How to Bend but Not Break an Empirically Supported Treatment for Anxiety in Youth

2021 ◽  
pp. 175-210
Author(s):  
Lara S. Rifkin ◽  
Lindsay Myerberg ◽  
Elizabeth A. Gosch ◽  
Lesley A. Norris ◽  
Margaret E. Crane ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Developmental Level ◽  
Empirically Supported Treatment ◽  
The Core ◽  
Empirically Supported ◽  
Youth Anxiety ◽  
Essential Components ◽  
Self Talk ◽  
Core Components ◽  
Building Rapport

This chapter addresses the treatment of youth anxiety. Cognitive behavioral therapy (CBT) for youth anxiety, as illustrated by the Coping Cat program, is implemented flexibly based on considerations including age/developmental level, co-occurring disorders, socioeconomic status, and cultural factors to enhance outcomes. For fidelity, the program adheres to key components: building rapport, providing psychoeducation about anxiety, addressing anxious self-talk, conducting exposures, assigning homework, and providing rewards/praise. The essential components, however, are applied with flexibility. Ultimately, research is needed to evaluate strategies to increase continued fidelity to the core components of treatment. Peer consultation and supervision may be valuable for maintaining fidelity while flexibly applying the program to a specific client.

scholarly journals New Developments in Emotion-Focused Therapy for Social Anxiety Disorder

2020 ◽  
Vol 9 (9) ◽  
pp. 2918
Author(s):  
Ben Shahar
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Skill Learning ◽  
Great Promise ◽  
Empirically Supported Treatment ◽  
Emotion Focused Therapy ◽  
Empirically Supported

Social anxiety disorder (SAD) is a highly complex, chronic, disabling and costly anxiety disorder. Although cognitive-behavioral therapy (CBT) is effective for many patients, many others do not respond to CBT or remain considerably symptomatic at the end of treatment. Pharmacological effects are also modest. More empirically-supported treatment options are needed in order to increase patient access to effective treatment. Emotion-focused therapy (EFT) shows great promise in treating SAD effectively and is particularly suitable for treating SAD because pervasive emotional avoidance, difficulties with emotional differentiation, and high levels of self-criticism, which are central psychopathological processes in SAD, are also primary therapeutic targets in EFT. EFT is based on the assumption that the most efficient way to change a maladaptive emotion is not through reason or skill learning, but through the activation of other, more adaptive emotions. EFT aims to access shame-based emotional memories that underlie SAD, and transform them by exposing them to new adaptive emotional experiences, such as empowering assertive anger, grief, and self-compassion. In this paper, the core features of EFT for SAD are presented, as well as the EFT view of dysfunction in SAD and EFT change processes. Research findings regarding the effectiveness of EFT for SAD are presented together with initial findings regarding mechanisms of change occurring during treatment.

Empirically Supported Treatment for Obsessive-Compulsive Disorder

2021 ◽  
pp. 76-94
Author(s):  
Martin E. Franklin ◽  
Sarah G. Turk Karan
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Empirical Support ◽  
Response Prevention ◽  
Obsessive Compulsive ◽  
Empirically Supported Treatment ◽  
Therapist Experience ◽  
Compulsive Disorder ◽  
Empirically Supported

This chapter assesses which treatment should be chosen as the first-line intervention for obsessive-compulsive disorder (OCD). Cognitive Behavioral Therapy (CBT) involving Exposure Plus Response Prevention (ERP) is the treatment with the most empirical support, and its effects appear to be both robust and durable. The chapter then reviews the data on predictors and moderators of differential ERP outcomes. Contemporary ERP manuals emphasize the following core procedures: (1) psychoeducation; (2) hierarchy development; (3) in vivo and imaginal exposure; (4) response prevention; and (5) relapse prevention. The chapter looks at situations in which clinical circumstances dictate a deviation or modification of the protocol from the way these procedures are described in the manual or customarily implemented—being flexible while maintaining fidelity. Therapist experience appears to play a role in how comfortable clinicians are in being flexible, and how successful they are likely to be when they do so.

