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PubMed2004

[Nurses' assertiveness training and cognitive therapy experiences with an outpatient suffering from low self-esteem].

The experiences during nine meetings with a psychotherapy outpatient suffering from low self-esteem between 1/1/02 to 4/10/02. Using comprehensive nursing assessment practices for guidance, two conclusions were arrived at regarding the patient's mental health: a) an imbalance in individual response ability, and b) long-term problems with low self-esteem. This assessment was used to help the authors practice appropriate nursing skills associated with assertiveness training and cognitive therapy and to establish a trusting, caring, and accepting relationship with the client. The treatment plan included attempts to increase personal confidence and to promote suitable skills for improving living functions, enhancing relationships, and practicing social behavior.

Adult↗
PubMed1992

Frame-of-reference training and cognitive categorization: an empirical investigation of rater memory issues.

We considered the effects of frame-of-reference (FOR) training on raters' ability to correctly classify ratee performance as well as their ability to recognize previously observed behaviors. The purpose was to examine the cognitive changes associated with FOR training to better understand why such training generally improves rating accuracy. We trained college students (N = 94) using either FOR or control procedures, had them observe three managers on videotape, and rate the managers on three performance dimensions. Results supported our hypotheses that, compared with control training, FOR training led to better rating accuracy and better classification accuracy. Also consistent with predictions, FOR training resulted in lower decision criteria (i.e., higher bias) and lower behavioral accuracy on a recognition memory task involving impression-consistent behaviors. The implications of these results are discussed, particularly in terms of the ability of FOR-trained raters to provide accurate performance feedback to ratees.

Adult↗
PubMedDate not supplied

Group social skills training or cognitive group therapy as the clinical treatment of choice for generalized social phobia?

This study focused on determining whether group social skills training (SST) or cognitive-behavioral group therapy (CBT) works best to treat social anxiety in psychiatric patients. Participants were psychiatric outpatients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of generalized social phobia (GSP). A matching procedure was used to obtain two equivalent samples in both conditions (N = 48). It was shown that both SST and CBT were effective in reducing social and general anxiety, decreasing the severity of psychopathology and increasing social skills and self-control. As for differential effects, patients participating in SST experienced a significantly greater reduction of social anxiety and a greater increase in social skills than those in CBT. Moreover, it was shown that social anxiety and social skills scores of the SST group at follow-up reached the level of a normal reference group, whereas those of the CBT participants improved only to that of nonsocially anxious patients with anxiety disorders. Finally, it was revealed that commitment to and satisfaction with treatment of participants in both conditions did not differ. Keeping in mind that this was a quasiexperimental study, the authors concluded that in a clinical setting, group SST may be the best way to treat psychiatric patients with GSP, where comorbidity is the rule rather than the exception.

Adult↗
PubMed1998

Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.

This study assessed the effects of training on the performance of 65 therapists in delivering manual-guided therapies to 202 cocaine-dependent patients. Changes in ratings of therapists' adherence and competence was assessed in 3 treatment modalities: supportive-expressive dynamic therapy (SE), cognitive therapy (CT), and individual drug counseling. Effects of manual-guided training on the therapeutic alliance were also assessed. Training effects were examined through a hierarchical linear modeling approach that examined changes both within cases and across training cases. A large effect across cases was detected for training in CT. Supportive-expressive therapists and individual drug counselors demonstrated statistically significant learning trends over sessions but not over training cases. Training in SE and CT did not have a negative impact on the therapeutic alliance, although alliance scores for trainees in drug counseling initially decreased but then rebounded to initial levels.

Adult↗
PubMed1999

Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations.

A randomized controlled trial was conducted to compare the efficacy of clinical hypnosis versus cognitive behavioral (CB) coping skills training in alleviating the pain and distress of 30 pediatric cancer patients (age 5 to 15 years) undergoing bone marrow aspirations. Patients were randomized to one of three groups: hypnosis, a package of CB coping skills, and no intervention. Patients who received either hypnosis or CB reported less pain and pain-related anxiety than did control patients and less pain and anxiety than at their own baseline. Hypnosis and CB were similarly effective in the relief of pain. Results also indicated that children reported more anxiety and exhibited more behavioral distress in the CB group than in the hypnosis group. It is concluded that hypnosis and CB coping skills are effective in preparing pediatric oncology patients for bone marrow aspiration.

