THE POSSIBILITY OF REDUCING THERAPIST CONTACT AND TOTAL LENGTH OF THERAPY IN THE TREATMENT OF PANIC DISORDER

1999 ◽  
Vol 27 (3) ◽  
pp. 231-247 ◽  
Author(s):  
Cristina Botella ◽  
Azucena García-Palacios
Keyword(s):  
Panic Disorder ◽  
Public Mental Health ◽  
Cost Benefit ◽  
Treatment Programs ◽  
Behavioural Treatment ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Post Test ◽  
The Cost

This study compares the effectiveness of a standard cognitive-behavioural treatment for panic disorder with a reduced therapist contact program supported by self-help materials. This program shortens the total therapy length (from 10 to 5 weeks) and the contact time with the therapist (from 10 to 5 sessions). The sample was mostly referred from a public mental health unit, and it had a low level of education (average of 9.7 years). The subjects were assessed according to several variables related with panic disorder at pre- and post-test, and at 12-month follow-up. The results demonstrated that both programs produced significant improvements for all variables at post-test, the benefits were maintained at follow-up assessment, and even heightened for some of the measures. Also, both treatment programs obtained comparable improvements for most measures. These results suggest that the programs that reduce the contact with the therapist, supported by self-help materials, and shorten the time that the patient suffers from this problem (Margraf, Barlow, Clark, & Telch, 1993) may be a good intervention for the treatment of panic disorder. These programs can help to overcome some of the cost-benefit therapeutic limitations of standard cognitive-behavioural programs.

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 High rates of relapse in adolescents crack users after inpatient clinic discharge

2016 ◽  
Vol 65 (3) ◽  
pp. 215-222
Author(s):  
Rosemeri Siqueira Pedroso ◽  
Luciano Santos Pinto Guimarães ◽  
Luciana Bohrer Zanetello ◽  
Veralice Maria Gonçalves ◽  
Ronaldo Lopes-Rosa ◽  
...  
Keyword(s):  
Contingency Management ◽  
Cost Benefit ◽  
Structured Interview ◽  
Therapeutic Modality ◽  
Behavioral Strategies ◽  
Crack Use ◽  
Sociodemographic Profile ◽  
The Cost ◽  
Crack Users

ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge) from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge), 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge), 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.

Internet-Based Self-Help Training for Children and Adolescents with Recurrent Headache: A Pilot Study

2008 ◽  
Vol 36 (2) ◽  
pp. 241-245 ◽  
Author(s):  
Ellen Trautmann ◽  
Birgit Kröner-Herwig
Keyword(s):  
Therapeutic Potential ◽  
Pain Catastrophizing ◽  
Small Sample Size ◽  
Controlled Trial ◽  
Small Sample ◽  
Post Treatment ◽  
The Internet ◽  
Behavioural Treatment ◽  
Self Help ◽  
Cognitive Behavioural

AbstractWe report the results of a randomized controlled trial that compared the efficacy of an internet-based self-help treatment for paediatric headache including chat communication (cognitive-behavioural treatment, CBT) with an internet-based psychoeducation intervention (EDU). In the CBT group, significant pre- to post-treatment decreases were found for headache frequency and pain catastrophizing, but not for headache intensity or duration. In the EDU group none of the variables (frequency, intensity, duration, pain catastrophizing) showed improvement. No significant between group differences were found for headache variables and pain catastrophizing at post-treatment. The patients reported high satisfaction with the internet-based training and a good patient-trainer-alliance. Results were maintained at 6-month follow-up. Due to the small sample size, no general conclusions can be drawn regarding the efficacy of the internet-based training regarding the outcome variables, but the training was well accepted by patients. Further research is necessary to evaluate the therapeutic potential of such interventions.

