Intensive Cognitive-Behaviour Group Therapy for Diagnostically Heterogeneous Groups of Patients with Psychiatric Disorder

1994 ◽  
Vol 28 (4) ◽  
pp. 667-674 ◽  
Author(s):  
J. J. Manning ◽  
G. R. Hooke ◽  
D. A. Tannenbaum ◽  
T. H. Blythe ◽  
T. M. Clarke
Keyword(s):  
Psychiatric Patients ◽  
Combined Treatment ◽  
Self Report ◽  
Psychiatric Clinic ◽  
Behaviour Therapy ◽  
Heterogeneous Groups ◽  
Cognitive Behaviour ◽  
Before And After ◽  
Clinically Significant ◽  
One Year

This uncontrolled study evaluates the efficacy of a combined treatment of medications (for the majority of patients) and a closed group, intensive (two-week) cognitive-behaviour therapy programme for heterogeneous groups of psychiatric patients. Five hundred and thirty-one patients at a private psychiatric clinic were included in the study. Self-report measures of depression, anxiety, self-esteem and “locus of control’ were administered before and after treatment and at intervals up to one year later. Statistically and clinically significant improvements were found in all measures and these improvements were maintained up to one year. The results provide support for the efficacy of the treatment.

Juvenile Obsessive—Compulsive Disorder

1997 ◽  
Vol 31 (1) ◽  
pp. 105-113 ◽  
Author(s):  
Chris Wever ◽  
Joseph M. Rey
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Remission Rate ◽  
Combined Treatment ◽  
Treatment Programs ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Oppositional Defiant ◽  
Cognitive Behaviour ◽  
Before And After

Objective: To describe the characteristics of a series of children and adolescents with obsessive—compulsive disorder (OCD) and evaluate the outcome of treatment. Method:Type of symptoms, severity before and after treatment and factors associated with outcome were examined in a large group (n = 82) of consecutive OCD cases referred for treatment. Results:Most children (95%) had both obsessions and compulsions. Symptoms had been present for 2 years on average. Seventy-one per cent (n = 57) of all eligible patients completed a combined behavioural and pharmacological protocol. Among these, there was a 68% remission rate and a 60% decrease of symptoms at 4 weeks. Comorbidity with oppositional defiant disorder and high aggression scores were associated with poor outcome. Conclusions:Juvenile OCD can be treated effectively in a standard clinical setting. Treatment programs of the kind described are accepted by young people. It remains to be seen whether in this age group a combined treatment produces better results than medication alone or cognitive—behaviour therapy alone.

scholarly journals Cognitive behaviour therapy in women with fibromyalgia: A randomized clinical trial

2015 ◽  
Vol 9 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Bo Karlsson ◽  
Gunilla Burell ◽  
Ulla-Maria Anderberg ◽  
Kurt Svärdsudd
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Control Group ◽  
Behaviour Therapy ◽  
Coping With Stress ◽  
Multidimensional Pain Inventory ◽  
Vital Exhaustion ◽  
Cognitive Behaviour ◽  
Before And After ◽  
Stress Behaviour ◽  
Individual Strategies

AbstractBackground and aimsStress has been pointed out as an important influential factor in the development and maintaining of the fibromyalgia syndrome (FMS) . Since stress may worsen the pain experience, the development of individual strategies for coping with stress is essential to reduce the impact of FMS on daily life. The aim of the study was to investigate whether a group based stress management cognitive behaviour therapy (CBT) programme could influence self-reported stress, wellbeing and life control, as well as self-reported pain behaviour in female FMS patients.Methods48 female FMS patient were randomized into a cognitive behaviour therapy treatment group (n = 24) and a waitlist control group (n = 24) . When the 6 months waitlist period was over the control group received the same CBT programme. This allowed two analytical approaches, one based on the randomized controlled trial design and one based on a before-and-after design to improve the statistical power of the study. Four psychometric instruments were used: The West Haven-Yale Multidimensional Pain Inventory (three parts, MPI-1 to MPI-3), the Maastricht Questionnaire, the Everyday Life Stress, and the Montgomery-Åsberg Depression rating scale – self-reported. Primary outcome was the MPI-1 dimension ‘life control’, secondary outcomes were the MPI-1 dimensions ‘interference’, ‘affective distress’ and ‘support from spouses or significant others’, the various MPI-2 dimensions, the ‘general activity level’ in the MPI-3 dimension, and ‘vital exhaustion’, ‘stress behaviour’, and ‘depression’. The only tertiary outcome was the MPI-1 dimension ‘pain severity’.ResultsIn the RCT design the West Haven-Yale Multidimensional Pain Inventory dimensions ‘life control’, ‘interference from pain’, ‘affective distress’, ‘support from spouses or significant others’, and ‘distracting responses’ and ratings for depression improved in the treatment group as compared with the control group. In the before-and after design these improvements were maintained and enhanced during 1-year follow-up, and so was the ‘vital exhaustion’ and ‘stress behaviour’. ‘Pain severity’ was rated higher after the intervention.ConclusionsCognitive behaviour therapy improved the life control in a female population with FMS. Coping behaviour in response to chronic pain was improved at the same time and in spite of higher subjective ratings of pain. Positive effects were seen on depression, vital exhaustion and stress behaviour. The effects of therapy were maintained and enhanced during the follow up period. It appears that women with FMS after the CBT treatment, according to this protocol obtained tools leading to better acceptance of their disorder.ImplicationsFMS is a disorder with great therapeutic challenges. Total abolishment of pain symptoms is extremely difficult or impossible to achieve. Thus, the development of individual strategies for coping with pain is essential to reduce its impact on daily life. Since stress may worsen the pain experience, coping with stress might be a promising route to accomplishing that goal. In evaluations of interventions for pain it is important to monitor the effect on behaviour responses to pain and not only ratings of pain itself.

