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Results for “Behavior Therapy”

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PubMed1992

Applying the Collaborative Study Psychotherapy Rating Scale to rate therapist adherence in cognitive-behavior therapy, interpersonal therapy, and clinical management.

Adherence of therapists to behaviors specified in cognitive-behavior therapy, interpersonal therapy, and clinical management manuals was studied. Raters used the Collaborative Study Psychotherapy Rating Scale (CSPRS) to rate therapist adherence in each of four sessions from 180 patients in the treatment phase of the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP). Results indicate that therapists exhibited more behaviors appropriate to their own respective treatment approaches than to other treatment approaches. In fact, the three treatments could be discriminated almost perfectly using the CSPRS. Analysis of the psychometric properties of the CSPRS revealed high interrater reliability and high internal consistency. However, a five-component structure extracted from the intercorrelations of the CSPRS items was substantially different from a five-factor structure found in an earlier study.

Cognitive Behavioral Therapy↗

PubMed2005

Cognitive changes, critical sessions, and sudden gains in cognitive-behavioral therapy for depression.

Using an independent cognitive-behavioral therapy (CBT) data set, the authors replicated T. Z. Tang and R. J. DeRubeis' (1999) discovery of sudden gains--sudden and large decreases in depression severity in a single between-session interval. By incorporating therapy session transcripts, the authors of this study improved the reliability of the Patient Cognitive Change Scale to .75 and found that these CBT sudden gains were also preceded by substantial cognitive changes in the pregain sessions.

Awareness↗

PubMed1993

Behavior therapy for obsessive compulsive disorder in the office-based practice.

The article provides guidance for the clinician in applying scientifically proven behavior therapy techniques for obsessive compulsive disorder. Rationale for considering behavior therapy for all patients with OCD is presented, along with guidelines for determining an adequate trial of this approach and for predicting if a particular patient is likely to benefit.

Ambulatory Care↗

PubMedDate not supplied

Randomized trial of cognitive behavior therapy versus supportive psychotherapy for HIV-related peripheral neuropathic pain.

The feasibility and acceptability of cognitive behavior therapy for HIV-related peripheral neuropathic pain was examined and the potential efficacy of the intervention was compared with that of supportive psychotherapy in reducing pain, pain-related interference with functioning, and distress. Sixty-one patients were randomly assigned to receive six weekly sessions of cognitive behavior therapy or supportive psychotherapy. Thirty-three subjects completed the protocol. Both groups showed significant reductions in pain. The cognitive behavior group improved in most domains of pain-related functional interference and distress; the supportive psychotherapy group showed fewer gains. The high dropout rate suggests that psychotherapeutic treatments for HIV-related pain may have limited feasibility and acceptability.

Cognitive Behavioral Therapy↗

PubMed1999

Cognitive-behavioral therapy for bulimia nervosa: an illustration.

Cognitive-behavioral therapy for bulimia nervosa (BN) is a well-developed, theoretically grounded treatment for BN with the strongest empirical support for its efficacy of any form of treatment for BN. The treatment package comprises three distinct phases typically delivered over 20 weeks. Incorporating a variety of specific interventions, these three phases of treatment focus systematically on (i) dietary restraint, (ii) dysfunctional beliefs about body weight and shape, and (iii) reactions to recurrence of symptoms, which are thought to be the primary operative mechanisms that cause and maintain BN symptoms. Case material is presented to illustrate cognitive-behavioral treatment principles.

Adult↗

PubMed1994

Alcoholics Anonymous and behavior therapy: can habits be treated as diseases? Can diseases be treated as habits?

Alcoholics Anonymous (AA) and behavior therapy have often been characterized as having opposing views of the nature and treatment of alcohol problems. This article describes the theoretical foundations, view of the change process, and treatment practices of AA and behavior therapy. Theoretical and practice perspectives on integration of the two models are examined, and advantages and disadvantages of integration are discussed.

Adult↗

PubMed1998

Combined pharmacotherapy and cognitive behavior therapy in the treatment of panic disorder.

Cognitive behavior therapy (CBT) has been combined with pharmacotherapy in the treatment of panic disorder in three ways: (1) to treat agoraphobic symptoms in the condition of panic with agoraphobia; (2) to reduce withdrawal effects during drug taper; and (3) to treat panic attacks. Exposure treatment and pharmacotherapy have a modest additive effect, although more patients drop out of exposure therapy combined with imipramine treatment compared with exposure therapy alone. CBT reduces symptoms of withdrawal from alprazolam and other benzodiazepines and improves the outcome of drug treatment. At present, sufficient data are not available to determine whether the effects of CBT combined with drug therapy are additive in treating panic disorder. The results of a large trial are awaited. Current CBT consists of 12 sessions and is not widely offered to patients because of cost considerations. Efforts are being made to decrease the number of sessions necessary by improving cognitive techniques. One of these models is the subject of an ongoing trial. Finally, efforts to educate and counsel patients in the clinical setting regarding the psychopathology of panic attacks may improve the outcome of pharmacotherapy.

