scholarly journals Helpful and Hindering Events in Internet-Delivered Cognitive Behavioural Treatment for Generalized Anxiety

2018 ◽  
Vol 47 (3) ◽  
pp. 386-399 ◽  
Author(s):  
John Burke ◽  
Derek Richards ◽  
Ladislav Timulak
Keyword(s):  
Anxiety Disorders ◽  
Behavioural Change ◽  
Behavioural Therapy ◽  
Generalized Anxiety ◽  
Behavioural Treatment ◽  
Future Directions ◽  
Helpful Events ◽  
Cognitive Behavioural ◽  
Technical Issues ◽  
Interpretative Framework

Background: Anxiety disorders are a highly prevalent cause of impairment globally with generalized anxiety disorder (GAD) sharing many features with other anxiety disorders. Aims: The present study investigated the helpful and hindering events and impacts for individuals with generalized anxiety who engaged with a supported 6-week online intervention based on cognitive behavioural therapy (iCBT). Method: Participants (n = 36) completed the Helpful and Hindering Aspects of Therapy (HAT) for each session. A descriptive-interpretative framework was used to analyse the data. Results: Helpful events were identified by participants as CBT techniques including psychoeducation, monitoring, cognitive restructuring and relaxation, and found supporter interaction, mindfulness and reading personal stories helpful. The associated impacts were identified as support and validation; behavioural change/applying coping strategies; clarification, awareness, and insight; reassurance/relief; and self-efficacy/empowerment. Hindering events were identified as treatment content/form; and amount of work/technical issues, which led to impacts such as frustration/irritation; increased anxiety; and isolation. Conclusion: The implications of the results, potential future directions of research and limitations of the study are discussed.

Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison: Thérapie cognitivo-comportementale de groupe en personne contre par vidéo téléconférence pour l’anxiété et les troubles connexes: une comparaison préliminaire

2021 ◽  
pp. 070674372110273
Author(s):  
Irena Milosevic ◽  
Duncan H. Cameron ◽  
Melissa Milanovic ◽  
Randi E. McCabe ◽  
Karen Rowa
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Symptom Improvement ◽  
Face To Face ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Group Cbt ◽  
Delivery Formats

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.

scholarly journals An investigation of general predictors for cognitive–behavioural therapy outcome for anxiety disorders in a routine clinical setting

BMJ Open ◽  
2016 ◽  
Vol 6 (3) ◽  
pp. e010898 ◽  
Author(s):  
Sara Kerstine Kaya Nielsen ◽  
Signe Vangkilde ◽  
Kate B Wolitzky-Taylor ◽  
Sarah Ingrid Franksdatter Daniel ◽  
Ida Hageman
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Clinical Setting ◽  
Behavioural Therapy ◽  
Therapy Outcome ◽  
Cognitive Behavioural ◽  
Routine Clinical Setting

Metacognitive Theory and Therapy for Worry and Generalized Anxiety Disorder: Review and Status

2010 ◽  
Vol 1 (1) ◽  
pp. jep.007910 ◽  
Author(s):  
Adrian Wells
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Specific Treatment ◽  
Generalized Anxiety ◽  
Behavioural Treatment ◽  
Negative Thinking ◽  
Negative Beliefs ◽  
Negative Appraisal ◽  
Cognitive Behavioural ◽  
Applied Relaxation

The metacognitive model of pathological worry and Generalized Anxiety Disorder (GAD) makes a crucial distinction between two types of worry and explains the persistence and uncontrollability of negative thinking as an effect of specific metacognitions. The negative appraisal of worry (meta-worry) and negative beliefs about worry are central to the development of GAD. Furthermore, GAD is associated with paradoxes in mental control such as the use of extended thinking to reduce thinking. Evidence is reviewed that supports major tenets of the model. A specific treatment, metacognitive therapy is described that focuses on modifying metacognitive beliefs and reducing the use of worry to cope with thoughts. The empirical status of the model is reviewed and evidence from recent trials of this treatment is summarized. The treatment appears to be effective and initial trials suggest it is associated with greater levels of recovery than approaches comprised of applied relaxation or cognitive-behavioural treatment focused on intolerance of uncertainty.

Treatment of anxiety disorders

2020 ◽  
pp. 961-966
Author(s):  
David S. Baldwin ◽  
Nathan T.M Huneke
Keyword(s):  
Anxiety Disorders ◽  
Previous Treatment ◽  
Patient Characteristics ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Physical Symptoms ◽  
Need For Treatment ◽  
Cognitive Behavioural ◽  
Choice Of Treatment ◽  
Characteristic Features

The personal and societal burden associated with anxiety disorders is considerable, but many individuals who might benefit from treatment are not recognized. Recognition relies on awareness of psychological and physical symptoms common to all anxiety disorders, and accurate diagnosis on identifying specific features of particular disorders. The need for treatment is determined by the severity and persistence of symptoms, the impact of symptoms on everyday life, the presence of coexisting depressive symptoms, and other features such as response to previous treatment approaches. Patient characteristics and patient and doctor preferences influence the choice of treatment. There is much overlap between anxiety disorders in evidence-based and effective therapies (such as the prescription of a selective serotonin reuptake inhibitor or a course of individual cognitive behavioural therapy), but there are also important differences, so it helps to be familiar with the characteristic features and evidence base for each condition.

