Therapy Sessions (therapy + session)

Distribution by Scientific Domains

Selected Abstracts

Balloon dilatation vs. balloon dilatation plus bile duct endoprostheses for treatment of anastomotic biliary strictures after liver transplantation

Thomas Zoepf
Biliary strictures after liver transplantation are a therapeutic challenge for endoscopy. Anastomotic strictures occur in 10% of patients after liver transplantation, leading untreated to mortality and ultimately to graft failure. Despite of successful reports, to date, there is no defined endoscopic therapy regimen for these cases. Therefore the aim of this study was to determine the most suitable concept for endoscopic treatment of post-liver transplant anastomotic strictures (PTAS). A total of 72 patients post-liver transplantation, who received endoscopic retrograde cholangiography (ERC) as a consequence of suspected biliary complications were retrospectively screened for the presence of PTAS. In all patients graft rejection or bile duct ischemia were excluded prior to ERC by liver biopsy or Doppler ultrasound respectively. We compared either balloon dilatation (BD) alone or dilatation plus placement of an increasing number of bile duct endoprostheses (BD + endoprostheses) in a retrospective analysis. A total of 25 of 75 patients showed PTAS. Overall, endoscopic therapy was successful in 22 of 25 patients (88%). BD was initially successful in 89% but showed recurrence in 62%. BD + endoprostheses was initially successful in 87%, and recurrence was observed only in 31%. All recurrences were successfully retreated by BD + endoprostheses. During 22 of 109 (20%) treatment sessions stone extraction was necessary. Complication rate was low with bacterial cholangitis in 8 of 109 (7.3%) sessions, mild pancreatitis in 10 of 109 (9%) sessions and minor bleeding in 2 of 25 (8%) sphincterotomies. Median follow-up after conclusion of endoscopic therapy is 6 months (range 1,43). In conclusion, our data confirm that endoscopic therapy of PTAS is highly effective and safe. As primarily successful BD shows a high rate of recurrence, we recommend a combination of BD followed by an increasing number and diameter of endoprostheses. Therapy sessions are effective at short intervals of every 2,3 months. Liver Transpl 12:88,94, 2006. © 2005 AASLD. [source]

Ankle dorsiflexion fMRI in children with cerebral palsy undergoing intensive body-weight-supported treadmill training: a pilot study

John P Phillips MD
This pilot study investigated the feasibility of using functional magnetic resonance imaging (fMRI) as a physiological marker of brain plasticity before and after an intensive body-weight-supported treadmill training (BWSTT) program in children with cerebral palsy (CP). Six ambulatory children (four males, two females; mean age 10y 6mo, age range 6,14y) with spastic CP (four hemiplegia, two asymmetric diplegia, all Gross Motor Function Classification System Level I) received BWSTT twice daily for 2 weeks. All children tolerated therapy; only one therapy session was aborted due to fatigue. With training, over ground mean walking speed increased from 1.47 to 1.66m/s (p=0.035). There was no change in distance walked for 6 minutes (pre-: 451m; post-: 458m;p 0.851). In three children, reliable fMRIs were taken of cortical activation pre- and post-intervention. Post-intervention increases in cortical activation during ankle dorsiflexion were observed in all three children. This study demonstrates that children with CP between 6 and 14 years of age can tolerate intensive locomotor training and, with appropriate modifications, can complete an fMRI series. This study supports further studies designed to investigate training-dependent plasticity in children with CP. [source]

Can music therapy engage patients in group cognitive behaviour therapy for substance abuse treatment?

Abstract Introduction and Aims. Despite the availability of effective treatments for substance use disorders, engaging people in treatment remains a challenge. This clinical study describes a 7-week trial of music therapy as an adjunct to group cognitive behaviour therapy with the aim of increasing patient engagement in a private hospital open group programme. Design and Methods. Patient attendance rates and perceptions of the music therapy were collected at the end of each music therapy session by means of an anonymous survey, and only data from each patient's first survey were used in the analysis. Twenty-four surveys were analysed, representing feedback from 10 men and 14 women, aged between 17 and 52 years. Results. The average attendance rate over the 7-week trial was 75%. The results indicated that enjoyment and motivation to participate during the sessions was uniformly high (mean ratings of 4.3 and 4.0 out of 5, respectively). The majority (83%) of participants reported that they would attend another music therapy session, and almost half (46%) endorsed that ,(music therapy) would help them to feel more a part of the group'. Additional analyses revealed that music therapy was able to engage patients regardless of their age group (25 years and under vs. over-25 years) or substance (alcohol only vs. other drugs). Discussion and Conclusions. Music therapy is a promising approach to improving engagement in substance abuse treatment groups. [source]

