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At least 127 records · Page 7Linked to original sources
PubMed2002

Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control.

BACKGROUND: The demand for effective behavior therapy for obsessive-compulsive disorder (OCD) by exposure and ritual prevention exceeds its supply by trained therapists. A computer-guided behavior therapy self-help system (BT STEPS) was created that patients access by telephone from home via interactive voice response technology. This study compared the value of computer-guided behavior therapy value with that of clinician-guided behavior therapy and systematic relaxation as a control treatment. METHOD: After screening by a clinician, 218 patients with DSM-IV OCD at 8 North American sites were randomly assigned to 10 weeks of behavior therapy treatment guided by (1) a computer accessed by telephone and a user workbook (N = 74) or (2) a behavior therapist (N = 69) or (3) systematic relaxation guided by an audiotape and manual (N = 75). RESULTS: By week 10, in an intent-to-treat analysis, mean change in score on the Yale-Brown Obsessive Compulsive Scale was significantly greater in clinician-guided behavior therapy (8.0) than in computer-guided (5.6), and changes in scores with both clinician-guided and computer-guided behavior therapy were significantly greater than with relaxation (1.7), which was ineffective. Similarly, the percentage of responders on the Clinical Global Impressions scale was significantly (p < .05) greater with clinician-guided (60%) than computer-guided behavior therapy (38%), and both were significantly greater than with relaxation (14%). Clinician-guided was superior to computer-guided behavior therapy overall, but not when patients completed at least 1 self-exposure session (N = 36 [65%]). At endpoint, patients were more satisfied with either behavior therapy group than with relaxation. Patients assigned to computer-guided behavior therapy improved more the longer they spent telephoning the computer (mostly outside usual office hours) and doing self-exposure. They improved slightly further by week 26 follow-up, unlike the other 2 groups. CONCLUSION: For OCD, computer-guided behavior therapy was effective, although clinician-guided behavior therapy was even more effective. Systematic relaxation was ineffective. Computer-guided behavior therapy can be a helpful first step in treating patients with OCD when clinician-guided behavior therapy is unavailable.

Adolescent↗
PubMed2006

Cognitive behavioral therapy for fibromyalgia.

Cognitive behavioral therapy (CBT) techniques offer short-term, goal-oriented psychotherapy. In this respect, it differs from classical psychoanalysis in emphasizing changes in thought patterns and behaviors rather than providing 'deep insight'. Importantly, the beneficial effects of CBT can be achieved in 10-20 sessions, compared with the many years required for classical psychoanalysis. Although CBT is often done on a one-to-one basis, it also lends itself to a group therapeutic setting. CBT was initially used in the treatment of mood disorders, but its use has subsequently been expanded to include various other medical conditions, including chronic pain states. Over the past 18 years, several chronic pain treatment programs have used CBT techniques in the management of fibromyalgia. In this review, the results from 13 programs using CBT, alone or in combination with other treatment modalities, are analyzed. In most studies, CBT provided worthwhile improvements in pain-related behavior, self-efficacy, coping strategies and overall physical function. Sustained improvements in pain were most evident when individualized CBT was used to treat patients with juvenile fibromyalgia. The current data indicate that CBT, as a single treatment modality, does not offer any distinct advantage over well-planned group programs of education or exercise, or both. Its role in the management of fibromyalgia patients needs further research.

Clinical Trials as Topic↗
PubMed1998

A controlled trial of desmopressin and behavioral therapy for nocturnal enuresis.

The combination of desmopressin (DDAVP) and behavioral therapy for treatment of nocturnal enuresis was compared with use of each of these modes alone. We randomly assigned 226 enuretic children being treated in primary care clinics of a major medical center in the largest health maintenance organization in Israel into 3 groups: Group A) DDAVP plus behavioral therapy (double-blind); Group B) behavioral therapy plus placebo (double-blind); and Group C) DDAVP alone (open group). DDAVP (20 micrograms/naris) and placebo were administered by intranasal spray. Both pharmacologic and behavioral therapy were initiated after a 2-week observation period and continued for 8 weeks. All patients were followed for 2 months after completion of treatment. A significant reduction in the number of wet nights/week was registered for all 3 groups: 49% in Group A, 45% in Group B, and 19% in Group C. After controlling for confounding factors, no significant difference in effect was noted among the 3 types of treatment during the trial period. However, on follow-up the results for the DDAVP patients were significantly less stable compared with the other 2 groups (p = 0.015). Minor side effects were registered, but none of the participants withdrew from the trial. To our knowledge, this is the largest randomized trial of nocturnal enuresis conducted to date. Our findings suggest that simply discussing the problem with the patient and family leads to improvement, and that behavioral therapy is also beneficial. DDAVP can help, but the relapse rate on discontinuation is high.

Adolescent↗
PubMedDate not supplied

[Behavior therapy in older adults].