Agoraphobia↗

PubMed1990

Therapeutic techniques vs therapeutic relationships in child behavior therapy.

The parents of 56 children who had received behavior therapy rated a number of variables, including the degree to which they viewed the therapeutic relationship versus the specific techniques used in treatment as important, the extent to which the child improved in therapy, and the child's present functioning. Therapists also provided ratings of clinical improvement. Even though parents gave the highest ratings for the importance of the relationship in therapy, the correlation between technique and clinical outcome was statistically significant while the correlations between the relationship and outcome was not. These statistical associations also held when therapists rated improvement. Also, therapists saw greater improvement in children than did the parents. Over-all, the results support the view that the relationship and techniques are interwoven and are both perceived as important factors in treatment.

Adolescent↗

PubMed2006

Cognitive behavioral therapy for depression in youth.

Without question, cognitive behavioral therapy (CBT) is the most studied non-pharmacological intervention for the treatment of depression in youth, with over 80% of published psychotherapy trials testing the effects of CBT protocols. Until quite recently, CBT also was widely proclaimed to be a highly effective intervention for youth depression, albeit with stronger data for adolescent than for child samples. However, within the past two years, a series of new findings have complicated this previously rosy picture of CBT. The most well-known results come from the Treatment of Adolescents with Depression Study (TADS, 2004). In the TADS investigation, CBT failed to outperform a pill placebo, while active medication treatments (fluoxetine alone and fluoxetine-plus-CBT) produced strong and consistent effects. In this article, the authors strive to make sense of these seemingly conflicting findings, provide direction for the appropriate use of CBT in practice given the current evidence base, and suggest areas of additional investigation that may help to clarify the current confusion on the effects of CBT.

Adaptation, Psychological↗

PubMed2002

Context in the clinic: how well do cognitive-behavioral therapies and medications work in combination?

Cognitive-behavioral therapy (CBT) and pharmacotherapy demonstrate efficacy across the anxiety disorders, but recognition of their limitations has sparked interest in combining modalities to maximize benefit. This article reviews the empirical literature to examine whether combining treatments influences efficacy of either monotherapy. We conducted a comprehensive literature search of published randomized trials that compared combined treatment with pharmacologic or CBT monotherapies. Ten studies that met our inclusion criteria were reviewed in detail, and within-subjects effect sizes were calculated to compare treatment conditions within and across studies. At posttreatment and follow-up, effect size and percentage responder data failed to clearly demonstrate an advantage or disadvantage of combined treatment over CBT alone for obsessive-compulsive disorder, social phobia, and generalized anxiety disorder. Some advantage of combined treatment over pharmacotherapy alone emerged from the few studies that allowed for such a direct comparison. In contrast, combined treatment for panic disorder seems to provide an advantage over CBT alone at posttreatment, but is associated with greater relapse after treatment discontinuation. The advantage of combined treatment may vary across the anxiety disorders. The potential differences in usefulness of combined treatment are discussed, directions for future research are suggested, and implications for clinical practice are considered.

Anxiety Disorders↗

PubMed2006

Is symptomatic improvement in clinical trials of cognitive-behavioral therapy for psychosis clinically significant?

Although cognitive-behavioral therapy (CBT) is becoming increasingly popular as an adjunctive treatment for psychosis, few studies to date have examined the clinical (in contrast to statistical) significance of treatment gains using standardized methods. The aim of the current study was to investigate the clinical significance of symptomatic reductions reported in trials of CBT for schizophrenia and related disorders using standardized group methods of analysis. An electronic literature search identified 12 studies that met the inclusion criteria of being randomized, controlled trials that compared CBT to routine care alone or to another comparison treatment. The analysis involved the following steps. First, reliable change on symptom measures was examined. Next, the proportion of patients in each study estimated to show clinically significant symptomatic reductions (i.e., two standard deviations) was calculated. When both post-treatment and follow-up data were considered, 42% of CBT conditions compared with only 25% of comparison conditions demonstrated reliable change on at least one psychotic symptom measure per study. Proportions of clinically significant symptomatic improvement in studies showing reliable change were similar between CBT and comparison conditions. Due to the adjunctive nature of CBT for schizophrenia and the limits imposed by the evaluation of group datasets, results of the current study are considered promising but preliminary. Future trials should examine clinical significance using similar standardized methods within studies, as well as broader functional outcome measures, to provide a clearer picture of the benefits derived from this type of intervention.

Cognitive Behavioral Therapy↗

PubMed1978

Behavior therapy and the treatment of flight phobia.

Research since 1960 was reviewed to compare the relative efficacy of behavior therapy and other therapy modalities in the treatment of flight phobias in trained military aircrew, commercial flight crews, and civilian air travellers. Results indicated that treatment programs involving behavior therapy techniques appeared to have a higher success rate than treatment programs not involving these techniques, especially in cases of focal fear with acute onset under stressful conditions. Other conditions for optimal outcome are outlined and hypotheses for a more programmatic research effort discussed.