Effects of Qi therapy (external Qigong) on symptoms of advanced cancer: a single case study

M.S. LEE phd
The aim of this study was to examine the effectiveness of Qi therapy (external Qigong) in the management of symptoms of advanced cancer in a man. We used a single case study design to evaluate the effectiveness of Qi therapy (external Qigong) in a 35-year-old man with advanced cancer (Stage IV) involving metastases in the stomach, lung and bone (Karnofsky performance scale: KPS, 40: requires special care and assistance, disabled). Treatment involved six days of pre-assessment, eight treatment sessions on alternate days over 16 days, and a two-week follow-up phase. A visual analogue scale (VAS) was used to assess the patient's self-reported symptoms of cancer over the intervention and follow-up periods. Following treatment, VAS scores' analysis revealed beneficial effects on pain, vomiting, dyspnoea, fatigue, anorexia, insomnia, daily activity and psychological calmness. These improvements were maintained over the two-week follow-up phase. After the first Qi therapy session, the patient discontinued medication and could sit by himself; after the fourth session, the patient was able to walk and use the toilet without assistance (improvement in KPS: 70: care for self, unable to perform normal activity or to do active work). Although limited by the single case study approach, our results support previous studies on this topic and provide reasons to conduct controlled clinical trials. [source]

Being there, experiencing and creating space for dialogue: about working with children in family therapy

Peter Rober
While most authors agree that it is important to mobilize the active participation of children in the family therapy session, a lot of family therapists exclude children from participating because they do not feel comfortable with children. Teaching family therapists to feel more comfortable around children is a good idea, but perhaps it is not enough. In this article, the author reflects on the complexity of the issue of the comfort of the therapist in a session with children and families. In the discussion of the case story of Elly and her mother, practitioners are reminded that the therapist's experiencing in the session can help her to understand something of what goes on in the families she is working with. [source]

Being With Feelings as a Recognition Practice: Developing Clients Self-Understanding

Bonnie Raingruber PhD
topic. How are shifts in clients'self-understanding related to focusing on feelings during therapy sessions? methods A phenomenological study involving matched-pairs of clients and nurse-therapists using video-cued narrative reflection. findings Feelings disclose significance within a therapy session. Dialogical relationships and involvements help clients experience the feelings they are discussing, obtain feedback from therapists, and develop self-understanding. conclusions. Nurse educators should stress the importance of focusing on feelings in a session, and clinicians should practice this skill to facilitate a client's developing self-understanding. [source]

Outcome of psychological treatments of pathological gambling: a review and meta-analysis

ADDICTION, Issue 10 2005
Ståle Pallesen
ABSTRACT Aims To investigate the short- and long-term effect of psychological treatments of pathological gambling and factors relating to treatment outcome. Design and setting This study provides a quantitative meta-analytical review of psychotherapeutic treatments of pathological gambling. Studies were identified by computer search in the PsycINFO and Medline databases covering the period from 1966 to 2004, as well as from relevant reference lists. Inclusion criteria The target problem was pathological gambling, the treatment was psychological, the study was published in English and outcomes directly pertaining to gambling were employed. Single case studies, studies where elimination of gambling not was the priority and studies with insufficient statistical information were excluded from the present meta-analysis. Participants A total of 37 outcome studies, published or reported between 1968 and 2004, were identified. Of these 15 were excluded, thus 22 studies were included, involving 1434 subjects. The grand mean age was 40.1 years. The overall proportion of men was 71.5%. Measurements The included studies were coded for outcome measures of pathological gambling. For each condition, means and standard deviations for gambling-related outcome measures, all based upon self-reports or therapist ratings, were compiled at three points in time: baseline, post-treatment and the last follow-up reported. Findings Effect sizes represent the difference between the mean score in a treatment condition and a control condition or the difference between mean scores at separated points in time for one group, expressed in terms of standard deviation units. At post-treatment the analysis indicated that psychological treatments were more effective than no treatment, yielding an overall effect size of 2.01 (P < 0.01). At follow-up (averaging 17.0 months) the corresponding effect size was 1.59 (P < 0.01). A multiple regression analysis showed that the magnitude of effect sizes at post-treatment were lower in studies including patients with a formal diagnosis of pathological gambling only, compared to studies not employing such inclusion criteria. Effect sizes were also higher in randomized controlled trials compared to not randomized controlled trials, higher in within subjects designs compared to between subjects designs and also positively related to number of therapy sessions. No mediator variables were significantly related to the magnitude of the effect sizes at follow-up. Conclusion Psychological interventions for pathological gamble seem to be yield very favourable short- and long-term outcomes. [source]

