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Cognitive-behavior Therapy (cognitive-behavior + therapy)
Selected AbstractsA multimodal behavioral approach to performance anxietyJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2004Arnold A. Lazarus Cognitive-behavior therapy (CBT) stresses a trimodal assessment framework (affect, behavior, and cognition [ABC]), whereas the multimodal approach assesses seven discrete but interactive components,behavior, affect, sensation, imagery, cognition, interpersonal relationships, and drugs/biological factors (BASIC I.D.). Only complex or recalcitrant cases call for the entire seven-pronged range of multimodal interventions. Various case illustrations are offered as examples of how a clinician might proceed when confronted with problems that fall under the general heading of performance anxiety. The main example is of a violinist in a symphony orchestra whose career was in serious jeopardy because of his extreme fear of performing in public. He responded very well to a focused but elaborate desensitization procedure. The hierarchy that was eventually constructed contained many dimensions and subhierarchies featuring interlocking elements that evoked his anxiety. In addition to imaginal systematic desensitization, sessions were devoted to his actual performance in the clinical setting. As a homework assignment, he found it helpful to listen to a long-playing record of an actual rehearsal and to play along with the world-renowned orchestra and conductor. The subsequent disclosure by the client of an important sexual problem was dealt with concomitantly by using a fairly conventional counseling procedure. Therapy required 20 sessions over a 3-month period. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session. [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] The future of psychotherapy for mentally ill children and adolescentsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 1-2 2009John S. March Objective:, Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy for mentally ill children, adolescents and adults. Method:, This article reviews the ,trajectory' of psychosocial interventions in pediatric psychiatry, and makes some general predictions about where this field is heading over the next several decades. Results:, Driven largely by scientific advances in molecular, cellular and systems neuroscience, psychotherapy in the future will focus less on personal narratives and more on the developing brain. In place of disorders as intervention targets, modularized psychosocial treatment components derived from current cognitive-behavior therapies will target corresponding central nervous system (CNS) information processes and their functional behavioral consequences. Either preventive or rehabilitative, the goal of psychotherapy will be to promote development along typical developmental trajectories. In place of guilds, psychotherapy will be organized professionally much as physical therapy is organized today. As with other forms of increasingly personalized health care, internet-based delivery of psychotherapy will become commonplace. Conclusion:, Informed by the new field of translational developmental neuroscience, psychotherapy in the future will take aim at the developing brain in a service delivery model that closely resembles the place and role of psychosocial interventions in the rest of medicine. Getting there will be, as they say, interesting. [source] Comprehensive Inpatient Treatment of Refractory Chronic Daily HeadacheHEADACHE, Issue 4 2009Alvin E. Lake III PhD Objective., (1) To assess outcome at discharge for a consecutive series of admissions to a comprehensive, multidisciplinary inpatient headache unit; (2) To identify outcome predictors. Background., An evidence-based assessment (2004) concluded that many refractory headache patients appear to benefit from inpatient treatment, underscoring the need for more research, including outcome predictors. Methods., The authors completed a retrospective chart review of 283 consecutive admissions over 6 months. The inpatient program (mean length of stay = 13.0 days) included intravenous and oral medication protocols, drug withdrawal when indicated, cognitive-behavior therapy, and other services when needed, including anesthesiological intervention. Patient-reported pain levels and consensus of medical staff determined outcome status. Results., The 267 completers (94%) included 212 women and 55 men (mean age = 40.3 years, range = 13-74) from 43 states and Canada. The modal diagnosis was intractable, chronic daily headache (85%), predominantly migraine. Most (59%) had medication overuse headache (MOH), involving opioids (48%), triptans (16%), or butalbital-containing analgesics (10%). Psychiatric diagnoses included stress-related headache (82%), mood disorders (70%), anxiety disorders (49%), and personality disorders (PD, 26%). More patients with a PD (62%) had opioid-related MOH than those with no PD (38%), P < .005. Of the completers, 78% had moderate to significant pain reduction, with comparable improvement in mood, function, and behavior. Clinical factors predicting moderate-significant headache improvement were limited to MOH (84% vs 69%, P < .007) and presence of a PD (68% vs 81%, P < .03). Conclusions., Most patients (78%) improved following aggressive, comprehensive inpatient treatment. Maintenance of improvement is likely to depend on multiple post-discharge factors, including continuity of care, compliance, and home or work environment. [source] Patterns of weight change after treatment for bulimia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2004Frances A. Carter Abstract Objective The current study examined changes in weight and body mass index (BMI) at 5-year follow-up among women treated for bulimia nervosa. Method The study comprised 80 women who had participated in a randomized clinical trial evaluating cognitive-behavior therapy for bulimia nervosa. The women had attended assessments at posttreatment and at 5-year follow-up while not pregnant. Results Changes in mean weight and BMI between posttreatment and 5-year follow-up were small in absolute terms and were not statistically significant. However, by the 5-year follow-up, approximately one half of the participants had either lost (31%) or gained (18%) 5 or more kilograms or were underweight (31%) or overweight (24%) as defined by BMI. Univariate analyses suggest that it is the patients who gain weight over the follow-up that are distinctive. Patients who gained weight over the follow-up were more likely to have commenced menstruation at a younger age, to have a lifetime history of being heavier, and to have been heavier and more dissatisfied with their body at pretreatment, posttreatment, and at 5-year follow-up. Conclusion Five years after treatment for bulimia nervosa, approximately one half of the participants had changed substantially in weight. For those who had changed, weight loss was more common than weight gain. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 36: 12,21, 2004. [source] Why I (really) became a therapistJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2005Albert Ellis This article describes how the author really became a therapist and worked on his own social and performance anxiety. He was at first a follower of liberal psychoanalysis, but, in successfully using in vivo desensitization on himself, he overcame his anxiety and became highly constructivist. He finally created rational emotive behavior therapy, the pioneering cognitive-behavior therapy; integrated it with emotional-evocative and experiential methods; and used it to cope with much criticism he received about his active-directive techniques. © 2005 Wiley Periodicals, Inc. J Clin Psychol/In Session 61: 945,948, 2005. [source] A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: A cross-over designJOURNAL OF TRAUMATIC STRESS, Issue 6 2005Devon E. Hinton We examined the therapeutic efficacy of a culturally adapted cognitive-behavior therapy for Cambodian refugees with treatment-resistant posttraumatic stress disorder (PTSD) and comordid panic attacks. We used a cross-over design, with 20 patients in the initial treatment (IT) condition and 20 in delayed treatment (DT). Repeated measures MANOVA, Group & times; Time ANOVAs, and planned contrasts indicated significantly greater improvement in the IT condition, with large effect sizes (Cohen's d) for all outcome measures: Anxiety Sensitivity Index (d = 3.78), Clinician-Administered PTSD Scale (d = 2.17), and Symptom Checklist 90-R subscales (d = 2.77). Likewise, the severity of (culturally related) neck-focused and orthostasis-cued panic attacks, including flashbacks associated with these subtypes, improved across treatment. [source] | |||||||||||||