Behavior therapy has up to now, only been applied to a limited degree to elderly people. Operant learning paradigma receive special meaning within the framework of intervention as well as theoretical explanation. Publications will be presented for the areas of social behavior, self care, motoric ability etc. according to their different techniques. It is remarkable that interest has only focused institutionalized elderly people with a high degree of incapacitation. In the following discussion the necessity for stronger consideration of the newer behavioral approach as well the latest developments in gerontology will be made clear.

Activities of Daily Living↗
PubMed2003

Therapist self-disclosure in cognitive-behavior therapy.

Although cognitive-behavior therapy emphasizes between-session change, therapist self-disclosure within the session can be an effective tool for strengthening the therapeutic bond and facilitating client change. After noting the use of self-disclosure in other theoretical orientations, we place self-disclosure in the context of cognitive-behavioral theories of reinforcement and modeling. Clinical vignettes illustrate the use of therapist self-disclosure to provide feedback on the interpersonal impact made by the client, enhance positive expectations and motivation, strengthen the therapeutic bond, normalize the client's reaction, reduce the client's fears, and model an effective way of functioning. Therapists need to observe appropriate boundaries when self-disclosing, and in particular, should consider their own motivations for self-disclosing. Although more research is needed on the effects of self-disclosure, cognitive-behavior therapists have found that self-disclosure can be a powerful intervention.

Cognitive Behavioral Therapy↗
PubMed1975

The role of attribution and self-perception in behavior change: implications for behavior therapy.

In this report extrapolations were made to behavior therapy from two related lines of social-psychological research: attribution and self-perception. A review of the relevant research literature on attribution suggested that (a) the perception and causal attribution of physiological arousal is an important determinant of emotional behavior and (b) self-attribution of behavior change increases the likelihood of maintenance of that change. A review of research concerned with Bem's self-perception theory indicated that inferences arising from self-observation of one's own overt behaviors may affect subsequent behavior, attitudes, and beliefs. These two lines of research converge in suggesting that an individual's perception of himself (in terms of overt behavior, situational circumstances, and physiological states) may have a marked influence on behavior change and the maintenance of that change. In the major body of this paper the implications of this research are discussed, particularly in terms of new procedures and specific modifications for existing procedures in behavior therapy. The major areas of behavior therapy discussed include: (a) behavioral assessment; (b) role playing (behavior rehearsal); (c) operant procedures; and (d) self-control strategies. Emphasis was placed upon treating the specific implications delineated as hypotheses requiring empirical investigation in the clinical arena. Strategies for such research were outlined.

Behavior Therapy↗
PubMedDate not supplied

[Treatment of a case of chronic obsessive troubles through combined behavioral therapy (author's transl)].

Behavior therapy of a young man, suffering from grave obsessive and compulsive troubles is the first example of combined therapy, with individual therapy, family therapy as group therapy. Two steps are find in the cure. There are benefits--trust and hope--due to psychiatric hospitalization and generous and constant affection of the sponse. The sponse was the key of reciprocal inhibition necessary to the control of anxieties due to the treatment. The aim reached was the control of obsessions and compulsions lasting for more than sixteen years.

Adult↗
PubMed2005

Methodological issues in clinical trials of drug and behavior therapies.

Trials that compare drug and behavior therapies or evaluate combination therapy raise special methodological issues. This article reviews these methodological issues and, where possible, offers guidelines for addressing them. Sources of bias in the selection and recruitment of participants and in the measurement of treatment outcomes are discussed. In addition, methodological problems presented by the differing structures of behavior and drug therapy, by confounding variables, such as allegiance effects, differential expectations and preferences for drug or behavior therapy, and differential adherence with drug or behavior therapy also are reviewed. Issues in the selection of appropriate control groups are also discussed.

Behavior Therapy↗
PubMed2004

Choosing a behavioral therapy platform for pharmacotherapy of substance users.

Behavioral therapy platforms have become virtual requirements in pharmacotherapy trials due to their utility in reducing noise variability, preventing differential medication adherence and protocol attrition, enhancing statistical power and addressing ethical issues in placebo-controlled trials. Selecting an appropriate behavioral platform for a particular trial requires study-specific tailoring, taking into account both the stage of development of the medication being evaluated, as well as the specific strengths and weaknesses of a broad array of available empirically supported behavioral therapies and the range of their possible targets (e.g., enhancing medication adherence, preventing attrition, addressing co-morbid problems, fostering abstinence, and targeting specific weaknesses of the pharmacologic agent). Choosing a suitable behavioral platform also requires consideration of the characteristics of the population to be treated, stage of scientific knowledge regarding the medication's effects, appropriate balance of internal and external validity, and consideration of potential ceiling effects. Available manualized behavioral treatments are reviewed, noting their strengths and limitations as behavioral therapy platforms for pharmacotherapy trials and as potential concomitant therapies in clinical practice.

