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Behavior Therapy (behavior + therapy)
Kinds of Behavior Therapy Selected AbstractsAssaultive Behavior Intervention in the Veterans Administration: Psychodynamic Group Psychotherapy Compared to Cognitive Behavior TherapyPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2002Marilyn L. Lanza DNSc PURPOSE. To compare the efficacy of a psychodynamic psychotherapy group (PPG) and a cognitive-behavior group (CBG) for male veterans with a history of assault. METHODS. Data collected included the Addiction Severity Index, the Overt Aggression Scale, and the State-Trait Anger Expression Inventory. Subjects (N = 27) were assigned randomly to a central group, PPG, or CBG. Analyses included an overall comparison of the groups as well as repeated-measures analyses and adjustments for covariates. FINDINGS. The PPG showed a trend toward improvement of overt aggression and significant improvement of trait aggression compared with CBG. There were no differences in state aggression or efforts to control aggression. CONCLUSIONS. Both the PPG and CBG are effective treatments for aggression. [source] Children and traumatic events: Therapeutic techniques for psychologists working in the schoolsPSYCHOLOGY IN THE SCHOOLS, Issue 3 2009Steven G. Little It is clear that exposure to traumatic events is not uncommon in childhood and adolescence, and psychologists working in schools should have some training in meeting the needs of this segment of the population. One intervention that has been empirically supported in the trauma field is Trauma-Focused Cognitive Behavior Therapy (TF-CBT). This article seeks to provide an overview of research on the efficacy of TF-CBT with children and adolescents who have experienced trauma with a primary focus on psychologists working in the schools. © 2009 Wiley Periodicals, Inc. [source] The social and economic impact of trichotillomania: results from two nonreferred samplesBEHAVIORAL INTERVENTIONS, Issue 2 2006Chad T. Wetterneck Behavior therapy has been widely used as a treatment for trichotillomania. However, behavioral treatments for TTM have tended to focus on behavior reduction, while not paying as much attention to social and economic impact. The current study sought to clarify the social and economic impact of Trichotillomania (TTM) in two samples of persons with TTM. Members of the first sample attended a TTM patient conference (N,=,36) and members of the second responded to an online survey (N,=,381). Both samples completed self-report measures that examined the impact of TTM on avoiding activities and relationships, as well as financial costs. Results indicated that both groups reported similar amounts of avoidance in social situations, sought help from multiple health professionals, spent considerable time engaged in hair pulling activities, and had interference in both work and school. The study suggests a number of ways to decrease the negative impact of TTM. Copyright © 2006 John Wiley & Sons, Ltd. [source] The feasibility of smoking reduction: an updateADDICTION, Issue 8 2005John R. Hughes ABSTRACT Aim To update conclusions of a previous review of smoking reduction on the extent to which (1) smokers spontaneously reduce their smoking, (2) smokers who try to quit and fail return to smoking less, (3) smokers can substantially reduce and maintain reductions via pharmacological and behavioral treatments and (4) smokers compensate when they reduce. Method Qualitative systematic review. Data sources Systematic computer searches and other methods. Study selection Published and unpublished studies of smokers not trying to stop smoking. We located 13,26 studies for each of the four aims. Data extraction The first author entered data with confirmation by second author. Data synthesis Due to the heterogeneity of methods and necessity of extensive recalculation, a meta-analysis was not feasible. Results Few daily smokers spontaneously reduce. Among those who try to stop smoking and relapse, some return to reduced smoking but whether they maintain this reduction is unclear. Nicotine replacement (and perhaps behavior therapies) can induce smokers not interested in quitting to make significant reductions in their smoking and maintain these over time. Some compensatory smoking occurs with reduction but significant declines in smoke exposure still occur. Conclusions These results indicate that reduction is feasible when aided by treatment. Whether reduction should be promoted will depend on the effect of reduction on health outcomes and future cessation. [source] A review of empirically supported psychological therapies for mood disorders in adultsDEPRESSION AND ANXIETY, Issue 10 2010Steven 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] Diversity of effective treatments of panic attacks: what do they have in common?,DEPRESSION AND ANXIETY, Issue 1 2010Walton T. Roth M.D. Abstract By comparing efficacious psychological therapies of different kinds, inferences about common effective treatment mechanisms can be made. We selected six therapies for review on the basis of the diversity of their theoretical rationales and evidence for superior efficacy: psychoanalytic psychotherapy, hypercapnic breathing training, hypocapnic breathing training, reprocessing with and without eye-movement desensitization, muscle relaxation, and cognitive behavior therapy. The likely common element of all these therapies is that they reduce the immediate expectancy of a panic attack, disrupting the vicious circle of fearing fear. Modifying expectation is usually regarded as a placebo mechanism in psychotherapy, but may be a specific treatment mechanism for panic. The fact that this is seldom the