Fluoxetine and Fluvoxamine Combined with Individual Cognitive-Behaviour Therapy in Binge Eating Disorder: A One-Year Follow-Up Study

2001 ◽  
Vol 70 (6) ◽  
pp. 298-306 ◽  
Author(s):  
Valdo Ricca ◽  
Edoardo Mannucci ◽  
Barbara Mezzani ◽  
Sandra Moretti ◽  
Milena Di Bernardo ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
Follow Up Study ◽  
Cognitive Behaviour ◽  
One Year

scholarly journals Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress

2018 ◽  
Vol 10 (2) ◽  
pp. 413-422 ◽  
Author(s):  
Allison J Applebaum ◽  
Aliza A Panjwani ◽  
Kara Buda ◽  
Mia S O’Toole ◽  
Michael A Hoyt ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Caregiver Burden ◽  
Psychosocial Interventions ◽  
Anxiety Symptoms ◽  
Open Trial ◽  
Self Report ◽  
Central Feature ◽  
Depression And Anxiety ◽  
Before And After ◽  
Clinically Significant

Abstract Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient’s illness—notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge’s g range: 0.36–0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs.

A Controlled Comparison of Cognitive—Behaviour Therapy, Diazepam and Placebo in the Management of Generalized Anxiety

1989 ◽  
Vol 17 (1) ◽  
pp. 1-14 ◽  
Author(s):  
K. G. Power ◽  
D. W. A. Jerrom ◽  
R. J. Simpson ◽  
M. J. Mitchell ◽  
V. Swanson
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Psychological Treatment ◽  
Subsequent Treatment ◽  
Self Report ◽  
Response To Treatment ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Treatment Interventions ◽  
Group Response ◽  
Cognitive Behaviour

Generalized anxiety patients were randomly allocated to Cognitive-Behaviour Therapy, Diazepam or Placebo and managed in a primary care setting. Treatments were balanced for degree of psychologist/patient contact. A range of outcome measures, including patient self report, psychologist assessor and general practitioner ratings were used. Large variations within group response to treatment emerged. At the end of active treatment the superiority of Cognitive-Behaviour Therapy was suggested. Post-study psychotropic prescription and psychological treatment was assessed at a 12-month follow-up. The Cognitive-Behaviour group revealed the lowest incidence of subsequent treatment interventions.

THE TREATMENT OF WHEELCHAIR-BOUND CHRONIC FATIGUE SYNDROME PATIENTS: TWO CASE STUDIES OF A PRAGMATIC REHABILITATION APPROACH

1999 ◽  
Vol 27 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Pauline Powell ◽  
Richard H. T. Edwards ◽  
Richard P. Bentall
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Case Studies ◽  
Chronic Fatigue ◽  
Behaviour Therapy ◽  
Face To Face ◽  
Fatigue Syndrome ◽  
End Of Treatment ◽  
Cognitive Behaviour ◽  
Ambulatory Patients ◽  
Clinically Significant

Chronic fatigue syndrome is a disabling condition characterized by persistent mental and physical fatigue. Its aetiology is controversial, and it has been attributed to both physical and psychological causes. Previous controlled trials with ambulatory patients have shown that a proportion of CFS patients respond to cognitive-behaviour therapy. In this paper, we report two case studies of patients who are wheelchair-bound, who have been treated by a pragmatic intervention designed to increase activity and challenge dysfunctional illness beliefs. The patients received 60 and 55 contacts with the therapist, some of which were face-to-face and some of which were by telephone. At the end of treatment, the patients experienced clinically significant reductions in fatigue, were not using wheelchairs, showed an increase in occupational and social functioning and were leading relatively independent existences.

