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PubMed1991

The practice of behavior therapy among clinical psychologists in Hong Kong.

A survey was conducted to assess the extent to which behavior therapy techniques were employed by clinical psychologists in Hong Kong. The most popular techniques included those that could be grouped under the self-management package and the least popular techniques generally involved an aversive element, or were in vivo. The use of behavior therapy was correlated with the younger age range of the treatment clientele. The results and the future development of behavior therapy were discussed in terms of cultural issues, training and the theoretical orientations of the respondents.

Behavior Therapy↗

PubMed2006

[Cognitive behavioral therapy for eating disorders].

Eating disorders include anorexia nervosa and bulimia nervosa. The former is characterized by failure to maintain a minimum normal body weight, while the latter is typified by recurrent binge eating followed by inappropriate compensating behavior, which may include self-inducing vomiting; abuse of laxatives, diuretics or other medications; fasting; and over-exercise. Because eating disorders are difficult to detect in the early stages and patients frequently try to hide their condition and avoid seeking medical help, medical treatment is sometimes sought only once a patient's condition poses an immediate threat to his/her health, or even life. Some patients suffer from chronic and treatment-refractory disorders. Cognitive behavioral therapy, administered through partially-structured guidance and education, has been shown to treat eating disorders effectively by correcting associated maladaptive and distorted cognitions and behaviors. A review of articles published in the domestic and international literature over the past five years show that cognitive behavioral therapy is more effective in treating eating disorders than other traditional approaches. Therefore, we chose to focus this study on the cognitive behavioral therapy model. Nurses can employ cognitive behavioral therapy to help eating disordered patients address and overcome the core beliefs that underpin their disorder (e.g., compulsive concern about body weight or figure) and recover health.

Anorexia Nervosa↗

PubMed1985

The establishment of a behavior therapy unit within a general hospital in Venezuela: the first five years.

This article describes the formation of a behavior therapy unit in a major general hospital in Venezuela. The unit was begun in 1978 despite considerable opposition. Initially sporadic seminars were given in which the essentials of behavior therapy were taught. This gradually grew into a 2-year post-graduate course in behavior therapy-a year of background and a year of clinical assignments. A wide range of treatments are used, all of which have a solid data base. Our experience shows that it is possible to design small behavior therapy units, not only in psychiatric hospitals but in general hospitals as well.

Behavior Therapy↗

PubMed1996

More theory-driven and less diagnosis-based behavior therapy.

Individualized treatment based on a functional analysis of problem behavior used to be considered a hallmark of behavior therapy. Yet the relative success of recently developed treatment manuals for DSM-defined disorders has cast doubts as to whether treatment individualization is really necessary. This article evaluates some of the relative merits of assessments and manualized treatments based on DSM categories and discusses data that indicate when a protocol treatment approach is sufficient and when it is not. Finally, a theory-driven approach to conducting behavior therapy is proposed as a way to complement individualized and manualized treatments. This approach is illustrated by presenting a model-based assessment and treatment approach to overcome excessive heart-focused anxiety (cardiophobia).

Behavior Therapy↗

PubMed1984

Cognitive versus behavioral procedures in cognitive-behavior therapy: a critical review of the evidence.

During the past decade there has been an increasing emphasis on cognition in psychology and behavior therapy. This movement has spawned several distinctive cognitive therapies. While those therapies do employ innovative cognitive treatment procedures, they often do so in the context of well-established behavioral treatment procedures which may or may not be acknowledged by the label "cognitive-behavior therapy". This paper addresses the question of whether cognitive therapy is an evolutionary or revolutionary development from behavior therapy and critically evaluates the evidence for the efficacy of procedures specific to cognitive therapy.

Agoraphobia↗

PubMed2006

Clinical trial of abstinence-based vouchers and cognitive-behavioral therapy for cannabis dependence.