A Close Look Into Coping Cat: Strategies Within an Empirically Supported Treatment for Anxiety in Youth

2020 ◽  
Vol 34 (1) ◽  
pp. 4-20
Author(s):  
Lesley A. Norris ◽  
Philip C. Kendall
Keyword(s):  
Coping Skills ◽  
Future Research ◽  
Second Phase ◽  
Empirically Supported Treatment ◽  
Randomized Controlled ◽  
Empirically Supported ◽  
Youth Anxiety ◽  
Coping Cat ◽  
Two Phases ◽  
Exposure Tasks

The Coping Cat protocol has shown both efficacy and effectiveness in the treatment of youth anxiety across numerous randomized controlled trials (RCTs), leading to its designation as an empirically supported treatment. The treatment is completed in two phases. In the first phase, children are taught a series of coping skills outlined using the FEAR plan acronym. The FEAR plan is then practiced in exposure tasks during the second phase of treatment. To illustrate implementation of both phases, and highlight core treatment components (i.e., exposure, flexibility within fidelity), a case description is presented. Directions for future research are discussed.

A method for defining the CORE of a psychosocial intervention to guide adaptation in practice: Reciprocal imitation teaching as a case example

Autism ◽  
2022 ◽  
pp. 136236132110644
Author(s):  
Sarah R Edmunds ◽  
Kyle M Frost ◽  
R Chris Sheldrick ◽  
Alice Bravo ◽  
Diondra Straiton ◽  
...  
Keyword(s):  
Social Communication ◽  
Core Model ◽  
Future Research ◽  
Evidence Based ◽  
Community Practice ◽  
Multiple Sources ◽  
The Core ◽  
Essential Components ◽  
Core Components ◽  
Reciprocal Imitation

Defining the central components of an intervention is critical for balancing fidelity with flexible implementation in both research settings and community practice. Implementation scientists distinguish an intervention’s essential components (thought to cause clinical change) and adaptable periphery (recommended, but not necessary). While implementing core components with fidelity may be essential for effectiveness, requiring fidelity to the adaptable periphery may stifle innovation critical for personalizing care and achieving successful community implementation. No systematic method exists for defining essential components a priori. We present the CORE (COmponents & Rationales for Effectiveness) Fidelity Method—a novel method for defining key components of evidence-based interventions—and apply it to a case example of reciprocal imitation teaching, a parent-implemented social communication intervention. The CORE Fidelity Method involves three steps: (1) gathering information from published and unpublished materials; (2) synthesizing information, including empirical and hypothesized causal explanations of component effectiveness; and (3) drafting a CORE model and ensuring its ongoing use in implementation efforts. Benefits of this method include: (1) ensuring alignment between intervention and fidelity materials; (2) clarifying the scope of the adaptable periphery to optimize implementation; and (3) hypothesizing—and later, empirically validating—the intervention’s active ingredients and their associated mechanisms of change. Lay abstract Interventions that support social communication include several “components,” or parts (e.g. strategies for working with children and families, targeting specific skills). Some of these components may be essential for the intervention to work, while others may be recommended or viewed as helpful but not necessary for the intervention to work. “Recommended” components are often described as “adaptable” because they can be changed to improve fit in different settings where interventions are offered or with different individuals. We need to understand which parts of an intervention are essential (and which are adaptable) when translating interventions from research to community settings, but it is challenging to do this before studying an intervention in the community. This article presents the CORE (COmponents & Rationales for Effectiveness) Fidelity Method—a new method for defining the essential components of evidence-based interventions—and applies it to a case example of Reciprocal Imitation Teaching, an intervention that parents are taught to deliver with their young children with social communication delays. The CORE Fidelity Method involves three steps: (1) gathering information from multiple sources; (2) integrating information from previous research and theory; and (3) drafting a CORE model for ongoing use. The benefits of using the CORE Fidelity Method may include: (1) improving consistency in intervention and research materials to help all providers emphasize the most important skills or strategies; (2) clarifying which parts of the intervention can be adapted; and (3) supporting future research that evaluates which intervention components work and how they work.