Relational Drawings in Couple Therapy

FAMILY PROCESS, Issue 1 2009
In couple therapy sessions, partners often get into long and drawn-out discussions, heavy with pain, resentment, and blame. It is vital for the therapist to avoid becoming entangled in these escalating interactions. In this article, as one way of avoiding these interactions, a protocol is proposed of using relational drawings in couple therapy for opening space for new stories. This approach is strongly rooted in extensive therapeutic experience, as well as in dialogical ideas. Not the content of the partners' imagery is central, but rather the dialogical exchange about the drawings. In particular, the focus of the therapist is on the partners' interactions, their hesitations and their surprises. Working in this way opens space for the partners to reflect on what they experience as crucial in their bond. The protocol is illustrated with two detailed case examples. RESUMEN En las sesiones de terapia de pareja los pacientes suelen tener conversaciones muy prolongadas cargadas de dolor, resentimiento y culpa. Es de vital importancia que el terapeuta evite enredarse en estas interacciones, que se hacen más y más intensas. En este artículo se propone un modo de conseguirlo, un procedimiento en el que se usan dibujos relacionales en la terapia de pareja para abrir un espacio para nuevas historias. Este enfoque está fuertemente arraigado en una amplia experiencia en terapia, así como en ideas dialógicas. No es el contenido de las imágenes creadas por los pacientes lo que tiene mayor importancia, sino el intercambio dialógico sobre los dibujos. En especial, el terapeuta se concentrará en las interacciones de la pareja, sus dudas y sus sorpresas. Trabajar de este modo abre un espacio para que ambos miembros de la pareja reflexionen sobre lo que consideran crucial en su unión. El procedimiento se ilustra con dos ejemplos detallados. Palabras clave: terapia relacional, no-verbal, dialógico, dibujos In couple therapy sessions, partners often get into long and drawn-out discussions, heavy with pain, resentment and blame. It is vital for the therapist to avoid becoming entangled in these escalating interactions. In this article, as one way of avoiding these interactions, a protocol is proposed of using relational drawings in couple therapy for opening space for new stories. This approach is strongly rooted in extensive therapeutic experience, as well as in dialogical ideas. Not the content of the partners' imagery is central, but rather the dialogical exchange about the drawings. In particular, the focus of the therapist is on the partners' interactions, their hesitations and their surprises. Working in this way opens space for the partners to reflect on what they experience as crucial in their bond. The protocol is illustrated with two detailed case examples. relational therapy, non-verbal, dialogical, drawings [source]

Relational Factors and Family Treatment Engagement among Low-Income, HIV-Positive African American Mothers

FAMILY PROCESS, Issue 1 2003
Victoria B. Mitrani Ph.D.
Clinically derived hypotheses regarding treatment engagement of families of low-income, HIV-positive, African American mothers are tested using univariate and multivariate logistic regression models. Predictors are baseline family relational factors (family support, mother's desire for involvement with family, and family hassles) and mother's history of substance dependence. The study examines a subsample of 49 mothers enrolled in a clinical trial testing the efficacy of Structural Ecosystems Therapy (SET). SET is a family-based intervention intended to relieve and prevent psychosocial distress associated with HIV/AIDS. Participants in the subsample were randomly assigned to SET and attended at least two therapy sessions. Findings reveal that family relational factors predicted family treatment engagement (family support, p < 004; mother's desire for involvement with family, p < 008; family hassles, p < 027). Family support predicted family treatment engagement beyond the prediction provided by the other relational factors and the mother's own treatment engagement (p < 016). History of substance dependence was neither associated with family treatment engagement nor family support. Post hoc analyses revealed that family hassles (p < 003) and mother's desire for involvement with family (p < 018) were differentially related to family treatment engagement in low-versus high-support families. Implications for clinical practice and future research are discussed. [source]

