What is the minimal dose of cognitive behavior therapy for psychosis? An approximation using repeated assessments over 45 sessions

2016 ◽  
Vol 38 ◽  
pp. 31-39 ◽  
Author(s):  
T.M. Lincoln ◽  
E. Jung ◽  
M. Wiesjahn ◽  
B. Schlier
Keyword(s):  
Clinical Practice ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Negative Symptoms ◽  
Optimal Dose ◽  
Symptom Distress ◽  
Psychotic Symptoms ◽  
Symptom Improvement ◽  
Cognitive Behavior ◽  
And Coping

AbstractBackgroundThe general efficacy of cognitive behavior therapy for psychosis (CBTp) is well established. Although guidelines recommend that CBTp should be offered over a minimum of 16 sessions, the minimal number of sessions required to achieve significant changes in psychopathology has not been systematically investigated. Empirically informed knowledge of the minimal and optimal dose of CBTp is relevant in terms of dissemination and cost-effectiveness.MethodsWe approached the question of what constitutes an appropriate dose by investigating the dose (duration of CBTp) × response (symptomatic improvement) relationship for positive symptoms, negative symptoms and depression. Patients with psychotic disorders (n = 58) were assessed over the course of 45 sessions of CBTp in a clinical practice setting. At baseline and after session 5, 15, 25, and 45, general psychopathology, psychotic symptoms, symptom distress and coping were assessed with self-report questionnaires. Additionally, individually defined target symptoms and coping were assessed after each session.ResultsSignificant symptom improvement and reduction of symptom distress took place by session 15, and stayed fairly stable thereafter. The frequency of positive and negative symptoms reached a minimum by session 25.ConclusionsOur findings support recommendations to provide CBTp over a minimum of 16 sessions and indicate that these recommendations are generalizable to clinical practice settings. However, the findings also imply that 25 sessions are the more appropriate dose. This study contributes to an empirically informed discussion on the minimal and optimal dose of CBTp. It also provides a basis for planning randomized trials comparing briefer and longer versions of CBTp.

Identifying the “Therapy Targets” for Treating the Negative Symptoms of Psychosis Using Cognitive Behavioral Therapy

2018 ◽  
Vol 32 (3) ◽  
pp. 203-220 ◽  
Author(s):  
Monica F. Tomlinson ◽  
Joshua D. Wright
Keyword(s):  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Negative Symptoms ◽  
Critical Discussion ◽  
Cognitive Behavioral ◽  
Empirical Literature ◽  
Psychotic Symptoms ◽  
Cognitive Behavior ◽  
Positive Symptoms ◽  
Treatment Targets

The division of psychotic symptoms into positive and negative categories has largely divided the research on them. While the research on positive symptoms of psychosis has rapidly developed over the last three decades, the literature on negative symptoms has noticeably lagged behind. Negative symptoms have likely been ignored in the treatment literature because they were previously thought to remit following the treatment of positive symptoms. Recent evidence does not consistently support this theory and indicates that the different manifestations of negative symptoms require distinct approaches to treatment. The current review provides a re-evaluation of the theoretical literature on negative symptoms to inform and identify “treatment targets” to reduce them. The “treatment targets” are then translated into intervention strategies using a cognitive behavioral framework. A review of the empirical literature on cognitive behavior therapy for treating negative symptoms is then offered along with a critical discussion of where cognitive behavior therapy stands compared to other interventions and what research is still needed.

scholarly journals O9.8. USING APPROPRIATE OUTCOMES WHEN EVALUATING COGNITIVE BEHAVIOR THERAPY FOR PSYCHOSIS (CBTP) FOR PATIENTS WITH SCHIZOPHRENIA IN AN INPATIENT SETTING: TRENDS OBSERVED IN CLINICAL PRACTICE

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S189-S190
Author(s):  
Heather Adams ◽  
Gopal Vyas ◽  
Jerome Kowalewski ◽  
Christopher Kitchen ◽  
Charles Richardson ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Inpatient Setting ◽  
Cognitive Behavior

Neuroscience-Informed Cognitive-Behavior Therapy in Clinical Practice: A Preliminary Study

2016 ◽  
Vol 38 (2) ◽  
pp. 139-154 ◽  
Author(s):  
Thomas A. Field ◽  
Eric T. Beeson ◽  
Laura K. Jones
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Mental Health Counseling ◽  
Cognitive Behavior ◽  
Health Counseling ◽  
Conventional Models

