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At least 235 records · Page 13Linked to original sources
PubMed2000

A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa.

BACKGROUND: Research suggests that cognitive-behavioral therapy (CBT) is the most effective psychotherapeutic treatment for bulimia nervosa. One exception was a study that suggested that interpersonal psychotherapy (IPT) might be as effective as CBT, although slower to achieve its effects. The present study is designed to repeat this important comparison. METHOD: Two hundred twenty patients meeting DSM-III-R criteria for bulimia nervosa were allocated at random to 19 sessions of either CBT or IPT conducted over a 20-week period and evaluated for 1 year after treatment in a multisite study. RESULTS: Cognitive-behavioral therapy was significantly superior to IPT at the end of treatment in the percentage of participants recovered (29% [n=32] vs 6% [n=71), the percentage remitted (48% [n=53] vs 28% [n = 31]), and the percentage meeting community norms for eating attitudes and behaviors (41% [n=45] vs 27% [n=30]). For treatment completers, the percentage recovered was 45% (n= 29) for CBT and 8% (n= 5) for IPT. However, at follow-up, there were no significant differences between the 2 treatments: 26 (40%) CBT completers had recovered at follow-up compared with 17 (27%) IPT completers. CONCLUSIONS: Cognitive-behavioral therapy was significantly more rapid in engendering improvement in patients with bulimia nervosa than IPT. This suggests that CBT should be considered the preferred psychotherapeutic treatment for bulimia nervosa.

Adult↗
PubMed2004

Case study: successful medication withdrawal using cognitive-behavioral therapy for a preadolescent with OCD.

The aim of this study was to evaluate the effectiveness of the addition of manual-based cognitive-behavioral therapy to a medication regimen of clomipramine and fluoxetine and the withdrawal of medication during cognitive-behavioral therapy. The participant was an 11-year-old girl with symptoms of obsessive thoughts about germs and illness and handwashing compulsions. The addition of cognitive-behavioral therapy reduced the participant's daily number of obsessions and avoidance behaviors after three sessions. When medication was tapered during the cognitive-behavioral therapy program, the participant's symptoms continued to decline, and after treatment, she no longer met diagnostic criteria for obsessive-compulsive disorder. Impressively, the participant remained medication free and treatment gains were maintained at 4 months' follow-up.

Child↗
PubMedDate not supplied

Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores.

BACKGROUND: Cognitive behavior therapy is well recognized as an effective treatment and prevention for depression when delivered face-to-face, via self-help books (bibliotherapy), and through computer administration. The public health impact of cognitive behavior therapy has been limited by cost and the lack of trained practitioners. We have developed a free Internet-based cognitive behavior therapy intervention (MoodGYM, http://moodgym.anu.edu.au) designed to treat and prevent depression in young people, available to all Internet users, and targeted to those who may have no formal contact with professional help services. OBJECTIVE: To document site usage, visitor characteristics, and changes in depression and anxiety symptoms among users of MoodGYM, a Web site delivering a cognitive-behavioral-based preventive intervention to the general public. METHODS: All visitors to the MoodGYM site over about 6 months were investigated, including 2909 registrants of whom 1503 had completed at least one online assessment. Outcomes for 71 university students enrolled in an Abnormal Psychology course who visited the site for educational training were included and examined separately. The main outcome measures were (1) site-usage measures including number of sessions, hits and average time on the server, and number of page views; (2) visitor characteristics including age, gender, and initial Goldberg self-report anxiety and depression scores; and (3) symptom change measures based on Goldberg anxiety and depression scores recorded on up to 5 separate occasions. RESULTS: Over the first almost-6-month period of operation, the server recorded 817284 hits and 17646 separate sessions. Approximately 20% of sessions lasted more than 16 minutes. Registrants who completed at least one assessment reported initial symptoms of depression and anxiety that exceeded those found in population-based surveys and those characterizing a sample of University students. For the Web-based population, both anxiety and depression scores decreased significantly as individuals progressed through the modules. CONCLUSIONS Web sites are a practical and promising means of delivering cognitive behavioral interventions for preventing depression and anxiety to the general public. However, randomized controlled trials are required to establish the effectiveness of these interventions.

Adolescent↗
PubMed2001

Cognitive versus behavior therapy in the group treatment of obsessive-compulsive disorder.

This study examined the effects of cognitive-behavior therapy (CBT) compared with traditional behavior therapy (exposure and response prevention [ERP]) in the group treatment of obsessive-compulsive disorder. Of the 76 participants who started treatment, 38 were wait-listed for 3 months before treatment to assess possible course effects. Both treatments were superior to the control condition in symptom reduction, with ERP being marginally more effective than CBT by end of treatment and again at 3-month follow-up. In terms of clinically significant improvement, treatment groups were equivalent on the conclusion of treatment, but 3 months later significantly more ERP participants met criteria for recovered status. Only 1 of 7 belief measures changed with treatment improvement, and the extent of this cognitive change was similar between CBT and ERP groups. Discussion includes consideration of optimal formats for the delivery of different types of treatment.