Adaptation, Psychological↗
PubMed1997

Effect of cognitive-behavioural training on job-finding among long-term unemployed people.

BACKGROUND: The principles of cognitive-behavioural therapy (CBT) have been applied successfully through individual psychotherapy to several psychiatric disorders. We adapted these principles to create a group--training programme for a non-psychiatric group-long-term (> 12 months) unemployed people. The aim was to investigate the effects of the programme on measures of mental health, job-seeking, and job-finding. METHODS: 289 volunteers (of standard occupational classification professional groups) were randomly assigned to a CBT or control programme, matched for all variables other than specific content, that emphasised social support. 244 (134 CBT, 110 control) people started the programmes and 199 (109 CBT, 90 control) completed the whole 7 weeks of weekly 3 h sessions (including three CBT, seven control participants who withdrew because they obtained employment or full-time training). Questionnaires completed before training, on completion, and 3-4 months later (follow-up data available for 94 CBT, 89 control) assessed mental health, job-seeking activities, and success in job-finding. Analyses were based on those who completed the programmes. Participants were not aware that two interventions were being used. Investigators were aware of group allocation, but were accompanied in all programmes by co-trainers who were non-investigators. FINDINGS: Before training, 80 (59%) CBT-group participants and 59 (54%) controls scored 5 or more on the general health questionnaire (GHQ; taken to define psychiatric caseness). After training, 29 (21%) and 25 (23%), respectively, scored 5 or more (p < 0.001 for both decreases). Improvements in mean scores with training on the GHQ (between-group difference 3.91, p = 0.05) and in other measures of mental health were significantly greater in the CBT group than in the control group. There were no significant differences between the groups in job-seeking activity during or after training, but significantly more of the CBT group than of the control group had been successful in finding full-time work (38 [34%] vs 13 [13%], p < 0.001), by 4 months after completion of training. INTERPRETATION: These results suggest that group CBT training can improve mental health and produce tangible benefits in job-finding. Application of CBT among the unemployed is likely to benefit both individuals and society in general.

Adult↗
PubMed1989

Cognitive impulsivity training: the effects of peer teaching.

An investigation was conducted into the effects of peer teaching on two 10 1/2-year-old hospitalized impulsive children. One of these, the subject-teacher, was given cognitive behavioral self-instructional training for four weeks and subsequently prompted to train a peer in the problem-solving skills that he had just learned. Initial treatment effects on the subject-teacher, additive benefits obtained by his teaching a peer, and the treatment effects on the subject-pupil were examined using multiple dependent measures. The procedure was found advantageous to both subject-teacher and subject-pupil. Limitations of single-subject experiments and the need for using multiple measures in assessing treatment gains from self-instructional training to reduce impulsivity are discussed.

Affective Symptoms↗
PubMed1990

Communication skills training, communication skills training with family and cognitive behavioral mood management training for alcoholics.

To evaluate three promising social learning approaches to the treatment of alcoholism, 69 male alcoholics in standard inpatient treatment participated in either a communication skills training group (CST), a communication skills training group with family participation (CSTF) or a cognitive behavioral mood management training group (CBMMT). Alcoholics who received CST or CSTF drank significantly less alcohol per drinking day during 6-month follow-up than those in CBMMT. The groups did not differ in abstinence rates or latency to relapse. All groups improved in skill and anxiety on the extensive battery of process measures, including role-play tests of general and alcohol-specific coping skills, but those in CST improved most in skill in alcohol-specific high-risk role plays and in ability to relax after the role plays. Alcoholics' skill, response latency, anxiety and urge to drink during alcohol-specific role plays were highly correlated with treatment outcome, demonstrating the importance of including comprehensive process measures in treatment outcome research. Implications for patient-treatment matching and future research are discussed.

Adaptation, Psychological↗
PubMed2005

[Effect of autogenic training with cognitive and symbol therapy on the treatment of patients with primary headache].