Behavior Therapy↗
PubMed2006

Cognitive behavior therapy for schizophrenia.

OBJECTIVE: A growing body of evidence supports the use of cognitive behavior therapy for the treatment of schizophrenia. A course of cognitive behavior therapy, added to the antipsychotic regimen, is now considered to be an appropriate standard of care in the United Kingdom. The objective of this article is to offer a broad perspective on the subject of cognitive behavior therapy for schizophrenia for the American reader. METHOD: The authors summarize current practice and data supporting the use of cognitive behavior therapy for schizophrenia. RESULTS: Five aspects of cognitive behavior therapy for schizophrenia are addressed: 1) evidence from randomized clinical trials, 2) currently accepted core techniques, 3) similarities to and differences from other psychosocial interventions for schizophrenia, 4) differences between the United States and United Kingdom in implementation, and 5) current directions of research. CONCLUSIONS: The strength of the evidence supporting cognitive behavior therapy for schizophrenia suggests that this technique should have more attention and support in the United States.

Antipsychotic Agents↗
PubMed2003

Problems and solutions: two concepts of mankind in cognitive-behavior therapy.

Scientific theories that are concerned with experience and behavior of human beings always include anthropological core assumptions. This applies in particular to psychotherapeutic theories. These anthropological core assumptions (i.e., concepts of mankind) affect techniques that are derived from these theories but they also have a great influence on acceptance and spreading of psychotherapeutic methods. This article examines the concept of mankind in cognitive-behavior therapy. In this connection two highly differing conceptions of the human being are identified: the early behavioristic black-box model and the conception of the human being as an actively performing subject ("man the scientist") in the framework of the self-management approach and in cognitive therapy. The image problem of today's behavior therapy, the lack of application of efficient methods of behavior therapy and problems in finding a professional identity as a behavior therapist can be seen as stemming from the differing concepts of mankind. To solve these problems we propose: an integrative concept of mankind, an increased emphasis of a cooperative therapist-patient relationship, and the taking into account of unconscious processes.

Anthropology, Cultural↗
PubMed1997

Cognitive behavior therapy for chronic fatigue syndrome: a randomized controlled trial.

OBJECTIVE: Cognitive behavior therapy for chronic fatigue syndrome was compared with relaxation in a randomized controlled trial. METHODS: Sixty patients with chronic fatigue syndrome were randomly assigned to 13 sessions of either cognitive behavior therapy (graded activity and cognitive restructuring) or relaxation. Outcome was evaluated by using measures of functional impairment, fatigue, mood, and global improvement. RESULTS: Treatment was completed by 53 patients. Functional impairment and fatigue improved more in the group that received cognitive behavior therapy. At final follow-up, 70% of the completers in the cognitive behavior therapy group achieved good outcomes (substantial improvement in physical functioning) compared with 19% of those in the relaxation group who completed treatment. CONCLUSIONS: Cognitive behavior therapy was more effective than a relaxation control in the management of patients with chronic fatigue syndrome. Improvements were sustained over 6 months of follow-up.

Adult↗
PubMed1977

[Possibilities of behavior therapy in childhood].

The author, after discussing methods of conditioning and their theoretical substantiation, describes the behavior disorders, forms of malconduct, and development disorders where methods of behavior therapy have so far been made successful use of. Possibilities of, and technical problems associated with, the treatment of nocturnal enuresis are discussed in addition to methods of treatment of autistic, electively mutistic, and stuttering children. Also discussed in this paper are methods of behavior therapy of states of anxiety, phobias, and hypermotor conditions as well as the instruction of educators in the use methods developed on the lines of behavior therapy. Behavior therapy is characterized as a form of psychotherapy which cannot replace general pedagogic influences.

Autistic Disorder↗
PubMed2004

[Clinical efficacy of Viagra with behavior therapy against premature ejaculation].

OBJECTIVE: To study the efficacy of Viagra combined with behavior therapy against premature ejaculation (PE). METHODS: Sixty PE patients were divided into two groups randomly: control group (behavior therapy alone) and the group of Viagra combined with behavior therapy. Intra-vaginal ejaculation latency time (IELT) and the coitus satisfaction of the patient and the partner were recorded before and after treatment. RESULTS: The IELTs of the two groups were 0.80 +/- 0.20 and 0.73 +/- 0.24 minutes respectively before treatment, and 1.82 +/- 0.54 and 3.63 +/- 0.55 minutes respectively after treatment. As for IELT and satisfaction degree, Viagra produced better result than behavior therapy. CONCLUSION: During this clinical trial, Viagra combined with behavior therapy prolonged IELT, which suggests that Viagra may be helpful for the treatment of premature ejaculation.

Adult↗