Art psychotherapy in a consumer diagnosed with borderline personality disorder: A case study

Scott Lamont
ABSTRACT This case study reviews 11 sessions of art psychotherapy with a consumer diagnosed with having borderline personality disorder. A consumer who reported difficulty in communicating her lived trauma verbally and engaged in self-harming behaviour was offered individual art therapy sessions following a consultation between an art therapy student and clinical nurse consultant in an attempt to understand her experiences and to collaboratively engage her. Notes were taken after each session by the art therapy student, reflecting conversations with this consumer while they were engaged in art making, which were subsequently explored within formal clinical supervision sessions with a mental health nurse consultant. An art portfolio is reproduced. It illustrates the expressive power of image creation. The key features of the images were that of lived trauma, the externalization of thoughts and feelings, and intense emotional expression. The results of this chronological art portfolio case study indicated therapeutic benefits from the intervention for this consumer. Further investigations of this type of intervention are warranted within the mental health setting. [source]

Effect of an In-Home Occupational and Physical Therapy Intervention on Reducing Mortality in Functionally Vulnerable Older People: Preliminary Findings

Laura N. Gitlin PhD
OBJECTIVES: To evaluate the effect of a multicomponent intervention on mortality and the role of control-oriented strategy use as the change mechanism. DESIGN: Two-group randomized design with survivorship followed for 14 months. Participants were randomized to intervention or a no-treatment control group. SETTING: Urban, community-living older people. PARTICIPANTS: Three hundred nineteen people aged 70 and older with functional difficulties. INTERVENTION: Occupational therapy and physical therapy sessions involving home modifications, problem solving, and training in energy conservation, safe performance, balance, muscle strength, and fall recovery techniques. MEASUREMENTS: Survival time was number of days between baseline interview and date of death or final interview if date unknown. Control-oriented strategy use was measured using eight items. RESULTS: Intervention participants exhibited a 1% rate of mortality, compared with a 10% rate for no-treatment control participants (P=.003, 95% confidence interval=2.4,15.04%). At baseline, those who subsequently died had more days hospitalized and lower control-oriented strategy use 6 months before study enrollment than survivors. No intervention participants with previous days hospitalized (n=31) died, whereas 21% of control group counterparts did (n=35; P=.001). Although intervention participants with low and high baseline control strategy use had lower mortality risk than control participants, mortality risk was lower for intervention participants with low strategy use at baseline (P=.007). CONCLUSION: An occupational and physical therapy intervention to ameliorate functional difficulties may reduce mortality risk in community-dwelling older people overall and benefit those most compromised. Instruction in control-oriented strategies may account for the intervention's protective effects on survivorship. [source]

A Randomized Trial of a Multicomponent Home Intervention to Reduce Functional Difficulties in Older Adults

