme levels than placebo. Side effects were similar in the 2 groups. Response to naltrexone was significantly related to medication adherence. Conclusions:, Results suggest the potential value and acceptable tolerability of naltrexone for alcohol dependence in bipolar disorder patients. A larger trial is needed to establish efficacy. [source] Combining pharmacotherapy with cognitive behavioral therapy: Traditional and new approachesJOURNAL OF TRAUMATIC STRESS, Issue 5 2006Michael Davis Given the ever-increasing sources of trauma both nationally and globally, it is imperative to develop new and better treatments for anxiety disorders such as posttraumatic stress disorder (PTSD). This review is a collection of presentations that seek to do just that, either by using pharmacotherapy to try to prevent or erase the formation of traumatic fear memories, or to enhance exposure-based cognitive,behavioral therapy using pharmacological agents that have been effective in enhanced extinction of fear in rodents. [source] Psychological Intervention Following Implantation of an Implantable Defibrillator: A Review and Future RecommendationsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2007SUSANNE S. PEDERSEN Ph.D. Background:The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current evidence on the efficacy of psychological intervention in ICD patients and recommendations for future research. Methods:We searched the PubMed and PsycInfo databases in the period between January 1980 and April 2007, using a set of a priori determined keywords. Based on the search and a hand search of the reference lists of the included articles, we identified nine studies that fulfilled the inclusion criteria. Results:The majority of studies used a randomized controlled trial design, but studies varied considerably in sample size, response, attrition rate, and type of intervention. However, most interventions were multifactorial, using cognitive behavioral therapy as one of the mainstays of treatment. Overall, psychological interventions seem to have little impact on shocks and heart rate variability. Some studies found a decrease in depressive symptoms and gains in quality of life, but the most notable effects are seen in improved exercise capacity and reductions in anxiety. Effect sizes for changes in anxiety in the intervention group ranged from small to large compared to small in the usual care group, using Cohen's effect size index. Conclusions:Preliminary evidence from small-scale intervention trials suggests that psychological intervention is worthwhile in ICD patients. Nevertheless, large-scale, well-designed trials are warranted to substantiate these findings. A multifactorial approach using a cognitive behavioral component paired with exercise training is likely to be the most successful. [source] The Development of the Negative Pain Thoughts QuestionnairePAIN PRACTICE, Issue 5 2008Ana-Maria Vranceanu PhD ,,Abstract Background: Cognitive processes play a pivotal role in the perception of pain intensity, pain-related disability, and response to medical treatments including surgeries. While various measures of dysfunctional pain coping exist in the literature, there is no instrument available to examine such negative cognitions in relation to perceptions of medical treatment in pain patients presenting to a surgical orthopedics practice. Aims: The purpose of this article is to report on the development and preliminary testing of the Negative Pain Thoughts Questionnaire (NPTQ). Methods: The NPTQ is an 11-item questionnaire assessing cognitions about pain and its treatment in patients presenting to orthopedics surgical practices. It was administered to 2 samples of patients with hand and arm pain seeking medical treatment in a hospital surgical practice. Patients in the second sample also completed a measure of depression and one of disability of hand, arm, and shoulder. Results: The NPTQ was found to be internally consistent, and unidimensional. The NPTQ total score was found to have a moderate to high positive correlation with perceived hand, arm, and shoulder disability, and a moderate positive correlation with depression. In multivariate analyses, high scores on the NPTQ significantly predicted high perceived hand, arm, and shoulder disability, even after controlling for depression. Conclusion: This short and easily administered measure of negative pain thoughts could potentially help surgeons identify at risk patients, and facilitate referrals to cognitive behavioral therapy. This, in turn, may prevent unnecessary surgeries, may decrease healthcare costs, and prevent transition toward costly chronic pain syndrome.,, [source] Cognitive-behavior therapy for Japanese patients with panic disorder: Acute phase and one-year follow-up resultsPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2008Yumi Nakano md Aim:, The aim of this paper is to report the outcomes and follow-up data of our cognitive behavioral therapy program for Japanese patients with panic disorder and to examine the baseline predictors of their outcomes. Methods:, Seventy outpatients with panic disorder with or without agoraphobia were treated with manualized group cognitive behavioral therapy. Results:, Fourteen patients (20%) did not complete the program. Among the completers, the average Panic Disorder Severity Scale score fell from 12.8 at baseline to 7.1 post-therapy (44.7% reduction). This effectiveness was sustained for 1 year. While controlling for the baseline severity, the duration of illness and the baseline social dysfunction emerged as significant predictors of the outcome. Conclusions:, Our data suggest that group cognitive behavioral therapy for panic disorder can bring about as much symptom reduction among Japanese patients with panic disorder as among Western patients. [source] High-Dose Naltrexone Therapy for Cocaine-Alcohol DependenceTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2009Joy M. Schmitz PhD This randomized, double-blind, placebo-controlled study compared the effects of high-dose (100 mg/d) naltrexone versus placebo in a sample of 87 randomized subjects with both cocaine and alcohol dependence. Medication conditions were crossed with two behavioral therapy platforms that examined whether adding contingency management (CM) that targeted cocaine abstinence would enhance naltrexone effects compared to cognitive behavioral therapy (CBT) without CM. Primary outcome measures for cocaine (urine screens) and alcohol use (timeline followback) were collected thrice-weekly during 12 weeks of treatment. Retention in treatment and medication compliance rates were low. Rates of cocaine use and drinks per day did not differ between treatment groups; however naltrexone did reduce frequency of heavy drinking days, as did CBT without CM. Notably, adding CM to CBT did not enhance treatment outcomes. These weak findings suggest that pharmacological and behavioral interventions that have shown efficacy in the treatment of a single drug dependence disorder may not provide the coverage needed when targeting dual drug dependence. [source] Child,therapist alliance and clinical outcomes in cognitive behavioral therapy for child anxiety disordersTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2009Angela W. Chiu Background:, Few studies have examined the link between child,therapist alliance and outcome in manual-guided cognitive behavioral therapy (CBT) for children diagnosed with anxiety disorders. This study sought to clarify the nature and strength of this relation. Methods:, The Therapy Process Observational Coding System for Child Psychotherapy , Alliance scale (TPOCS-A; McLeod, 2005) was used to assess the quality of the child,therapist alliance. Coders independently rated 123 CBT therapy sessions conducted with 34 children (aged 6,13 years) diagnosed with anxiety disorders. Parents reported on children's symptomatology at pre- mid-, and post-treatment. Results:, A stronger child,therapist alliance early in treatment predicted greater improvement in parent-reported outcomes at mid-treatment but not post-treatment. However, improvement in the child,therapist alliance over the course of treatment predicted better post-treatment outcomes. Conclusions:, The quality of the child,therapist alliance assessed early in treatment may be differentially associated with symptom reduction at mid- and post-treatment. Results underscore the importance of assessing the relation between alliance and outcome over the course of therapy to clarify the role the child,therapist alliance plays in child psychotherapy. [source] Depression and cognitive behavioral therapyASIA-PACIFIC PSYCHIATRY, Issue 3 2009Li Fang Neo BSocSci [source] Treatment intensity and regularity in early outpatient psychotherapy and its relation to outcomeCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2006Susanne Kraft The distribution of treatment sessions (number of interruptions, weeks without psychotherapy and number of sessions) during the first three months of psychodynamic psychotherapy (PD), cognitive behavioral therapy (CBT) and psychoanalytic psychotherapy (PAP) was analyzed prospectively over two years in a sample of 256 outpatients. Number of weeks without psychotherapy in early treatment was predicted by initial helping alliance in PD and by initial quality of interpersonal relations in CBT. Level of initial psychological or physical impairment showed no effect on distribution of sessions during early treatment. In PD and CBT, session distribution early in treatment did not predict subsequent course of improvement. Only in PAP did weeks without psychotherapy and number of sessions affect rate of symptom change, in that participants showed better outcome when treatment started continuously at a rather slow pace. Implications for psychotherapy practice and research are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Acceptance and Commitment Therapy: New Wave or Morita Therapy?CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2008Stefan G. Hofmann Acceptance and commitment therapy (ACT) is an approach to treatment that includes potentially useful strategies. Some proponents of ACT view it as part of a third wave movement destined to replace cognitive behavioral therapy (CBT) as the dominant form of psychological therapy. This perception is problematic, because the criticism offered by ACT against CBT is based on a misrepresentation of the empirical evidence. Moreover, the strategies of ACT are not specific to the theory and philosophy underlying ACT. There are considerable similarities between ACT and Eastern holistic approaches, such as Morita therapy, which was developed 80 years ago. Future research on the mechanism of treatment change directly comparing CBT and ACT will help solve many of the current controversies. The term third wave in connection with ACT should be avoided. [source] Climbing Our Hills: A Beginning Conversation on the Comparison of Acceptance and Commitment Therapy and Traditional Cognitive Behavioral TherapyCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2008Steven C. Hayes The history and developmental program of acceptance and commitment therapy (ACT) and relational frame theory (RFT) is described, and against that backdrop the target article is considered. In the authors' comparison of ACT and traditional cognitive behavioral therapy (CBT), traditional CBT does not refer to specific processes, principles, or theories but to a tribal tradition. Framed in that way, comparisons of ACT and CBT cannot succeed intellectually, because CBT cannot be pinned down. At the level of theory, change processes, and outcomes, ACT/RFT seems to be progressing as measured against its own goals. [source] | |||||||||||||