Ninety cannabis-dependent adults seeking treatment were randomly assigned to receive cognitive-behavioral therapy, abstinence-based voucher incentives, or their combination. Treatment duration was 14 weeks, and outcomes were assessed for 12 months posttreatment. Findings suggest that (a) abstinence-based vouchers were effective for engendering extended periods of continuous marijuana abstinence during treatment, (b) cognitive-behavioral therapy did not add to this during-treatment effect, and (c) cognitive-behavioral therapy enhanced the posttreatment maintenance of the initial positive effect of vouchers on abstinence. This study extends the literature on cannabis dependence, indicating that a program of abstinence-based vouchers is a potent treatment option. Discussion focuses on the strengths of each intervention, the clinical significance of the findings, and the need to continue efforts toward development of effective interventions.

Adult↗

PubMed1997

Dialectical behavior therapy in the treatment of persons with borderline personality disorder.

Highly suicidal, borderline patients are difficult to treat within the hospital and the community. The institution of managed care necessitates that care for these and other chronically hospitalized populations take place in the community. Psychotherapy has shown moderate success for some borderlines, however, treatment attrition is a significant problem. Without an intervention that successfully maintains suicidal borderline patients in therapy, either more costly methods of treatment must be used or death will result. A form of cognitive-behavioral therapy called dialectical behavior therapy has shown a high rate of effectiveness in reducing inpatient hospital days, suicide attempt frequency, and therapy attrition.

Borderline Personality Disorder↗

PubMed2000

A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication.

BACKGROUND: Research evidence supports the efficacy of cognitive-behavioral therapy in the treatment of drug-refractory positive symptoms of schizophrenia. Although the cumulative evidence is strong, early controlled trials showed methodological limitations. METHODS: A randomized controlled design was used to compare the efficacy of manualized cognitive-behavioral therapy developed particularly for schizophrenia with that of a nonspecific befriending control intervention. Both interventions were delivered by 2 experienced nurses who received regular supervision. Patients were assessed by blind raters at baseline, after treatment (lasting up to 9 months), and at a 9-month follow-up evaluation. Patients continued to receive routine care throughout the study. An assessor blind to the patients' treatment groups rated the technical quality of audiotaped sessions chosen at random. Analysis was by intention to treat. RESULTS: Ninety patients received a mean of 19 individual treatment sessions over 9 months, with no significant between-group differences in treatment duration. Both interventions resulted in significant reductions in positive and negative symptoms and depression. At the 9-month follow-up evaluation, patients who had received cognitive therapy continued to improve, while those in the befriending group did not. These results were not attributable to changes in prescribed medication. CONCLUSION: Cognitive-behavioral therapy is effective in treating negative as well as positive symptoms in schizophrenia resistant to standard antipsychotic drugs, with its efficacy sustained over 9 months of follow-up.

Adult↗

PubMed1977

Behavior therapy: a promising drug abuse treatment and research approach of choice.

Behavior therapy appears a promising drug abuse treatment and research approach of choice, reporting effective pilot studies utilizing such techniques as token economy, aversive conditioning, relaxation training, contract writing, covert conditioning, and combinative approaches. Behavior therapy appears to merit considerable investment of funds, time, and facilities to design and to execute carefully controlled research studies with systematic follow-up. Behavioral research and treatment is also consistent with presently available diagnostic techniques--the highly structured interview and the Synanon Game--and seems eminently applicable in specific work sites, to problems of staff selection and training, and to patient screening problems.

Attitude of Health Personnel↗

PubMed1991

Smoking-cessation treatment combining transdermal nicotine substitution with behavioral therapy.

Effects of smoking-cessation treatment combining transdermal nicotine substitution with behavioral therapy were investigated in two studies. A total of 403 smokers underwent nine weeks of behavioral self-control treatment. For seven weeks, groups with transdermal nicotine substitution were also provided with nicotine patches that continuously release nicotine through the skin into the circulatory system. The effects of treatment were measured by total abstinence. The results showed that the nicotine concentration in the patch, special relapse prevention methods, and the type of dosage (individual versus fixed dose) had no influence on therapeutic success. Nicotine concentration played a decisive role in the compatibility of the patch. Combining transdermal nicotine substitution with behavioral therapy produced 12-month success rates (total abstinence) of about 35%.