Laura N. Gitlin PhD
OBJECTIVES: To test the efficacy of a multicomponent intervention to reduce functional difficulties, fear of falling, and home hazards and enhance self-efficacy and adaptive coping in older adults with chronic conditions. DESIGN: A prospective, two-group, randomized trial. Participants were randomized to a treatment group or no-treatment group. SETTING: Urban community-living older people. PARTICIPANTS: Three hundred nineteen community-living adults aged 70 and older who reported difficulty with one or more activities of daily living. INTERVENTION: Occupational and physical therapy sessions involving home modifications and training in their use; instruction in strategies of problem-solving, energy conservation, safe performance, and fall recovery techniques; and balance and muscle strength training. MEASUREMENTS: Outcome measures included self-rated functional difficulties with ambulation, instrumental activities of daily living, activities of daily living, fear of falling, confidence performing daily tasks, and use of adaptive strategies. Observations of home hazards were also conducted. RESULTS: At 6 months, intervention participants had less difficulty than controls with instrumental activities of daily living (P=.04, 95% confidence interval (CI)=,0.28,0.00) and activities of daily living (P=.03, 95% CI=,0.24 to ,0.01), with largest reductions in bathing (P=.02, 95% CI=,0.52 to ,0.06) and toileting (P=.049, 95% CI=,0.35,0.00). They also had greater self-efficacy (P=.03, 95% CI=0.02,0.27), less fear of falling (P=.001, 95% CI=0.26,0.96), fewer home hazards (P=.05, 95% CI=,3.06,0.00), and greater use of adaptive strategies (P=.009, 95% CI=0.03,0.22). Benefits were sustained at 12 months for most outcomes. CONCLUSION: A multicomponent intervention targeting modifiable environmental and behavioral factors results in life quality improvements in community-dwelling older people who had functional difficulties, with most benefits retained over a year. [source]

The Effect of an Attachment-Based Behaviour Therapy for Children with Visual and Severe Intellectual Disabilities

P. S. Sterkenburg
Background, A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method, Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded continuously in the residential home and during therapy sessions. Alternating treatments were given by two therapists. In phase 1, the experimental therapist attempted to build an attachment relationship in sessions alternating with sessions in which a control therapist provided positive attention only. In phase 2, both therapists applied the same behaviour modification protocol. Results, Across clients, challenging behaviour in the residential home decreased during the attachment therapy phase. The behaviour modification sessions conducted by the experimental therapist resulted in significantly more adaptive target behaviour than the sessions with the control therapist. Conclusion, For these clients with a background of attachment problems, attachment-based behaviour modification treatment may have important advantages over standard behaviour modification. [source]

Reasons for therapy termination in a university psychology clinic

Kimberly Renk
This study examined the reasons for therapy termination documented by graduate student therapists. The closed case files of individual adult clients who had terminated their therapy experience at a university-based psychology clinic were reviewed. Results indicated that the most frequent reasons for termination documented by graduate student therapists were that clients stopped attending therapy sessions without providing their therapists with notice or reason and that clients reached a satisfactory termination point in their therapy experience. A substantial number of clients terminated therapy because of difficulties unrelated to therapy, seeking services elsewhere, or dissatisfaction with therapy services. Level of depressive symptomatology and the number of sessions attended differed across clients who had different reasons for termination. By addressing such client concerns early in the therapy experience, premature termination may be prevented. © 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 1173,1181, 2002. [source]

Modifying therapeutic homework for patients with personality disorders

Arthur Freeman
Generalizing therapeutic gains made during therapy sessions to patients' daily lives is the most fundamental goal of psychotherapy. Assigning between-session homework is an efficient method to teach new skills and to generalize those skills to the patient's natural environment. Given the persistent, chronic, and pervasive nature of the problems presented by the individual with a personality disorder, homework is not merely recommended but is an important and essential part of the therapeutic work. This article discusses modifying homework for personality-disordered patients in the context of a literature review and case examples from the various Personality Disorder Clusters. Also offered are a number of techniques to overcome patient "resistance." © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 513,524, 2002. [source]

A case illustration of resistance from a gestalt-experiential perspective

David Engle
The case of Victoria illustrates psychotherapy with a woman faced with a difficult and unexpected divorce. The authors present a summary of typical struggles faced by Victoria through three phases of therapy. The therapy focused initially on coping with the divorce, then moved to work on her career dissatisfaction, and finally to her efforts to develop a new relationship. The case presentation illustrates resistance as it manifested itself in both a behavioral manner and as in-session resistance to awareness of internal states. The behavioral mode of resistance is manifested by her inability to follow through on decisions made in therapy sessions and by her interruptions of ongoing therapy. A transcript of a typical in-session exchange illustrates the resistance to awareness. The authors also describe interventions intended to work with the resistance. © 2002 John Wiley & Sons, Inc. J Clin Psychol/In Session 58: 151,156, 2002. [source]