Adolescent↗
PubMed1992

[Behavior therapy as a new procedure in health education--recommendation for introducing behavior science into personal health services].

Recent efforts to integrate biomedical and behavioral science perspectives and techniques have revealed the creativity and efficacy of behavioral health approaches to health enhancement and disease prevention. There are expectations that behavioral medicine and behavioral health will be significant in approaches toward changing life style, improving patient's compliance with medical advice, and in rehabilitation. Three examples of actual practice of behavioral procedures in a public health center are studied-behavior therapies for obesity and hypercholesterolemia, and prompting of patient clinic utilization behavior by a letter of introduction. The importance of proper selection of target problems, staff training is emphasized. In conclusion, it is recommended that behavioral science and its techniques of assessment and treatment are incorporated into public health activities, especially in the field of health education.

Behavior Therapy↗
PubMedDate not supplied

Behavioral therapies at the primary care level: the current state of knowledge.

Urinary incontinence, the complaint of any involuntary loss of urine, is a troubling symptom experienced by men and women of all ages. Options for treatment include a range of behavioral, pharmacologic, and surgical therapies. Behavioral therapies, such as dietary modification, pelvic floor muscle training, and bladder training, are noninvasive, with little risk of side effects, and experts agree they should represent the first line of treatment whenever possible. These therapies can be initiated and monitored at the primary care level, thereby enhancing the accessibility of care for those affected. The purpose of this article is to methodically review what is and is not known about behavioral therapies, with attention to research needs. Although there is clear evidence for pelvic floor muscle training in women with urinary incontinence and modest evidence in men for a short time after radical prostatectomy, less is known about bladder training, prompted voiding, habit retraining, and timed voiding. Additional research is required to enhance our understanding of the comparative efficacy of behavioral interventions in specific populations. This research must take an increasingly long-term focus, given the potentially chronic nature of urinary incontinence.

Behavior Therapy↗
PubMed2005

Double-blind, placebo-controlled study of dialectical behavior therapy plus olanzapine for borderline personality disorder.

OBJECTIVE: The aim of this study was to determine the efficacy and safety of dialectical behavior therapy plus olanzapine compared with dialectical behavior therapy plus placebo in patients with borderline personality disorder. METHOD: Sixty patients with borderline personality disorder were included in a 12-week, double-blind, placebo-controlled study. All patients received dialectical behavior therapy and were randomly assigned to receive either olanzapine or placebo following a 1-month baseline period. RESULTS: Seventy percent of the patients completed the 4-month trial. Combined treatment showed an overall improvement in most symptoms studied in both groups. Olanzapine was associated with a statistically significant improvement over placebo in depression, anxiety, and impulsivity/aggressive behavior. The mean dose of olanzapine was 8.83 mg/day. CONCLUSIONS: A combined psychotherapeutic plus pharmacological approach appears to lower dropout rates and constitutes an effective treatment for borderline personality disorder.

Adult↗
PubMed2005

[Cognitive and Cognitive-Behavioral Therapy for substance abuse disorders].

This article describes the current status of Cognitive and Behavioral Therapy as well Relapse Prevention and Coping Skill approaches applied in drug abuse treatments. The objective is show a review about theories and technique used by Cognitive Therapy and others approaches derived that, specifically Relapse Prevention and Coping Skill Treatments. Cognitive and Behavioral Therapy, Coping Skill, and Relapse Prevention are a short-time, goal-oriented and structured treatments. Thus, they assume a posture directive and active. We pointed out some difference between the theories about Cognitive Therapy, Relapse Prevention and Coping Skill. The Cognitive Therapy accentuated the focus in patients thought, feeling and circumstances that get in a dysfunctional behavioral. Relapse Prevention and Coping Skill are based in behavioral theories besides of the Cognitive. We, finally, look forward to introduce the lasted scientific finding to helpful the general psychiatric to improve the assistance in drug abuse treatment.

Adaptation, Psychological↗
PubMed1994

Cognitive behavior therapy for treatment-refractory panic disorder.

