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PubMed1991

Behavioral therapy for temporomandibular disorders.

Temporomandibular disorders are varied in terms of etiology, pathophysiology, chronicity, and the disability they involve. The majority of adults in the Western world have some minor symptoms of these disorders, but only about 5% need treatment. Reversible therapies, including medication, physical therapy, behavioral therapy, and bite appliances, are popular today because of the lack of knowledge concerning the natural course of the disorders and the long-term effects of nonreversible treatments. Review articles and published guidelines generally support the use and efficacy of behavioral therapies for temporomandibular disorders. However, because these results are based on studies with methodical weaknesses, the recommendations must be viewed with caution, and further study must be conducted.

Behavior Therapy↗
PubMed1981

Comments about cognitive therapy and behavior therapy.

This article identifies, describes and discusses two major sources of controversy between cognitive therapists and behavior therapists. One class of conflict has been generated by specific misinterpretations of opposing viewpoints. Appropriate quotations are used in an attempt to clarify the views of the major protagonists. The other source of conflict is the metaphysical issue of mind-body dualism and differing definitions of psychology. After discussing justifications for renewed research on cognitive interactions and the major behaviorist objections to such an effort, the author recommends intensified applications of behavioral technology in the socio-economic and political arena.

Behavior Therapy↗
PubMed1981

A systems analysis of psychobiology and behavior therapy. Implications for behavioral medicine.

This article examines some basic principles of systems theory and applies them to the integration of psychobiology and behavior therapy in the evolution of behavioral medicine. Using the concepts of whole/part relationships, level and emergent property, and self-regulation and disregulation, it is proposed that all behavioral therapies involve psychobiological processes, and therefore, indirectly impinge on physical health. It is argued that the distinction between behavior and biology is one of level, and, therefore, behavioral therapies are ultimately biobehavioral therapies having biobehavioral consequences. It is proposed that contrary to traditional reductionistic logic, modern advances in biology are providing strong justification for the importance of including psychological methods in treating diseases manifested at the biological level. Various clinical examples are used to demonstrate how systems theory can be applied to differential diagnosis and treatment, computing cost/benefit ratios of different treatments, and conducting comprehensive clinical research and evaluation. Assessing the interaction of biological, psychological, and social treatment modalities becomes the hallmark of responsible patient care. Implications of the systems conception of behavioral medicine for collaboration among health care providers, the training of future clinicians in different disciplines, and policy decisions regarding the larger social consequences of health care are considered.

Behavior Therapy↗
PubMedDate not supplied

A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder.

BACKGROUND: The study was designed to compare cognitive therapy (CT) with intensive behavior therapy (BT) in obsessive-compulsive disorder (OCD) and to study their change process. METHODS: Sixty-five outpatients with DSM-4 OCD were randomized into 2 groups for 16 weeks of individual treatment in 3 centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20 h in two phases: 4 weeks of intensive treatment (16 h), and 12 weeks of maintenance sessions (4 h). No medication was prescribed. RESULTS: Sixty-two patients were evaluated at week 4, 60 at week 16 (post-test), 53 at week 26 and 48 at week 52 (follow-up). The response rate was similar in the 2 groups. The Beck Depression Inventory (BDI) was significantly more improved by CT (p = 0.001) at week 16. The baseline BDI and Obsessive Thoughts Checklist scores predicted a therapeutic response in CT, while the baseline BDI score predicted a response in BT. At week 16, only the changes in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a scale measuring the interpretation of intrusive thoughts correlated in CT, while the changes in Y-BOCS, BDI, and interpretation of intrusive thoughts correlated in BT. Improvement was retained at follow-up without a between-group difference. The intent-to-treat analysis (last observation carried forward) found no between-group differences on obsessions, rituals and depression. CONCLUSIONS: CT and BT were equally effective on OCD, but at post-test CT had specific effects on depression which were stronger than those of BT. Pathways to improvement may be different in CT and BT. The outcomes are discussed in the light of an effect size analysis.

Adult↗
PubMed1997

The future of behavior therapy.