Aerospace Medicine↗

PubMed1993

Effectiveness of combined triazolam-behavioral therapy for primary insomnia.

The authors examined sleep improvement in subjects with primary insomnia who received triazolam plus behavioral therapy (N = 8) or triazolam plus sleep-related information (N = 7). At follow-up, total sleep and restedness in the morning showed greater improvement with combined triazolam-behavioral therapy and returned toward baseline in the control subjects.

Adult↗

PubMed1997

A randomized controlled trial of fluoxetine and cognitive behavioral therapy for bulimia nervosa: short-term outcome.

This study compared and combined fluoxetine and individual cognitive behavioral therapy in the treatment of bulimia nervosa. Participants were 76 women who sought treatment at the Eating Disorders Program of the Toronto Hospital and who met DSM-III-R criteria for bulimia nervosa. Subjects were randomly assigned to receive fluoxetine alone, cognitive behavior therapy alone, or the two in combination and were treated over 16 weeks. Short-term outcome revealed that all three treatment conditions were associated with clinical improvement across a wide range of parameters. The combination of pharmacotherapy and psychotherapy was superior to pharmacotherapy alone on specific parameters and there was no statistically significant advantage to the combination over psychotherapy alone. Limitations to the study include the absence of a placebo pill group and a waiting list control group as well as a substantial dropout rate across all three treatment conditions.

Adolescent↗

PubMed1993

Clomipramine in the treatment of agoraphobic inpatients resistant to behavioral therapy.

BACKGROUND: Both behavior-modification methods and antidepressants have proved to be effective in the treatment of agoraphobia. The authors examined the effects of clomipramine on agoraphobia in patients who failed to respond to exposure-based behavioral treatment. METHOD: Eighteen patients with panic disorder with agoraphobia who had not responded to previous inpatient behavioral treatment were recruited to a 12-week, placebo-controlled, double-blind crossover study of clomipramine, at top doses of 150 mg/day for 3 weeks. The patients were assessed on measures of phobic avoidance, agoraphobic cognitions, panic, state and trait anxiety, subjective anxiety, and depression. RESULTS: One patient dropped out of the study after 6 weeks. On most outcome measures, the 17 study completers had significantly (p < .05) lower symptom scores at posttest in the active drug period than at posttest in the placebo period; however, the clinical gains were modest. CONCLUSION: The short-term efficacy of clomipramine for agoraphobic patients who failed to respond lastingly to behavioral treatment was demonstrated. It remains to be shown that clomipramine can lead to clinically significant and lasting benefits in these patients.

Adult↗

PubMedDate not supplied

[Behavior therapy of onchophagia and trichotillomania. Ethological and behavioral perspectives].

Emphasis is brought to similarities between informations collected from the study and treatment of patients suffering from nail biting and trichotillomania, by behavioural treatment and the concept according to which such troubles are "tics", learned responses which will become non adapted, present in a given situation, reinforced by time and progressively more resistant to extinction on the one hand, and ethological concepts which consider those behaviours as displacement of activity such as "grooming" in primates, ritual activities, free from nutritions activities, triggered by some attitudes and facilitated by the presence of fear affects, aggressivity or sexual drive.

Behavior Therapy↗

PubMed1994

Dialectical behavior therapy for borderline personality disorder: theoretical and empirical foundations.

Dialectical behavior therapy (DBT) is a cognitive-behavioral psychotherapy developed by Linehan for parasuicidal patients with a diagnosis of borderline personality disorder (BPD). DBT is based on a biosocial theory that views BPD as primarily a dysfunction of the emotion regulation system. The treatment is organized around a hierarchy of behavioral goals that vary in different modes of therapy. In two randomized trials, DBT has shown superiority in reducing parasuicide, medical risk of parasuicides, number of hospital days, dropout from treatment and anger while improving social adjustment. Most gains were maintained through a 1-year follow-up. In one process study testing DBT theory, dialectical techniques balancing acceptance and change were more effective than pure change or acceptance techniques in reducing suicidal behavior.

Borderline Personality Disorder↗

PubMed2001

Evaluation of manual-based cognitive-behavioral therapy for bulimia nervosa in a service setting.

In the present study manual-based cognitive-behavioral therapy for bulimia nervosa was evaluated on an unselected sample of an out-patient service facility. A total of 73 female patients who asked for treatment received the primary diagnosis of bulimia nervosa. Of these, 67 took up treatment. Treatment was completed by 66 patients. Outcome variables were the number of binge episodes along with questionnaire scores for restraint eating, emotional eating, body dissatisfaction and depressiveness. At the end of treatment and 1 year after the end of treatment significant improvements were found in all outcome variables. Effect sizes for outcome variables were within the range of those of controlled research. Therefore, the present study delivered empirical evidence that manual-based cognitive-behavioral therapy is an effective treatment for bulimia nervosa not only within the restricted area of research.

Adolescent↗