BACKGROUND: Only a minor part of headaches are associated with an organic abnormality in the nervous system. In case of migraine and tension headache, the main provoking factor is psychological stress. Furthermore, these syndromes often occur together with depression and anxiety disorders, and when these comorbid conditions are present headache attacks tend to be more frequent, longer and stronger, causing an increase in the consumption of antimigraine agents, and at the same time increase the consumption of antidepressant and anxiolytic agents. Further to drugs, modified versions of Schultz-type autogenic training is also frequently used for anxiolysis. The aim of our research was to study the effect of the cognitive and symbol therapy enhanced autogenic training on headache and related drug consumption in three different types of primary headaches. METHOD: Twenty five female patients with migraine, tension-type headache or mixed headache participated in an eight-month follow-up study. Headache frequency, analgesic, antimigraine and anxiolytic consumption were measured by means of a headache diary. During the first four months (observation phase) patients became familiar with using the diary, and in the second four months they participated in autogenic training. The data of the second, third and fourth months were considered as baseline data. RESULTS AND CONCLUSION: Our method decreased headache frequency and drug consumption in all three headache groups. This means that the cognitive and symbol therapy enhanced autogenic training is an effective alternative for medications in the treatment of primary headaches.

Adolescent↗
PubMedDate not supplied

Neurocognitive enhancement therapy with work therapy: Productivity outcomes at 6- and 12-month follow-ups.

Neurocognitive enhancement therapy (NET), which involves computerized cognitive training and other methods, has been shown to improve working memory and executive function in schizophrenia. In the present study, 145 outpatients with diagnoses of schizophrenia or schizoaffective disorder recruited from a Department of Veterans Affairs mental hygiene clinic and from a community mental health center were ran domized to 6 months of paid work therapy (WT) or to NET+WT. Mixed random effects analyses revealed significant increase in hours worked and money earned over time for both conditions (p < 0.0001). NET+WT worked more hours than WT (p < 0.03), with differences emerging after rehabilitation. Responders to NET+WT worked the most during follow-up and tended to have more competitive-wage employment. Results indicate that work outcomes were enhanced by NET training. Effects were greatest for NET responders. Findings support the efficacy of cognitive training when it is integrated into broader rehabilitation programs.

Adult↗
PubMed2004

Physician you can heal yourself! Cognitive behavioural training reduces stress in GPs.

BACKGROUND: High stress and low morale is a well accepted and studied phenomenon in general practice. OBJECTIVE: This study aimed to determine the benefits and mechanisms of stress management training in improving the psychological well-being and morale of GPs. METHODS: There were 85 GPs in the treatment group and 25 GPs in the control group, all from the Adelaide metropolitan region. The treatment group GPs were surveyed by questionnaire before and after a 15 h cognitive behavioural stress management training programme. RESULTS AND CONCLUSION: The study found that following this training programme, GPs' quality of work life and morale improved while their work-related distress and general psychological distress decreased. These gains were maintained or further improved at 12 week follow-up. Furthermore, results suggested that the most robust long-term benefits came from developing a problem-focused style to cope with life and work events.

Adult↗
PubMed1995

Non-pharmacological aspects of acute pain management.

In this paper, non-pharmacological aspects of acute pain management were explored. Much of the research to date with regard to pain management, has been done, addressing the needs of chronic rather than acute pain. It is thought that misconceptions are still held by some health care professionals regarding the adequacy of pharmacology to deal totally with the problems of acute pain management, and it is of more importance to concentrate on issues associated with chronic pain. This is borne out by the relative attention paid to acute and chronic pain in the current body of research. Some aspects of non-pharmacological methods of pain management have been well researched over the last 20 to 30 years, whilst others are more recent innovations. Non-pharmacological aspects of acute pain management were examined under two headings: 1. Psychological approaches: including preoperative information giving, cognitive methods, relaxation training, distraction, guided imagery, humour, hypnosis, music and biofeedback. 2. Complementary therapies and other techniques: including both hands on and other physical therapies using equipment: massage, aromatherapy, reflex zone therapy, acupuncture, shiatsu, therapeutic touch and TENS. There is a sound body of knowledge to support the use of many of the established nonpharmacological methods in the management of acute pain. These include: appropriate preoperative information giving, preoperative relaxation, guided imagery and breathing training, cognitive reframing, distraction in both visual and auditory (music) forms, massage, acupuncture, TENS. Other methods which may be of assistance in acute pain management but are inconclusive in their effect from the current body of available research and may require further examination include: hypnosis, humour therapy, biofeedback techniques, aromatherapy, reflex zone therapy, shiatsu, Therapeutic Touch.