Although behavior therapy is designed to modify observable behaviors, it also brings about cognitive change. To achieve the best results with behavior therapy, it is sometimes necessary to combine it with cognitive procedures. The author gives examples of the uses of behavior therapy on its own and as combined cognitive-behavior therapy. These treatments have been tested extensively in clinical trials, and they are brief and highly suitable for use in managed care. Future developments are likely to include closer integration with pharmacotherapy and further extension into the field of behavioral medicine.

Behavior Therapy↗
PubMed1989

Hospital-based behavior therapy services.

Behavior therapy has been underutilized in the private psychiatric hospital setting. A recent survey of member hospitals of the National Association of Private Psychiatric Hospitals (NAPPH) found that fewer than 25 percent of those surveyed provided behavior-therapy consultation for inpatients and fewer than 40 percent had a behavior therapist on staff (1). This situation is unfortunate because behavior therapy has made significant contributions to the mental health field, and the approach offers a research-based system of accountability and cost-efficiency. Moreover, behavior therapy is applicable to a wide range of psychiatric problems, and its methods and procedures provide a practical and effective complement or alternative to a patient's pharmacotherapy and insight-oriented psychotherapy. Clearly, behavior therapy has much to offer the private psychiatric hospital, and this contribution is gradually being recognized. This paper describes the development and growth of a behavioral-consultation and treatment program in a private psychiatric hospital.

Behavior Therapy↗
PubMed1992

Risk management in the practice of behavior therapy: boundaries and behavior.

Behavior therapy represents a treatment modality widely utilized by clinicians but to date insufficiently examined from the risk-management standpoint. Given that the determination of negligence is dependent on the role of the therapist as proximate cause of the adverse outcome and on the availability of an accepted standard of care from which deviations can be specified, a number of general characteristics of behavior therapy may render its practitioners potentially vulnerable to litigation. These may include its directiveness, its replicability, and its methodologic rigor. Similarly, certain specific behavioral techniques may carry some medicolegal risks, including the use of aversion methods, utilization of family members or other lay cotherapists, response cost, and exposure therapies. In addition, therapeutic boundaries in behavioral treatment may be different from those in psychoanalytic therapy, allowing for therapist practices that might otherwise be considered unusual or in themselves negligent, but the therapist may have a heavier burden of justification in such cases. The authors suggest that recognition of the possibility of adverse results, ongoing and competent informed consent, adequate documentation, willingness to consult, and careful monitoring of treatment outcome may help mitigate the medicolegal risks of these procedures.

Behavior Therapy↗
PubMed2002

Family therapy and dialectical behavior therapy with adolescents: Part I: Proposing a clinical synthesis.

Although the practice of family therapy in dialectical behavior therapy (DBT) with multiproblem suicidal adolescents is common and generally indicated, a particular model has yet to be delineated with this age group. The purpose of this article is to propose a coherent clinical synthesis of the more individually oriented DBT strategies with a broader family-systems orientation that maintains the integrity of both theoretical approaches while addressing the treatment needs of adolescents and their families. First, the authors briefly review the literature. Second, they describe the core dialectic of DBT, balancing acceptance and change, and its relevance to family therapy. Finally, the authors propose several specific acceptance and change strategies useful when implementing DBT family therapy with multi-problem adolescents.

Adolescent↗
PubMed1998

[Psychological concepts in pain therapy practice. 2: Behavior therapy, self-management and overview of cognitive interventions].

In this part, the contribution of cognitive behavior therapy and the self management approach in psychological pain therapy is presented. A five-step-model of cognitive behavior is explained. The different steps are diagnostics, development of a new cognitive model of the disorder, acquisition of coping strategies, applications, transfer and relapse prevention. Focus of this paper are the coping strategies, thus, the interventions in confrontation with a pain stimulus. The self management approach has the goal to enable the patient to use coping strategies as quickly as possible by himself and to support the self-regulation of the patient. At the end, a survey about cognitive self-control strategies is given.

Adaptation, Psychological↗