BATTLING BOREDOM: GROUP COGNITIVE BEHAVIOUR THERAPY FOR NEGATIVE SYMPTOMS OF SCHIZOPHRENIA

2002 ◽  
Vol 30 (3) ◽  
pp. 341-346 ◽  
Author(s):  
Louise C. Johns ◽  
William Sellwood ◽  
John McGovern ◽  
Gillian Haddock
Keyword(s):  
Group Intervention ◽  
Negative Symptoms ◽  
Control Design ◽  
Inclusion Criteria ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
The Subject ◽  
Clinically Significant ◽  
Group Cbt

We conducted a pilot group intervention for negative symptoms, particularly targeting avolition/apathy. A baseline control design was used. Six patients were recruited, and four completed the group. The main inclusion criteria were clinically significant negative symptoms, plus associated distress and concern. The group involved 16 sessions, which were cognitive behavioural in approach. The main outcome measures were the Scale for the Assessment of Negative Symptoms, and the Subject Experience of Negative Symptoms Scale. Patients showed a reduction in avolition/apathy, and two patients reported reduced distress. These preliminary results suggest that group CBT is a possible intervention for negative symptoms.

scholarly journals Serotonin tranporter methylation and response to cognitive behaviour therapy in children with anxiety disorders

2014 ◽  
Vol 4 (9) ◽  
pp. e444-e444 ◽  
Author(s):  
S Roberts ◽  
K J Lester ◽  
J L Hudson ◽  
R M Rapee ◽  
C Creswell ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Anxiety Disorders ◽  
Cognitive Behaviour Therapy ◽  
Environmental Influences ◽  
Psychological Therapy ◽  
Behaviour Therapy ◽  
Effective Treatment Option ◽  
Cognitive Behaviour ◽  
Before And After ◽  
Beneficial Response

Abstract Anxiety disorders that are the most commonly occurring psychiatric disorders in childhood, are associated with a range of social and educational impairments and often continue into adulthood. Cognitive behaviour therapy (CBT) is an effective treatment option for the majority of cases, although up to 35–45% of children do not achieve remission. Recent research suggests that some genetic variants may be associated with a more beneficial response to psychological therapy. Epigenetic mechanisms such as DNA methylation work at the interface between genetic and environmental influences. Furthermore, epigenetic alterations at the serotonin transporter (SERT) promoter region have been associated with environmental influences such as stressful life experiences. In this study, we measured DNA methylation upstream of SERT in 116 children with an anxiety disorder, before and after receiving CBT. Change during treatment in percentage DNA methylation was significantly different in treatment responders vs nonresponders. This effect was driven by one CpG site in particular, at which responders increased in methylation, whereas nonresponders showed a decrease in DNA methylation. This is the first study to demonstrate differences in SERT methylation change in association with response to a purely psychological therapy. These findings confirm that biological changes occur alongside changes in symptomatology following a psychological therapy such as CBT.

Predictors of outcome in a fatigued population in primary care following a randomized controlled trial

2003 ◽  
Vol 33 (2) ◽  
pp. 283-287 ◽  
Author(s):  
T. CHALDER ◽  
E. GODFREY ◽  
L. RIDSDALE ◽  
M. KING ◽  
S. WESSELY
Keyword(s):  
Primary Care ◽  
Social Adjustment ◽  
Illness Perceptions ◽  
Controlled Trial ◽  
Demographic Variables ◽  
Self Report ◽  
Behaviour Therapy ◽  
Randomized Controlled ◽  
Cognitive Behaviour ◽  
Illness Attribution

Background. The objective of this study was to examine factors that predicted outcome in a chronically fatigued group of patients who were randomized to cognitive behaviour therapy or counselling in primary care.Method. Illness perceptions, attributions, fatigue, disability and demographic variables were recorded at assessment and levels of fatigue and disability were measured at 6 months post randomization. Logistic regression was used to examine associations.Results. Factors that predicted a poor outcome (four or more on the fatigue questionnaire) were: poor social adjustment at assessment; the patients self-report that they had never seen the GP for an emotional reason; a physical illness attribution; and, a long perceived future illness duration.Conclusions. Patients who are more psychologically minded are more likely to improve with psychological treatments in primary care. General practitioners need to assess this before referring to an appropriate therapist.

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