BACKGROUND: The purpose of this pilot study is to assess the efficacy of cognitive behavior therapy for the treatment of patients with panic disorder who experience an incomplete response to a trial of pharmacotherapy. METHOD: Fifteen consecutive patients with a DSM-III-R diagnosis of panic disorder referred for further treatment because of an incomplete response to pharmacotherapy were treated with 12-weeks of group cognitive behavior therapy. Patients were evaluated at baseline, endpoint, and at a mean of 2-months' follow-up to assess changes in panic attack frequency and global outcome. Eight of the 15 patients were deemed to have received an inadequate prior trial of medication at baseline, mainly because of a desire to control their symptoms without medication or fear of withdrawal and/or addiction. Seven of the patients were symptomatic at baseline despite an adequate prior trial of medication. RESULTS: Overall, patients experienced a significant improvement in global function at the end of the cognitive behavior therapy intervention, as well as a decrease in panic attack frequency. Improvement was maintained at follow-up. CONCLUSION: This study is consistent with a growing body of evidence that many patients with panic disorder remain symptomatic over time and are receiving inadequate pharmacotherapeutic treatment. Further, we observed that patients with panic disorder who are incompletely responsive or resistant to pharmacotherapeutic management may benefit from the addition of cognitive behavior therapy.

Adult↗
PubMed2001

Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy.

BACKGROUND: The objective of this study was to examine the long-term course of obsessive-compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and behavioral therapy and to identify predictors of clinical outcome. METHOD: Sixty outpatients meeting DSM-II-R or DSM-IV criteria for OCD were followed up for 1 to 5 years (mean = 2.5 years). All of them received prolonged pharmacologic therapy with an SRI. RESULTS: Thirty-seven patients (61.7%) completed an adequate behavioral treatment. At long-term assessment, 22 patients (36.7%) exhibited a global Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score greater than 16 or a final reduction in Y-BOCS global score of less than 35% and were considered nonresponders. Patients who completed behavioral therapy showed a significant decrease in Y-BOCS compulsions subscale score (p = .01), whereas no significant differences in either Y-BOCS global or obsessions subscale scores between those who did and those who did not undergo behavioral therapy were detected. Obsessions of sexual/religious content were the unique factor related to a poorer long-term outcome. CONCLUSION: A substantial number of OCD patients showed persistent disabling symptoms at the long-term follow-up in spite of combined pharmacologic and behavioral treatment. Major benefits from behavioral therapy appeared to be the improvement of ritualistic behaviors. Sexual/religious obsessions predicted poorer long-term outcome, whereas short-term response to SRI treatment failed to achieve predictive value in the long-term course of OCD.

Adolescent↗
PubMed1983

Parental judgments of behavior therapy efficacy with autistic children: a social validation.

As a complement to objective measures of treatment effectiveness, behavioral researchers have utilized social validation procedures to gather information from significant others regarding the social importance of behavior changes. The present study represents an attempt to socially validate the efficacy of behavior therapy with autistic children. Thirty-four parents of autistic children and 18 parents of normal children judged (via questionnaire) the behavior of four autistic children before and after behavior therapy. The results indicated that (1) parents socially validated the effects of behavior therapy in that they judged the children as significantly improved after treatment, and (2) the effects of treatment were also socially validated by the parents' indication that they were more willing to interact with the children after treatment than before treatment.

Attitude↗
PubMed1988

The neglect of data-gathering instruments in behavior therapy practice.

Although the Willoughby Personality Questionnaire and the Fear Survey Schedule are demonstrably valuable aids to the practice of behavior therapy of neurosis, it is evident that many behavior therapists do not use them. In order to determine the extent of their neglect, we sent a questionnaire to all Clinical Fellows of the Behavior Therapy and Research Society. The 134 replies we received revealed that the Willoughby was routinely used by only 19% and the Fear Survey Schedule by only 42%. This seems to be manifestation of a wide-spread but indefensible homogenized view of neuroses. It is a sad reflection on the quality of behavior therapy training programs.

Attitude of Health Personnel↗
PubMed1993

Comparing the process in psychodynamic and cognitive-behavioral therapies.

Archival records were used to compare the therapy process in 30 brief psychodynamic and 32 cognitive-behavioral therapies. Verbatim transcripts of 186 treatment sessions were rated with the Psychotherapy Process Q-set, designed to provide a standard language for the description of process. Results demonstrated that although some features were common to both treatments, there were important differences. Cognitive-behavioral therapy promoted control of negative affect through the use of intellect and rationality combined with vigorous encouragement, support, and reassurance from therapists. In psychodynamic psychotherapies, there was an emphasis on the evocation of affect, on bringing troublesome feelings into awareness, and on integrating current difficulties with previous life experience, using the therapist-patient relationship as a change agent. The clinical theoretical precepts underlying psychodynamic treatments received considerable support. In cognitive-behavioral therapies, there was evidence for the importance of developmental, as opposed to rationalist, intervention strategies for treatment outcome.

Adaptation, Psychological↗
PubMed1998

Cognitive-behavioral therapy for panic: effectiveness and limitations.