Importance of knowledge in the behavioural treatment of panic disorder

2019 ◽  
Vol 47 (5) ◽  
pp. 611-615
Author(s):  
Kathleen M. Grubbs ◽  
James D. Broussard ◽  
Emily L. Hiatt ◽  
Melissa A. Beason-Smith ◽  
Ellen J. Teng
Keyword(s):  
Panic Disorder ◽  
Intensive Therapy ◽  
Behavioural Therapy ◽  
Behavioural Treatment ◽  
Knowledge Domains ◽  
Cognitive Behavioural ◽  
Severity Scores ◽  
Good Internal Consistency ◽  
Knowledge Scale

AbstractBackground:Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist.Aims:The aim of this study was to examine if increases within specific knowledge domains of panic disorder were related to improvement in panic symptoms following an intensive 2-day panic treatment.Method:Thirty-nine Veterans enrolled in an intensive weekend panic disorder treatment completed knowledge measures immediately before the first session of therapy and at the end of the last day of therapy. Four panic disorder experts evaluated items and reached consensus on subscales. Subscales were reduced further to create psychometrically sound subscales of catastrophic misinterpretation (CM), behaviours (BE), and self-efficacy (SE). A simple regression analysis was conducted to determine whether increased knowledge predicted symptom change at a 3-month follow-up assessment.Results:The overall knowledge scale was reduced to three subscales BE (n = 7), CM (n = 13) and SE (n = 8) with good internal consistency. Veterans’ knowledge of panic disorder improved from pre- to post-treatment. Greater increase in scores on the knowledge assessment predicted lower panic severity scores at a 3-month follow-up. A follow-up analysis using the three subscales as predictors showed that only changes in CM significantly contributed to the prediction.Conclusions:In an intensive therapy format, reduction in panic severity was related to improved knowledge overall, but particularly as a result of fewer catastrophic misinterpretations.

scholarly journals Online Attention Bias Modification in Combination With Cognitive-Behavioural Therapy for Children and Adolescents With Anxiety Disorders: A Randomised Controlled Trial

2019 ◽  
Vol 36 (4) ◽  
pp. 200-215 ◽  
Author(s):  
Jasmijn M. de Lijster ◽  
Gwendolyn C. Dieleman ◽  
Elisabeth M.W.J. Utens ◽  
Jan van der Ende ◽  
Tamsin M. Alexander ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Controlled Trial ◽  
Attention Bias ◽  
Behavioural Therapy ◽  
Attention Bias Modification ◽  
Cognitive Behavioural ◽  
Secondary Outcomes ◽  
Bias Modification

AbstractAttention Bias Modification (ABM) targets attention bias (AB) towards threat, which is common in youth with anxiety disorders. Previous clinical trials showed inconsistent results regarding the efficacy of ABM, and few studies have examined the effect of online ABM and its augmented effect with cognitive behavioural therapy (CBT). The aim of the current study was to examine the efficacy of online ABM combined with CBT for children and adolescents with anxiety disorders in a randomised, double-blind, placebo-controlled trial. Children (aged 8–16 years) completed nine online sessions of ABM (n= 28) or online sessions of the Attention Control Condition (ACC;n= 27) over a period of 3 weeks (modified dot-probe task with anxiety disorder-congruent stimuli), followed by CBT. Primary outcomes were clinician-reported anxiety disorder status. Secondary outcomes were patient-reported anxiety and depression symptoms and AB. Results showed a continuous decrease across time in primary and secondary outcomes (ps < .001). However, no differences across time between the ABM and ACC group were found (ps > .50). Baseline AB and age did not moderate treatment effects. Online ABM combined with CBT does not show different efficacy compared with online ACC with CBT for children and adolescents with anxiety disorders.

scholarly journals Cognitive Behavioural Therapy for Auditory Hallucinations: Effectiveness and Predictors of Outcome in a Specialist Clinic

2010 ◽  
Vol 39 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Neil Thomas ◽  
Susan Rossell ◽  
John Farhall ◽  
Frances Shawyer ◽  
David Castle
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Behavioural Therapy ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Predictors Of Outcome ◽  
Formal Thought Disorder ◽  
Behavioural Treatment ◽  
Cognitive Behavioural

Background: Cognitive behavioural therapy has been established as an effective treatment for residual psychotic symptoms but a substantial proportion of people do not benefit from this treatment. There has been little direct study of predictors of outcome, particularly in treatment targeting auditory hallucinations. Method: The Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Syndrome Scale (PANSS) were administered pre- and post-therapy to 33 people with schizophrenia-related disorders receiving CBT for auditory hallucinations in a specialist clinic. Outcome was compared with pre-therapy measures of insight, beliefs about the origin of hallucinations, negative symptoms and cognitive disorganization. Results: There were significant improvements post-treatment on the PSYRATS and PANSS Positive and General Scales. Improvement on the PSYRATS was associated with lower levels of negative symptoms, but was unrelated to overall insight, delusional conviction regarding the origins of hallucinations, or levels of cognitive disorganization. Conclusions: Lack of insight and presence of formal thought disorder do not preclude effective cognitive-behavioural treatment of auditory hallucinations. There is a need to further understand why negative symptoms may present a barrier to therapy.

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