Administration, Cutaneous↗

PubMed2004

[Cognitive behavioral therapy for depressed older outpatients--a controlled, randomized trial].

OBJECTIVE: There is a lack of scientific evidence of psychotherapy with depressed elderly. In a controlled randomized trial we compare a cognitive behavioral group intervention with a waiting list control condition. It is expected that cognitive behavior therapy is more efficient in reducing depressive symptoms than the control group at post-treatment as well as at follow-up. METHOD: A total of 100 older adults presently fulfilling the diagnosis of a depressive disorder but not showing any signs of cognitive impairment were randomly assigned (ratio 2 : 1) to either cognitive behavior therapy (N=65) or to waiting list condition (N=35). Assessment took place at pre-treatment, after 3 months of treatment or waiting, and after 6 months follow-up. RESULTS: As expected, cognitive behavior group therapy was superior to waiting list control in all measures at post-treatment as well as at follow-up (intent-to-treat analysis). These effects are statistically and clinically relevant and not influenced by parallel treatment with antidepressant medication. After cognitive behavior therapy 36 patients were in complete remission but only 4 after three months of waiting. Six patients in the control group became even worse during the 3 months waiting while only 1 patient under cognitive behavior therapy has to be considered as treatment failure. DISCUSSION: Cognitive behavioral group treatment is a well accepted, successful intervention for older adults. Waiting for treatment is problematic. It does not only produce no changes in symptomatology but even leads to worsening of depression in a large number of subjects.

Aged↗

PubMed2001

Comparative effects of short-term psychodynamic psychotherapy and cognitive-behavioral therapy in depression: a meta-analytic approach.

UNLABELLED: This article reviews the efficacy of short-term psychodynamic psychotherapy (STPP) in depression compared to cognitive-behavioral therapy (CBT) or behavioral therapy (BT). In this review, only studies in which at least 13 therapy sessions were performed have been included, and a sufficient number of patients per group were treated (N > or = 20). With regard to outcome criteria, the results were reviewed for improvements in depressive symptoms, general psychiatric symptoms, and social functioning. Six studies met the inclusion criteria. RESULTS: In 58 of the 60 comparisons (97%) performed in the six studies and their follow-ups, no significant difference could be detected between STPP and CBT/BT concerning the effects in depressive symptoms, general psychiatric symptomatology, and social functioning. Furthermore, STPP and CBT/BT did not differ significantly with regard to the patients that were judged as remitted or improved. According to a meta-analytic procedure described by R. Rosenthal (1991) the studies do not differ significantly with regard to the patients that were judged as remitted or improved after treatment with STPP or CBT/BT. The mean difference between STPP and CBT/BT concerning the number of patients that were judged as remitted or improved corresponds to a small effect size (post-assessment: phi = 0.08, follow-up assessment: phi = 0.12). Thus, STPP and CBT/BT seem to be equally effective methods in the treatment of depression. However, because of the small number of studies which met the inclusion criteria, this result can only be preliminary. Furthermore, it applies only to the specific forms of STPP that were examined in the selected studies and cannot be generalized to other forms of STPP. Further studies are needed to examine the effects of specific forms of STPP in both controlled and naturalistic settings. Furthermore, there are findings indicating that 16-20 sessions of both STPP and CBT/BT are insufficient for most patients to achieve lasting remission. Future studies should address the effects of longer treatments of depression.

Adult↗

PubMed1999

The negative impact of the cognitive movement on the continued growth of the behavior therapy movement: a historical perspective.

In recent years, a growing number of behavior therapists have expressed concern over the current state of the behavioral therapy movement. Some of the major problems raised center on current overload and fractionization, the lack of a coherent overall picture, the loss of identity, and the influx of cognitivism. In an attempt to enhance understanding of the factors responsible for the current crises in the behavior therapy field, the author provides a historical overview of the behavioral movement from its original conception to its current state. An argument is made that the solution to the afore-mentioned problems resides in the readoption of the underlying philosophy of science that originally gave birth and purpose to the field.