The cognitive model of panic and cognitive-behavioral therapy were evaluated. It was argued that the cognitive model is not clear about the definition of threat, and that panic is evoked by the fear of the dissolution of the self. Furthermore, panic attacks will not lead to panic disorder unless the individual is experiencing general anxiety and is concerned with his/her physical or mental state. Controlled studies have demonstrated that cognitive-behavioral therapy is superior to other treatments for panic--85% of patients are panic-free at posttreatment and improvements are maintained at follow-up. However, 26% of waiting-list controls are also panic-free making the net percentage of panic-free treated patients 59%. There is room for improvement in at least 50% of patients, and a substantial number of patients continue to take medication and seek additional treatment. There is a need to determine the essential components of cognitive-behavioral therapy. It was predicted that exposure will prove to be the most crucial component. Exposure to phobic situations and interoceptive cues should be extended to the underlying causes of panic disorder, such as concerns with identity and dependency needs.

Cognitive Behavioral Therapy↗
PubMed2003

Telephone-administered cognitive behavior therapy for obsessive-compulsive disorder.

Exposure with response prevention and cognitive behavior therapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive-compulsive disorder--particularly those living in rural areas--do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Two open trials are reported, for a total of 33 people with obsessive-compulsive disorder (without major depression). The first trial consisted of 12 weeks on a waiting list followed by 12 weeks of treatment (delayed treatment). The second trial consisted of 12 weeks of immediate treatment. Obsessive-compulsive symptoms did not change during the waiting period. Symptoms declined from pre- to post-treatment, with gains maintained at 12-week follow-up. For the pooled sample our pre-to-post-treatment effect size was as large or larger than those obtained in other studies of reduced contact treatment, and similar to those of face-to-face exposure with response prevention. Our proportion of treatment dropouts tended to be lower than those of other reduced contact interventions. The results suggest that telephone-administered cognitive behavior therapy is effective and well-tolerated, at least for people with obsessive-compulsive disorder without major depression. It remains to be seen whether this treatment is safe and effective when comorbid major depression is present.

Journal Article↗
PubMed1996

Cognitive-behavioral therapy and treatment for late-life depression.

Cognitive-behavioral therapy is a brief psychotherapy stemming from a model that emphasizes the importance of distorted thoughts and the lack of pleasurable activities in the development of affective disorders. The focus of the therapy can be on either eliminating distorted thought systems or increasing the number of pleasant events that occur on a daily basis, or both. The highly structured therapy presents various skills for patients to learn through class exercises and homework assignments. Older adults respond well to cognitive-behavioral therapy, reporting that they appreciate the structure and the opportunity to learn skills that can help when they are confronted with new stresses. Many also like the focus on here-and-now problems rather than the past. A few treatment modifications are necessary to accommodate community elders complaining of depression. Generally, information must be presented more slowly, taking advantage of multiple modes of presentation. To maintain an active learning process, elder patients should be asked frequently to summarize the material being presented. They should also be given handouts of complex materials and encouraged to maintain notebooks. Other modifications may be required for special populations of older patients.

Age Factors↗
PubMed1996

Abnormal electroencephalographic sleep profiles in major depression: association with response to cognitive behavior therapy.

BACKGROUND: To test the hypothesis that depressed patients with selected neurobiologic disturbances are less responsive to psychotherapy, we examined responses to cognitive behavior therapy in relation to electroencephalographic sleep profiles. METHODS: Under a prospective, case-control design, 90 outpatients with probable or definite endogenous major depression (Schedule for Affective Disorders and Schizophrenia and Research Diagnostic Criteria) were stratified into abnormal and normal sleep subgroups (on the basis of an empirically validated electroencephalographic sleep profile) and more severe and less severe depression subgroups (on the basis of pretreatment Hamilton scores). Response to 16 weeks of treatment was analyzed for both intention-to-treat and completers (n = 82) samples. Outcomes during a 36-month prospective follow-up were assessed with survival analyses. RESULTS: Abnormal sleep profiles and higher pretreatment depression severity were independently associated with poorer outcomes on several analyses. The association between sleep abnormality and cognitive behavior therapy response was not significant in the completers analyses, however, largely because of differential attrition. During follow-up, pretreatment depression severity was predictive of relapse and a lower recovery rate, whereas sleep abnormality was predictive of a lower recovery rate and a higher risk of recurrence. CONCLUSIONS: Depressed patients characterized by higher severity and/or an abnormal electroencephalographic sleep profile were relatively less responsive to cognitive behavior therapy. These associations are hypothesized to result from a constellation of neurophysiologic disturbances that interfere with the acquisition, application, and implementation of the skills emphasized in cognitive behavior therapy.

Adult↗