Helping clients ‘restart their engine’ – use of in-session cognitive behavioural therapy behavioural experiments for engagement and treatment in persistent depression: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Lilian Skilbeck ◽  
Christopher Spanton ◽  
Ian Roylance
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
List Type ◽  
Perceptual Field ◽  
Major Depressive ◽  
Cognitive Behavioural ◽  
Persistent Depression ◽  
Recommendations For Practice ◽  
Behavioural Experiments

Abstract Behavioural experiments (BEs) are a major cognitive ingredient in the cognitive behavioural therapy (CBT) model which can be applied in-session or between-sessions. In-session BEs are particularly effective and widely demonstrated in anxiety disorders, yet they remain under-utilised in depression. Clients presenting with persistent depression are often difficult to engage due to the chronicity of their symptoms and their learnt self-perpetuating demoralised states. Research to date demonstrates the effectiveness of in-session BEs in engagement and treatment in depression. This case study details the treatment of a client presenting with persistent major depressive disorder (MDD) with hopelessness and how in-session BEs effected engagement and treatment. This case study is discussed with reference to strengths, limitations, clinical implications and recommendations for practice and development. Key learning aims It is hoped that the reader of this case study will increase their understanding of the following: (1) Using BEs to help engagement and treatment in persistent MDD. (2) Instilling hope by starting in-session BEs during the assessment stage. (3) When to plan or seize opportunities for off-the-cuffin-session BEs. (4) Setting no-lose BEs to enable clients to widen their perceptual field. (5) The importance of repeated BEs to consolidate experiential learning.

Mending a broken heart: a single case study on cognitive behavioural therapy for depression after romantic relationship break-up

2020 ◽  
Vol 13 ◽  
Author(s):  
Muthmainah Mufidah Gozan ◽  
Adhityawarman Menaldi
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Romantic Relationship ◽  
Single Case ◽  
Behavioural Therapy ◽  
Depression Symptoms ◽  
List Type ◽  
Cognitive Behavioural ◽  
Negative Thoughts ◽  
Break Up

Abstract Having and building a romantic relationship is an important aspect of development in young adulthood. However, there are some challenges in relationships, including basic principle differences such as faith and culture that lead to fights and break-ups. Going through a break-up is not easy for some people and is considered to be one of the stress sources in people’s lives that often links to depression symptoms. It is crucial to focus on intervention aiming at the cognitive aspects, including negative thoughts and bias when dealing with depression, such as cognitive behavioural therapy (CBT). However, CBT in the Indonesian context, especially with religious and ethnic problems in a romantic relationship before marriage, is limited. This study aims to explore this by presenting the case of a 26-year-old Indonesian male with depressive episodes after a painful break-up due to religious and cultural differences. The previous history of childhood abuse and problems in social adjustment and communication had also worsened his conditions. CBT was used for treatment as he developed many negative thoughts about himself and had maladaptive beliefs about his conditions and his future. This case study report shows the effectiveness of CBT intervention in decreasing depression symptoms, such as sadness and the thought of being unworthy, as well as increasing self-confidence in facing difficulties. Key learning aims (1) To understand delivering CBT in a single case with mild depression triggered by relationship break-up. (2) To understand the applicability of CBT in the Indonesian context with a cultural and religious background. (3) To reflect on the challenges faced and treatment strategies in implementing an adapted CBT technique.

The Efficacy of Traditional Cognitive Behavioural Therapy for Depressed Adults with Anhedonia: A Systematic Review

2021 ◽  
Vol 7 (5) ◽  
pp. 520-544
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Primary Outcome ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Eligibility Criteria ◽  
Cognitive Behavioural ◽  
System Therapy ◽  
Randomised Controlled ◽  
The Impact

To date, the impact of traditional cognitive behavioural therapy (CBT) on anhedonia in major depressive disorder (MDD) has yet been systematically evaluated. This systematic review aims to examine the efficacy of traditional CBT for depressed adults with anhedonia. A literature search for randomised controlled trials of traditional CBT in adults with MDD from inception to July 2020 was conducted in 8 databases. The primary outcome was the levels of anhedonia. Ten studies with adults with MDD met the eligibility criteria. Our results indicate that traditional CBT is as effective as euthymic therapy, positive psychology therapy, self-system therapy,and medications for anhedonia in depression. Besides, our data provide further support for the development of augmented CBT to optimise treatment outcome for depressed adults with anhedonia. Received 11th June 2021; Revised 2nd September 2021; Accepted 20th September 2021

Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs)

2022 ◽  
Vol 15 ◽  
Author(s):  
Sérgio A. Carvalho ◽  
Paula Castilho ◽  
Daniel Seabra ◽  
Céu Salvador ◽  
Daniel Rijo ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioural Therapy ◽  
Minority Stress ◽  
Sexual Minorities ◽  
Clinical Work ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Critical Issues ◽  
Societal Structure

Abstract In a cisheteronormative culture, gender and sexual minorities (GSMs) may experience additional challenges that get in the way of a meaningful life. It is crucial that clinicians are mindful of these challenges and cognizant about the specificities of clinical work with GSMs. This article points out how societal structure interferes with mental health, and clarifies what clinicians must take into account when using affirmative cognitive behavioural therapy (CBT) interventions. Knowledge of up-to-date terminology and use of affirmative language are the first steps that contribute to clients’ experience of respect, which is paramount for the development of a good therapeutic relationship. Considering a conceptual framework of minority stress to understand vulnerability in GSM, specificities in formulation and key psychological processes are discussed. Moreover, guidelines and practical tools for intervention are presented within a CBT approach. Some reflections on therapists’ own personal biases are encouraged, in order to increase the efficacy of interventions. Key learning aims After reading this article you will be able to: (1) Recognize the uniqueness of gender and sexual minorities (GSM) stressors in broad and specific contexts, and their impact on mental health. (2) Identify the underlying key processes and specificities in therapeutic work with GSMs, from a CBT perspective. (3) Recognize the importance of a culturally sensitive approach in affirmative CBT interventions.