Behavioral Medicine↗

PubMed1980

[Results of behavior therapy in potency disorders (author's transl)].

There is no doubt that behavior therapy is sucessful in treating psychically-induced disturbances of sexual function in the male. It is decisive, however, that the sexual disturbances which are the expression of considerable partnership problems cannot be treated by a therapy which is directed to sexual problems. Then a partnership therapy is indicated. The majority of sexual disorders may, however, be accessible to the form of psychotherapy described with necessary individual changes which emerge from the behavior analysis. Behavior therapy can fulfil no exaggerated desire. Even if the very greatly reduced self-conceit can be rebuilt by restoration of sexual capacity, such a treatment is still no "fountain of youth", which will compensate other disappointments and dissatisfactions in life by a perhaps exaggerated sexuality.

Behavior Therapy↗

PubMed1992

Group rational-emotive and cognitive-behavioral therapy.

The theory of rational-emotive therapy (RET) and of cognitive-behavioral therapy (CBT) is briefly explained and is applied to group therapy. It is shown how RET and CBT therapy groups deal with transference, countertransference, levels of group intervention, process versus content orientation, identifying underlying group process themes, here-and-now activation, working with difficult group members, activity levels of therapist and group members, and other group problems. Although they particularly concentrate on people's tendencies to construct and create their own "emotional" difficulties, RET and CBT group procedures fully acknowledge the interactions of human thoughts, feelings, and actions and active-directively employ a variety of cognitive, emotive, and behavioral group therapy techniques.

Cognitive Behavioral Therapy↗

PubMed2006

[Significance of emotion-focused concepts to cognitive-behavioral therapy].

Emotions are the central process of motivation and play a key role in adaptive behavior in humans. Although cognitive-behavioral therapy stresses the importance of changing both cognition and behavior, there is growing emphasis on direct therapeutic work on emotions and emotional processing, as problematic emotional processes are at the core of nearly all psychic disorders. This type of work is the goal of emotion-focused psychotherapy, which centers on direct change of problematic emotions, especially those which are usually suppressed resp. overregulated by the patient. This paper examines the basic phobic/emotional conflict, the problematic emotional processes arising from this conflict, and the importance to cognitive-behavioral therapy of their potentially integrative role.

Adaptation, Psychological↗

PubMed2004

Cognitive-behavioral therapy for bulimia nervosa: an empirical analysis of clinical significance.

OBJECTIVE: The purpose of this review was to assess the clinical significance of cognitive-behavioral therapy for bulimia nervosa using the reliable change index and normative comparison analyses. METHOD: Fifteen treatment outcome studies using either individual or group cognitive-behavioral therapy for bulimia nervosa were selected for inclusion. RESULTS: Results suggest that cognitive-behavioral therapy for bulimia nervosa produces clinically significant change for many treatment outcome measures when using the reliable change index. However, posttreatment symptomatology is rarely within a normative range when examined with normative comparison analyses. DISCUSSION: This review provides a first step in examining the clinical significance of treatment for bulimia nervosa. Future studies should further this work by comparing the clinical significance of different types of treatment for bulimia nervosa using additional assessment measures.

Adult↗

PubMed1997

Cognitive-behavioral therapy for clinical pain control: a 15-year update and its relationship to hypnosis.

Since Tan's (1982) review of cognitive and cognitive-behavioral methods for pain control was published 15 years ago, significant advances have been made in cognitive-behavioral therapy for pain. The scientific evidence for its efficacy for clinical pain attenuation is now much more substantial and is briefly reviewed. In particular, cognitive-behavioral therapy for chronic pain was recently listed as one of 25 empirically validated or supported psychological treatments available for various disorders. A number of emerging issues are further discussed in light of recent developments and research findings. The relationship of cognitive-behavioral therapy to hypnosis for pain control is briefly addressed, with suggestions for integrating hypnotic and cognitive-behavioral techniques.

Cognitive Behavioral Therapy↗