Acute Disease↗
PubMed2006

Technology-based training in cognitive behavioral therapy for substance abuse counselors.

This study compared the learning outcomes achieved by 166 practicing substance abuse counselors who were randomized to one of three conditions: (1) a Web-Based Training (WBT) module designed to familiarize practitioners with the "Coping with Craving" module from the NIDA treatment manual, "A Cognitive-Behavioral Approach: Treating Cocaine Addiction" (www.nidatoolbox.org), (2) a face-to-face training workshop covering the identical content, or (3) a delayed training control condition. Participants in all three conditions completed an identical test of knowledge before and after the session. Results indicated that participants in both the WBT and face-to-face workshop conditions showed improvement in mean test scores, while participants in the delayed training control condition did not. Improvements in test scores for participants in both the WBT and face-to-face conditions were statistically significant and equally modest in magnitude. The finding of equivalent rates of knowledge transfer across these two delivery mechanisms highlight one function for which WBT may be particularly well-suited, and suggest that the most effective clinical training applications may use a "blended delivery" format that leverages the strengths of both WBT and face-to-face training.

Adult↗
PubMed2006

Determinants of retrieval solutions during cognitive skill training: source confusions.

Diverse outcomes, both facilitative and disruptive, have been reported for the effect of interpolated item recognition tests on the acquisition of a cognitive skill. We collected data from a repeated set of 12 artificial arithmetic problems, soliciting compute/retrieve strategy reports after every trial. In one condition, a recognition test was administered after every three blocks of training. Recognition testing was found to depress retrieve frequencies in both younger and older adults, particularly for newly acquired items. Pairing training items with similar recognition foils mitigated these effects. This pattern of results could be explained by assuming that the participants based compute/retrieve decisions on item familiarity or frequency, tracked across both skill trials and recognition trials, and on a threshold influenced by source confusion. Variations in the threshold parameter could lead to depressed reports of item retrieval (our findings) or to elevated retrieval decisions, as has been shown in some other studies.

Adolescent↗
PubMedDate not supplied

Rehabilitation during alcohol detoxication in comorbid neuropsychiatric patients.

For this study, we evaluated the effectiveness of a cognitive training program in improving cognitive function in patients with alcoholism comorbid with another neuropsychiatric disorder and going through the subacute phase of detoxication. We employed a randomized clinical trial design in which 20 subjects were assigned to a five-session cognitive rehabilitation program and 20 subjects were assigned to an attention placebo control condition. All subjects received a battery of cognitive tests for reasoning, attention, and visual-spatial abilities. These tests were repeated at the completion of the study. The training consisted of a number of component tasks designed to improve attention, speed of information processing, perceptual analysis, and visual-spatial cognition. We plotted performance on training results across sessions to detect evidence of learning effects. Comparisons of the cognitive tests revealed greater improvement in the training as compared to the attention placebo group on measures of attention and conceptual flexibility. We concluded that the training produced significant improvement over and above natural recovery during detoxication.

Adult↗
PubMed1995

Potential of cognitive plasticity as a diagnostic instrument: a cross-validation and extension.

Examination of the range and limits of cognitive developmental reserve capacity (plasticity) by means of cognitive training has been proffered as a promising diagnostic strategy for the early identification of Alzheimer's disease. Previous findings of differential gains after cognitive training for healthy older persons and older persons at risk for dementia were supported, rendering cognitive plasticity a criterion by which the overlap in performance distributions between healthy older persons and older persons at risk can be reduced. Stepwise hierarchical regression analyses demonstrated that posttraining scores, which represented developmental reserve capacity, explained significantly more variance in mental health status than pretest or baseline performance. Older persons at risk profited significantly less from training in 2 components of fluid intelligence, figural relations, and inductive reasoning. The authors discuss the possibilities of turning this testing-the-limits procedure into an instrument for screening purposes in clinical practice.

Aged↗