rationale communicated to the patient creates a moral dilemma: Is it ethical for therapists to mislead patients to help them? Pragmatic justification of a successful practice is a way out of this dilemma. Therapies should be evaluated that deal with expectations directly by promoting positive thinking or by fostering non-expectancy. Depression and Anxiety, 2010. Published 2009 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] Excessive belching and aerophagia: two different disordersDISEASES OF THE ESOPHAGUS, Issue 4 2010Albert J. Bredenoord SUMMARY Belching is physiological venting of excessive gastric air. Excessive and bothersome belching is a common symptom, which is often seen in patients with functional dyspepsia and gastroesophageal reflux disease. Other symptoms are usually predominant. However, a small group of patients complain of isolated excessive belching, with a frequency of several belches per minute. In these patients, the eructated air does not originate from the stomach but is sucked or injected in the esophagus from the pharynx and expelled immediately afterward in oral direction. This behavior is called supragastric belching because the air does not originate from the stomach and does not reach the stomach either. Excessive belching can be treated by speech therapy or behavior therapy. The term aerophagia should be reserved for those patients where there is evidence that they swallow air too frequently and in too large quantities. These patients have excessive amounts of intestinal gas visualized on a plain abdominal radiogram and their primary symptoms are bloating and abdominal distension and they belch only to a lesser degree. Aerophagia and excessive supragastric belching are thus two distinct disorders. [source] Failure to improve cigarette smoking abstinence with transdermal selegiline + cognitive behavior therapyADDICTION, Issue 9 2010Joel 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] Extended cognitive behavior therapy for cigarette smoking cessationADDICTION, Issue 8 2008Joel 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] Moral Agency, Cognitive Distortion, and Narrative Strategy in the Rehabilitation of Sexual OffendersETHOS, Issue 3 2010James B. Waldram I demonstrate that what forensic psychologists refer to as a "cognitive distortion" or "thinking error" is often embedded within a broader narrative, and that these narratives reveal the existence of identifiable strategies designed to communicate something salient, enduring, and moral about the offender. Through the examination of narratives offered by imprisoned sexual offenders, several such narrative strategies containing the seeds of moral agency are identified. It is suggested that CBT's current focus on cognitive distortions effectively eliminates this narrative context and thus serves to disguise and even eradicate the positive, moral notions of self that most offenders exhibit in some form or another. A rehabilitative approach that works with narrative, facilitating development of shared narratives among offenders and therapists, would allow for the emergence of a plan for morally agentive living, transcending what is currently possible within the hostile, challenging framework of CBT. [narrative theory; cognitive behavior therapy; moral agency; sexual offenders; prisons] [source] Prediction of success and failure of behavior modification as treatment for dental anxietyEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2004I. Eli Behavior modification techniques are effective in the treatment of extreme dental anxiety, but their success is by no means absolute. In the present article, the Corah Dental Anxiety Scale (DAS), the self-report symptom inventory SCL-90R and a questionnaire accessing subjects' daydreaming styles (the Short Imaginal Process Inventory) were used to develop possible predictive measures for success and failure of behavior modification as a treatment for dental fear. The patients' level of distractibility and mind wandering, initial dental anxiety and somatization significantly predicted the success of therapy. The odds ratio indicated that the risk of therapy failure increased about 11 times with an increase of one scale of the Poor Attention Control Scale, about three times with an increase of one level of the mean DAS score, and 0.17 times with an increase of one level of somatization. The predictive value of the chosen scales was 80%. Thus, the use of these scales as part of an initial admittance process for patients who suffer from dental anxiety can enhance our ability to better recognize patients who are prone to fail behavior therapy as treatment for their problem, and enable their referral for other possible modes of treatment. [source] Role of exposure with response prevention in cognitive,behavioral therapy for bulimia nervosa: Three-year follow-up resultsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2003Frances A. Carter Abstract Background Previous studies have not reported the longer-term outcome of exposure-based treatments for bulimia nervosa. The current study evaluated the 3-year outcome of a randomized clinical trial that compared the additive efficacy of exposure-based versus nonexposure-based behavioral treatments (BT) with a core of cognitive,behavior therapy (CBT). Methods One hundred thirteen women participated in the original treatment trial and attended a 3-year follow-up assessment. Eating disorder diagnoses and primary, secondary, and tertiary outcome measures were assessed. The impact of treatment completion on symptomatology and the stability of treatment effects over time were evaluated. Results At the 3-year follow-up, 85% of the sample had no current diagnosis of bulimia nervosa and 69% had no current eating disorder diagnoses of any sort. Failure to complete CBT was associated with inferior outcome. No clear advantages were evident for participants who completed BT in addition to CBT. For subjects who did complete both CBT and BT, outcome was mostly stable from posttreatment to follow-up. No differential effects were found for exposure versus nonexposure-based treatments at 3-year follow-up. Discussion The results of the current study compare favorably with other treatment outcome studies for bulimia nervosa and suggest that treatment gains are maintained after 3 years. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 127,135, 2003. [source] Cue reactivity as a predictor of outcome with bulimia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2002Frances A. Carter Abstract The present study sought to evaluate specific hypotheses concerning the relation between cue reactivity and outcome among women with bulimia nervosa. Participants were 135 women aged between 17 and 45 years with a current, primary diagnosis of bulimia nervosa who participated in a randomized clinical trial evaluating the additive efficacy of exposure and nonexposure-based behavior therapy, to a core of cognitive behavior therapy (CBT). Physiological, self-report, and behavioral measures of cue reactivity to individualized high-risk binge foods were obtained at pretreatment and posttreatment. Primary, secondary, and tertiary outcome measures are reported for posttreatment and six-month follow-up. Self-report measures of cue reactivity at posttreatment were significantly positively associated with symptomatology at posttreatment. Cue reactivity at posttreatment was significantly positively associated with symptomatology at 6-month follow-up. However, cue reactivity at posttreatment did not contribute to the prediction of outcome at follow-up over and above posttreatment outcome. The notion that pretreatment cue reactivity may predict which treatment modality will be most beneficial (exposure or nonexposure-based treatment), as measured by reductions in symptomatology at posttreatment could not be supported. Implications for future research are discussed. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 31: 240,250, 2002; DOI 10.1002/eat.10041 [source] Response to the van Alphen et al. 'Reaction to "treatment of older adults with co-morbid personality disorder and depression: a dialectical behavior therapy approach"INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2007Jennifer S. Cheavens No abstract is available for this article. [source] Therapist empathy and client anxiety reduction in motivational interviewing: "She carries with me, the experience"JOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2009Lynne E. Angus Abstract In this article, we examine the use of motivational interviewing (MI) to treat generalized anxiety disorder (GAD) by means of case illustration that focuses on four categories drawn from the client's experience of the key ingredients in MI therapy. The case illustration, drawn from the York study on combining MI and cognitive behavior therapy in the treatment of GAD (uses the client's pre- and post-therapy narrative interviews) to arrive at categories representative of the client's experience of MI therapy. The results of the qualitative analysis highlight the key contributions to positive client outcomes and readiness for change in brief MI therapy for GAD. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,12, 2009. [source] Dialectical behavior therapy for comorbid personality disordersJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2008Thomas R. Lynch Abstract Dialectical behavior therapy (DBT) was originally designed as a treatment of emotionally dysregulated, impulsive, and dramatic disorders (e.g., borderline personality disorder) and populations (e.g., parasuicidal women). However, a number of complex disorders represent the dialectical opposite of BPD and related disorders; these disorders are characterized by being overcontrolled, emotionally constricted, perfectionistic, and highly risk-averse. In this article, the authors introduce a recent adaptation of DBT that targets cognitive,behavioral rigidity and emotional constriction and illustrates its application through the case of a man suffering from both paranoid personality disorder and obsessive,compulsive personality disorder. © 2008 Wiley Periodicals, Inc. J Clin Psychol. In Session 64: 1,14, 2008. [source] Impact of PTSD comorbidity on one-year outcomes in a depression trialJOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2006Bonnie L. Green Low-income African American, Latino, and White women were screened and recruited for a depression treatment trial in social service and family planning settings. Those meeting full criteria for major depression (MDD; N = 267) were randomized to cognitive,behavior therapy (CBT), antidepressant medication, or community mental health referral. All randomly assigned participants were evaluated by baseline telephone and clinical interview, and followed by telephone for one year. Posttraumatic stress disorder (PTSD) comorbidity was assessed at baseline and one-year follow-up in a clinical interview. At baseline, 33% of the depressed women had current comorbid PTSD. These participants had more exposure to assaultive violence, had higher levels of depression and anxiety, and were more functionally impaired than women with depression alone. Depression in both groups improved over the course of one year, but the PTSD subgroup remained more impaired throughout the one-year follow-up period. Thus, evidence-based treatments (antidepressant medication or structured psychotherapy) decrease depression regardless of PTSD comorbidity, but women with PTSD were more distressed and impaired throughout. Including direct treatment of PTSD associated with interpersonal violence may be more effective in alleviating depression in those with both diagnoses. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 815,835, 2006. [source] Psychosocial treatments of suicidal behaviors: A practice-friendly reviewJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2006Katherine Anne Comtois Worldwide, almost a million people die by suicide each year. Intentional, nonfatal, self-inflicted injury, including both suicide attempts and acts without suicide intent, also has very high prevalence. This article provides a practice-friendly review of controlled studies of psychosocial treatments aiming to prevent suicide, attempted suicide, and nonsuicidal self-inflicted injuries. Despite relatively small sample sizes for a low-base-rate outcome such as self-inflicted injury, several psychotherapies have been found effective, including cognitive therapy, dialectical behavior therapy, problem-solving therapy, and interpersonal psychotherapy, as well as outreach interventions, such as sending caring letters. The clinical implications of the review are discussed with the goal of translating the science to service,particularly the importance of outreach and treatment of non-compliance, the assessment and management of suicide risk, and competency in effective psychotherapies. These are critical steps for clinical psychology and psychotherapists to take in their role in suicide prevention. © 2005 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 161,170, 2006. [source] Remembering and honoring Paul MeehlJOURNAL OF CLINICAL PSYCHOLOGY, Issue 10 2005Albert Ellis The author commemorates Paul Meehl by briefly presenting some of his cardinal contributions to clinical psychology, including the Minnesota Multiphasic Personality Inventory (MMPI), rational,emotive behavior therapy, and clinical versus statistical prediction. He also describes a few of his personal contacts with him. Meehl modeled a way of thinking, and thinking about thinking, that should be useful to all clinical psychologists. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 1231,1232, 2005. [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] Computer-aided CBT self-help for anxiety and depressive disorders: Experience of a London clinic and future directionsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2004Lina Gega This article describes a broad-spectrum, computer-aided self-help clinic that raised the throughput of anxious/depressed patients per clinician and lowered per-patient time with a clinician without impairing effectiveness. Many sufferers improved by using one of four computer-aided systems of cognitive behavior therapy (CBT) self-help for phobia/panic, depression, obsessive-compulsive disorder, and general anxiety. The systems are accessible at home, two by phone and two by the Web. Initial brief screening by a clinician can be done by phone, and if patients get stuck they can obtain brief live advice from a therapist on a phone helpline. Such clinician-extender systems offer hope for enhancing the convenience and confidentiality of guided self-help, reducing the per-patient cost of CBT, and lessening stigma. The case examples illustrate the clinical process and outcomes of the computer-aided system. © 2003 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] Cognitive,behavior therapy for PTSD in rape survivorsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2002Lisa H. Jaycox In recent years, new data have appeared, further suggesting the utility of cognitive,behavioral interventions for posttraumatic stress disorder (PTSD) subsequent to sexual assault. In this article, we present a model of cognitive,behavioral treatment (CBT) for PTSD in rape survivors. Emotional-processing theory, which proposes mechanisms that underlie the development of disturbances following rape, is reviewed. A CBT-based therapy (Prolonged Exposure) is presented that entails education about common reactions to trauma, relaxation training, imaginal reliving of the rape memory, exposure to trauma reminders, and cognitive restructuring. Current research regarding the use of prolonged exposure is discussed. The case example of a young female rape survivor is described in detail, and her prior substance dependence and intense shame are highlighted. The therapy was successful in reducing the client's symptoms of PTSD, as well as her depressive symptoms, and these gains were maintained at a one-year follow-up assessment. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 891,906, 2002. [source] Cognitive strategies and the resolution of acute stress disorder,JOURNAL OF TRAUMATIC STRESS, Issue 1 2001Richard A. Bryant Abstract Information processing theories propose that resolution of posttraumatic stress is mediated by activation of traumatic memories and modification of threat-based beliefs. It is argued that this adaptive response is associated with reduced cognitive avoidance. Thought control strategies were assessed in civilian trauma survivors with acute stress disorder (N = 45) prior to and following either cognitive behavior therapy or supportive counseling. Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the State Trait Anxiety Inventory, the Impact of Event Scale, and the Thought Control Questionnaire within 2 weeks of their trauma and 6 months following treatment. Receiving cognitive behavior therapy was associated with reductions in the use of punishment and worry, and increases in the use of reappraisal and social control strategies. Further, reduced posttraumatic stress symptoms were associated with increased use of social control strategies and reappraisal strategies, and decreased use of worry. Findings are discussed in terms of the cognitive strategies that may mediate acute posttraumatic stress. [source] Socioeconomic Status in the Treatment of DepressionAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009Lydia Falconnier PhD This study examined outcomes and attrition across three treatments for depression in relation to socioeconomic status (SES). The study was based on data available from the Treatment of Depression Collaborative Research Program (TDCRP) of the National Institute of Mental Health (NIMH; Elkin, 1994), a multisite collaborative study that examined the effectiveness of two forms of psychotherapy, cognitive behavior therapy and interpersonal psychotherapy, and pharmacotherapy. Results indicated that lower SES, measured by the Hollingshead Index of Social Position, was associated with less improvement across all three treatments for depression. The effect of SES on outcome did not differ by treatment modality. Contrary to expectations, SES was not associated with attrition. These findings suggest that there may be limitations in the use of these empirically validated treatments with lower SES depressed patients, as their improvement rates may be less than those of middle SES depressed patients treated by the same modalities. The results of this study also suggest that a standardized measure of SES may be more sensitive to SES differences in outcome than the more easily obtained measures of education or income. Suggestions are provided for additional research in this area to address the potential mediators and moderators of the association between SES and outcome. [source] Response of patients with panic disorder and symptoms of hypomania to cognitive behavior therapy for panicBIPOLAR DISORDERS, Issue 2 2003Rudy C Bowen Objectives:, The purpose of this cohort study was to determine in patients with Panic Disorder (PD): (1) the prevalence of subsyndromal symptoms of hypomania, and (2) whether subsyndromal hypomania symptoms affect the outcome of cognitive behavior therapy (CBT) for panic. Methods:, Using the Diagnostic Interview Schedule, and DSM-III-R criteria we identified 18 individuals with a history of symptoms of hypomania among 56 patients with PD. Patients were treated in an open CBT group program. They were assessed before treatment and 6 and 12 months later. We used the Brief Symptom Inventory (BSI), the Perceived Stress Scale (PSS), the Pearlin-Schooler Mastery Scale (PMS), and the Social Adjustment Scale (SAS) at all assessments. Results:, The total group significantly improved on all measures. The Clinically Significant Change was 71.4% and the Reliable Change Index 48.2%. Between 6 and 12 months, there was a trend for the hypomania symptom subgroup (PH) to continue to improve on the BSI Depression Scale, the Perceived Stress Scale, the Pearlin,Schooler Mastery Scale, and the Social Adjustment Scale but to lose gains on the BSI Phobic Anxiety and Somatization subscales compared with the group without symptoms of hypomania (PNH). Conclusions:, Thirty-two percent of patients with PD had symptoms of hypomania. With CBT for panic, patients with PD and symptoms of hypomania improve as much as those without hypomania symptoms. The presence or absence of symptoms of hypomania might help explain the inconsistent effects of depression and personality disorders on the treatment of PD. [source] Cognitive therapy with people with intellectual disabilities: a selective review and critiqueCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 4 2004Peter Sturmey The literature on cognitive therapy with people with intellectual disabilities was selectively reviewed, including application to problems such as anger management, depression and offending. The literature on anger management showed the most promise. The literature on depression was weak. Research on offenders was promising, but no controlled trials were found. Much of the literature incorrectly identified behavioral interventions as cognitive interventions. Many interventions, such as anger management, were in fact packages that included many behavioral interventions, such as relaxation and social skills training, alongside cognitive methods, such as cognitive restructuring. Hence, evaluations of anger management packages can not tell us anything about the effectiveness of cognitive therapy, since cognitive therapy is confounded with behavior therapy. Future directions for research include well controlled experimental trials to evaluate the effectiveness of these packages and the contribution of cognitive therapy to treatment outcome.,Copyright © 2004 John Wiley & Sons, Ltd. [source] Behavioral Activation Treatment for Depression: A CommentaryCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 3 2001Steven D. Hollon Over the last two decades, cognitive therapy has largely eclipsed more purely behavioral interventions in the treatment of depression. Although cognitive behavior therapy has fared well in controlled clinical trials, behavior therapy has tended to languish, despite doing well in earlier trials. Jacobson and colleagues describe an approach to behavioral activation that is likely to reinvigorate interest in more purely behavioral interventions. This approach is based on a contextual analysis of the external events that trigger distress and the consequences that follow what are often ineffectual efforts to cope. Recent studies suggest that the approach may both be effective and easy to disseminate to applied clinical settings. [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] | ||||||||||||||||