The Cost of Child Behaviour Therapy: The First Step to Demonstrating Cost-effectiveness

1996 ◽  
Vol 13 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Mervyn Jackson ◽  
Ray Wilks
Keyword(s):  
Cost Effectiveness ◽  
Total Duration ◽  
Clinical Problem ◽  
Treatment Programs ◽  
Future Research ◽  
Behaviour Therapy ◽  
Face To Face ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
The Cost

There has been extensive debate over the last three decades about which professional groups should receive government-funded rebates in the mental health field. Cognitive-behaviour therapists appear to be in the best position to demonstrate clinical efficacy, but have failed to demonstrate cost-effectiveness of cognitive-behaviour therapy. There is a need to demonstrate the cost of behaviour therapy as the first step in determining the cost-effectiveness of behaviour therapy compared to the traditional (medical-based) interventions. Using archival data from a university-based psychology clinic specialising in cognitive-behavioural interventions with child and adolescent problems, the present research determined the cost of successful treatment programs with the clinic's major referral areas: nocturnal enuresis, behaviour management, and education-based problems. Analysing 77 cases, it was found that there were significant between group differences in the number and total duration of face-to-face interviews, in the number of other contacts between therapist and client, in total therapist time, and in the estimated average cost of cases. There emerged different treatment patterns for each clinical problem, and these were reflected in costing. A number of research and methodological issues are explored. Implications for future research on cost-effectiveness and the subsequent collection of comparative data across clinics and a variety of clinical problem areas are discussed.

scholarly journals Cognitive–behavioural therapy and motivational intervention for schizophrenia and substance misuse

2003 ◽  
Vol 183 (5) ◽  
pp. 418-426 ◽  
Author(s):  
Gillian Haddock ◽  
Christine Barrowclough ◽  
Nicholas Tarrier ◽  
Jan Moring ◽  
Robert O'Brien ◽  
...  
Keyword(s):  
Service Use ◽  
Substance Misuse ◽  
Controlled Trial ◽  
Routine Care ◽  
Control Treatment ◽  
Health Economy ◽  
Motivational Intervention ◽  
Behavioural Treatment ◽  
Cognitive Behavioural

BackgroundComorbid substance misuse in people with schizophrenia is associated with poor clinical and social outcomes. There are few studies of psychological treatments for this population and little long-term follow-up of their benefits.AimsTo investigate symptom, substance use, functioning and health economy outcomes for patients with schizophrenia and their carers 18 months after a cognitive–behavioural treatment (CBT) programme.MethodPatients with dual diagnosis from a randomised controlled trial of motivational intervention, individual CBT and family intervention were assessed on multiple outcomes at 18-month follow-up. Carers were assessed on symptom, functioning and needs over 12 months. Health economy data were collected over 18 months.ResultsThere were significant improvements in patient functioning compared with routine care over 18 months. No significant differences between treatment groups were found in carer or cost outcomes.ConclusionsThe treatment programme was superior to routine care on outcomes relating to illness and service use, and the cost was comparable to the control treatment.

scholarly journals Positive Psychology for Overcoming Symptoms of Depression: A Pilot Study Exploring the Efficacy of a Positive Psychology Self-Help Book versus a CBT Self-Help Book

2018 ◽  
Vol 47 (1) ◽  
pp. 95-113
Author(s):  
Katie Hanson
Keyword(s):  
Positive Psychology ◽  
Well Being ◽  
Behavioural Therapy ◽  
Mental Health Disorder ◽  
Depression Symptoms ◽  
Symptoms Of Depression ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Book Versus ◽  
Post Test

Background: Depression is an extremely common mental health disorder, with prevalence rates rising. Low-intensity interventions are frequently used to help meet the demand for treatment. Bibliotherapy, for example, is often prescribed via books on prescription schemes (for example ‘Reading Well’ in England) to those with mild to moderate symptomology. Bibliotherapy can effectively reduce symptoms of depression (Naylor et al., 2010). However, the majority of self-help books are based on cognitive behavioural therapy (CBT), which may not be suitable for all patients. Research supports the use of positive psychology interventions for the reduction of depression symptoms (Bolier et al., 2013) and as such self-help books from this perspective should be empirically tested. Aims: This study aimed to test the efficacy of ‘Positive Psychology for Overcoming Depression’ (Akhtar, 2012), a self-help book for depression that is based on the principles of positive psychology, in comparison with a CBT self-help book that is currently prescribed in England as part of the Reading Well books on prescription scheme. Method: Participants (n = 115) who were not receiving treatment, but had symptoms of depression, read the positive psychology or the CBT self-help book for 8 weeks. Depression and well-being were measured at baseline, post-test and 1-month follow-up. Results: Results suggest that both groups experienced a reduction in depression and an increase in well-being, with no differences noted between the two books. Conclusions: Future directions are discussed in terms of dissemination, to those with mild to moderate symptoms of depression, via books on prescription schemes.

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