Michael P. Nichols
In this investigation we examine the elements of enactments-in-session dialoguse used to observe and modify family interactions in sturctrual family therapy. Twenty-one videotaped segments of 18 therapy sessions with differnt familes were used to compile detailed descriptions of therapist techniques and client responses. Enactments were analyzed as consisting of three distinst phases-initiation, facilitation, adn closing-each of which required more numerous and complex interventions than are usually described in the clinical literautre. Judges were able to reliable describe therapist interventions that led to successful enactments as well as what therapists did or failed to do that led to unproductive outcomes. Clinical implications of these findings are discussed. [source]

Problem-Solving Treatment for Complicated Depression in Late Life: A Case Study in Primary Care

Rita Haverkamp MSN
TOPIC Treatment of depression in primary care. PURPOSE To describe the application of problem-solving treatment for a person with complicated depression. SOURCES Specific treatment details from audiotaped therapy sessions; published literature. CONCLUSION This case demonstrates how an older person benefited from problem-solving treatment. [source]

Being With Feelings as a Recognition Practice: Developing Clients Self-Understanding

Bonnie Raingruber PhD
topic. How are shifts in clients'self-understanding related to focusing on feelings during therapy sessions? methods A phenomenological study involving matched-pairs of clients and nurse-therapists using video-cued narrative reflection. findings Feelings disclose significance within a therapy session. Dialogical relationships and involvements help clients experience the feelings they are discussing, obtain feedback from therapists, and develop self-understanding. conclusions. Nurse educators should stress the importance of focusing on feelings in a session, and clinicians should practice this skill to facilitate a client's developing self-understanding. [source]

Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy

PSYCHO-ONCOLOGY, Issue 11 2007
Gil Bar-Sela
Abstract Introduction: Cancer patients are particularly vulnerable to depression and anxiety, with fatigue as the most prevalent symptom of those undergoing treatment. The purpose of this study was to determine whether improvement in depression, anxiety or fatigue during chemotherapy following anthroposophy art therapy intervention is substantial enough to warrant a controlled trial. Material and methods: Sixty cancer patients on chemotherapy and willing to participate in once-weekly art therapy sessions (painting with water-based paints) were accrued for the study. Nineteen patients who participated in ,4 sessions were evaluated as the intervention group, and 41 patients who participated in ,2 sessions comprised the participant group. Hospital Anxiety and Depression Scale (HADS) and the Brief Fatigue Inventory (BFI) were completed before every session, relating to the previous week. Results: BFI scores were higher in the participant group (p=0.06). In the intervention group, the median HADS score for depression was 9 at the beginning and 7 after the fourth appointment (p=0.021). The median BFI score changed from 5.7 to 4.1 (p=0.24). The anxiety score was in the normal range from the beginning. Conclusion: Anthroposophical art therapy is worthy of further study in the treatment of cancer patients with depression or fatigue during chemotherapy treatment. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Art therapy with adult bone marrow transplant patients in isolation: a pilot study

Bonnie Gabriel
Psycho-social interventions for cancer patients in isolation for bone marrow transplant (BMT) have been advocated in the recent literature. It is not clear what type of interventions would be most appropriate. This study was conducted at Memorial Sloan-Kettering Cancer Center (MSKCC), with three aims. (1) To test the feasibility of introducing art therapy as a supportive intervention for adult BMT patients in isolation. Nine patients were seen in art therapy sessions twice a week while in isolation, and were helped to develop free personal images. The three art therapists used the same art therapy program as a model. (2) Toassess how patients would use the program. Forty-two images were made by the nine patients during the art therapy sessions. A thematic analysis of the images showed that the patients used art therapy effectively in three ways: (a) to strengthen their positive feelings, (b) to alleviate their distress, and (c) to clarify their existential/spiritual issues. (3) The third aim was to identify which patients would most benefit from art therapy. Our results suggest that the non-verbal metaphorical modality of art therapy may be especially beneficial for patients who need to deal with emotional conflicts, and with feelings about life and death, in a safe setting. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Child,therapist alliance and clinical outcomes in cognitive behavioral therapy for child anxiety disorders

Angela 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]

What Allows Cognitive Behavioral Therapy to Be Brief: Overview, Efficacy, and Crucial Factors Facilitating Brief Treatment

Lata 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]