scholarly journals ‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Katherine Newman-Taylor
Keyword(s):  
Behavioural Therapy ◽  
Illustrative Case ◽  
Imagery Task ◽  
List Type ◽  
Short Term ◽  
Cognitive Behavioural ◽  
Imagery Rescripting ◽  
Illustrative Case Study ◽  
The Impact

Abstract People with psychosis do not have routine access to trauma-focused cognitive behavioural therapy (CBT) interventions such as imagery rescripting (IR), partly due to clinical caution. This case study describes the use of a simple imagery task designed to engender ‘felt security’, as a means of facilitating IR with a woman struggling with distressing memory intrusions, linked to her voices and paranoia. We assessed the impact of the felt security task, which was used before IR to enable Kip to engage in reprocessing of her trauma memories, and again after IR so that she would leave sessions feeling safe. The brief imagery task was effective in improving felt security before IR sessions. Felt security then reduced during IR, when distressing material was recalled and reprocessed, and increased again when the task was repeated. It is not yet clear whether trauma-focused interventions such as IR need to be routinely adapted for people with psychosis. In the event that individuals express concerns about IR, if the person’s formulation indicates that high levels of arousal may trigger an exacerbation of voices, paranoia or risk, or where clinicians are otherwise concerned about interventions likely to increase emotional arousal in the short term, the felt security task may facilitate safe and effective reprocessing of trauma memories. This in turn may increase access to trauma-focused CBT for people with psychosis. Key learning aims (1) To understand that people with psychosis need access to trauma-focused CBT. (2) To be familiar with a simple attachment-based imagery task designed to foster ‘felt security’. (3) To learn that this task may facilitate imagery rescripting in people with psychosis.

The practice and research of cognitive behavioural therapy in Egypt: a review of the current status

2020 ◽  
Vol 13 ◽  
Author(s):  
Reham Aly ◽  
Hisham Ramy ◽  
Shanaya Rathod
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Arab World ◽  
Behavioural Therapy ◽  
Current Status ◽  
Evidence Based ◽  
List Type ◽  
Cultural Variations ◽  
Western Countries ◽  
Mixed Response ◽  
Cognitive Behavioural

Abstract Cognitive behavioural therapy (CBT) is generally defined as a short-term, problem-oriented psychotherapy that focuses on modifying dysfunctional emotions, thoughts and actions. In clinical practice, CBT consists of a number of cognitive and behavioural techniques that aim to help patients suffering from psychological disorders. The practice of CBT is well established in Western countries. In non-Western countries, CBT is still in the process of being established as the evidence-based psychotherapy. Despite being the heart of the Arab world, the development and practice of psychotherapy in Egypt in general, and CBT specifically, is still emerging. The training and practice of CBT has received a mixed response in Egypt. In practical settings, evidence-based CBT is subject to individual and cultural variations and adaptations. Many local studies examining the efficacy of CBT in psychiatric disorders among different population groups in Egypt have been conducted. Unfortunately, many of these studies have not been published and therefore have missed the opportunity for international recognition. The current review aims to explore the practice of CBT with a specific focus on national research of efficacy and adaptability of CBT for different populations in Egypt. Key learning aims (1) Current status of the practice and education of CBT in Egypt. (2) Body of research conducted on CBT in Egypt. (3) Needs and recommendations for further development of CBT provision in Egypt.

Client-led culturally responsive CBT – integrating familism in the treatment of chronic depression: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Lilian Skilbeck ◽  
Christopher Spanton ◽  
Ian Roylance
Keyword(s):  
Cultural Adaptation ◽  
Treatment Plan ◽  
Behavioural Therapy ◽  
Cultural Responsiveness ◽  
Chronic Depression ◽  
List Type ◽  
Her Family ◽  
Psychological Therapies ◽  
Cognitive Behavioural

Abstract Britain has increasingly become a multi-cultural society. In order to improve access to primary care psychological therapy including cognitive behavioural therapy (CBT), there has been an increase in focus on cultural adaptation and cultural responsiveness. To date, these adaptations have focused on domains such as language, beliefs and values. In this case, familism was the focus for adaptation. The client was a 22-year-old female from a black African-British background. She presented with severe symptoms of chronic depression as measured on routine standard questionnaires and the interview. She had minimal success from previous interventions and was struggling to make progress. Therapy was guided by the client’s views on what issues had a bearing on her difficulties. The client hypothesised that familism factors with themes around ‘my parents’ culture’ and ‘family comes first’ were interacting with her cognitive behavioural factors to maintain her problem. She requested the involvement of her family in her treatment plan. In line with the Improving Access to Psychological Therapies–Black, Asian and Minority Ethnic service user Positive Practice Guide, this was integrated as part of her formulation. Upon involvement of her father in a single session, the client attained reliable improvement. She attributed her improvement to this involvement. By the end of therapy, she reached recovery, which was maintained at 3-month follow-up. This study was responsive to the client’s own perceived cultural needs through the integration of familism into her CBT formulation. It illustrates a client-led cultural adaptation of CBT to treat chronic depression. Key learning aims It is hoped that the reader will increase their understanding of the following from reading this case study: (1) Creating an environment where clients can freely discuss their perceived cultural factors from the outset. (2) Client-led cultural responsiveness to their expressed cultural needs. (3) Familism as a domain for adapting CBT.

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