The field of neuroscience has influenced revisions to conventional models of cognitive behavioral therapy (CBT). In the mental health counseling field, a conceptual model of neuroscience-informed cognitive-behavior therapy (n-CBT) was first published in the Journal of Mental Health Counseling in 2015. The present article reviews findings from the first six months of a year-long pilot study that examined counselor and client use and perceptions of n-CBT following application in clinical practice settings. Counselors reported successful alleviation of client symptomatology with n-CBT, particularly anxiety and depressive disorders. Counselors and clients also held similar and consistently high perceptions of n-CBT's credibility and the likelihood of improvement when using the model.

scholarly journals The effect of group cognitive behavior therapy on Chinese patients with anorexia nervosa: an open label trial

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Lian Gu ◽  
Yunling Zou ◽  
Yue Huang ◽  
Qiang Liu ◽  
Han Chen ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Weight Regain ◽  
Symptom Improvement ◽  
Cognitive Behavior ◽  
Open Label ◽  
Cost Of Treatment ◽  
Open Label Trial

Abstract Background The high cost of treatment for anorexia nervosa (AN) and lack of trained specialists have resulted in limited accessibility of effective treatment to patients with AN, which is particularly problematic in China. To increase the accessibility of evidence-based treatment and reduce the cost of treatment, this study aimed to explore the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy for eating disorders (CBT-E) in Chinese AN patients. Method A total of 78 patients with AN were assigned to G-CBT or individual outpatient treatment (IOT) and received three months of treatment for AN in each condition. Measures of eating pathology, depression and anxiety were administrated to both intervention groups at three time points: baseline, one month of treatment, and end of treatment; results were compared between groups and over time. Results There were 70 participants included in the final analysis. Both G-CBT and IOT groups showed significant improvement in eating pathology and associated psychopathology (ps < .001) over the course of treatment, but no significant difference in symptom improvement was found between the two groups (ps > .05). G-CBT resulted in additional significant improvement in ED psychopathology over the last two months of treatment, and its overall therapeutic effect was influenced by baseline weight and early symptom improvement. Conclusion Preliminary findings from this open label trial suggest that G-CBT adapted from CBT-E is feasible in an outpatient setting and as effective as IOT in facilitating weight regain and reducing psychopathology in Chinese AN patients with little evidence for the superiority of either intervention. Trial registration: The current study was registered at clinical trials.gov on September 23, 2018 (registration number NCT03684239). Plain English summary People with anorexia nervosa (AN) are known to be unmotivated for treatment and prone to relapse. Recovery from AN often needs intensive, long-term treatment from a specialized multidisciplinary team, which is not accessible for most people in China. Given the increasing incidence of AN and lack of eating disorder (ED) specialists in China, it is important to develop short-term cost-effective treatments for AN. In this study, we explored the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy (CBT-E) for people with AN from China. We found that G-CBT was as effective as individual outpatient treatment (IOT) typically provided to AN patients at the research site in facilitating weight regain, improving eating behaviors, and reducing ED and other symptoms. We also found that patients receiving G-CBT made more improvements in cognitive symptoms of the ED, which might help maintain treatment gains and prevent relapse in the long run. This potential long-term advantage of G-CBT needs to be verified in long-term follow-up.

Nurses’ Perception of Using Cognitive Behavior Therapy for Death Anxiety and Ageism

2021 ◽  
pp. 003022282110467
Author(s):  
Mohammad Rababa ◽  
Sami Al-Rawashdeh ◽  
Imteyaz El Jarrah ◽  
Abdallah Abu Khait
Keyword(s):  
Clinical Practice ◽  
Comparative Study ◽  
Treatment Adherence ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Death Anxiety ◽  
Cognitive Behavior ◽  
Jordanian Nurses ◽  
Promising Avenue

Despite the effectiveness of cognitive behavior therapy (CBT) in relieving death anxiety and ageism among nurses, there is not a complete consensus on its acceptability, adherence, credibility, and expectancy in the literature. Therefore, this descriptive-comparative study aimed to examine Jordanian nurses’ perception of using CBT in relieving death anxiety and ageism. Most participants perceived CBT as a credible and adherable treatment for death anxiety and ageism. Significant differences were found in the CBT credibility and expectancy between nurses grouped according to levels of perceived treatment adherence and acceptability of CBT. The findings provide a promising avenue for adopting CBT to target death anxiety and its associated ageism among nurses and for improving CBT adherence, acceptability, credibility, and expectancy. A better understanding of participants’ perception of CBT is crucial for optimal clinical practice.

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