Empirically Supported Treatment for Panic Disorder: Research, Theory, and Application of Cognitive Behavioral Therapy

2000 ◽  
Vol 14 (3) ◽  
pp. 219-244 ◽  
Author(s):  
William C. Sanderson ◽  
Simon A. Rego
Keyword(s):  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Model ◽  
Cognitive Behavioral ◽  
Empirically Supported Treatment ◽  
Empirically Supported ◽  
Dsm Iv

In this article we review the DSM-IV criteria for Panic Disorder (PD), provide a brief overview of the cognitive model of PD, discuss empirically supported treatment components, and review pivotal experiments examining cognitive behavioral therapy for PD. A case example is also included to illustrate the application of treatment components.

Obsessive–Compulsive and Related Disorders

2018 ◽  
Author(s):  
Lara J. Farrell ◽  
Sharna L. Mathieu ◽  
Cassie Lavell
Keyword(s):  
Body Dysmorphic Disorder ◽  
Psychological Treatment ◽  
Behavioral Therapy ◽  
Repetitive Behaviors ◽  
Evidence Based ◽  
Obsessive Compulsive ◽  
Empirically Supported Treatment ◽  
Compulsive Disorder ◽  
Empirically Supported ◽  
Evidence Based Treatments

Obsessive compulsive and related disorders (OCRDs) in children and adolescents represent a cluster of conditions that significantly interfere in the lives of sufferers and their families. These disorders involve repetitive behaviors and often a preoccupation with distressing, obsessional thoughts. OCRDs include obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder, trichotillomania, and excoriation disorder. The severity, functional impairment, and associated health conditions of these disorders call for timely evidence-based assessment and treatment. Evidence-based assessments include structured and semistructured interviews. Interviews allow for the assessment of symptoms, comorbid conditions, and differential diagnoses. Evidence-based psychological treatment for OCD and BDD in youth involves cognitive behavioral therapy with exposure and response prevention; research is required to determine evidence-based assessment and treatments for less studied OCRDs; identify factors that predict poorer response to evidence-based treatment; develop approaches to augment evidence-based treatments for nonresponders; and further the reach of empirically supported treatment.

A Proposed Framework for Enhancing Collaboration in Early Intervention/Early Childhood Special Education

2020 ◽  
pp. 027112141989068 ◽  
Author(s):  
Diane D. Bricker ◽  
Huda S. Felimban ◽  
Fang Yu Lin ◽  
Sondra M. Stegenga ◽  
Sloan O’Malley Storie
Keyword(s):  
Special Education ◽  
Early Childhood ◽  
Early Intervention ◽  
Relevant Literature ◽  
Early Childhood Special Education ◽  
The Core ◽  
Essential Components ◽  
Young Children With Disabilities ◽  
Sustained Change ◽  
Core Components

Collaboration with caregivers and between disciplines and agencies is a recommended practice in the field of early intervention and early childhood special education (EI/ECSE) as well as required by federal legislation for young children with disabilities. Review of relevant literature suggests that collaboration entails a complex set of principles and practices that are essential for teams and programs to employ if they are to ensure effective and sustained change. Despite the recognized complexity of collaboration in EI/ECSE, few systems frameworks have been proposed that organize the essential components of effective collaboration. We offer a framework that defines the core components of collaboration in EI/ECSE. The proposed system further identifies and operationalizes the infrastructure and practices associated with the components and the levels of action at which these practices operate.

Treatment of Anxiety Disorders

2021 ◽  
pp. 122-133
Author(s):  
Kirstin Painter ◽  
Maria Scannapieco
Keyword(s):  
Side Effects ◽  
Anxiety Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Promising Practices ◽  
The Core ◽  
Core Components ◽  
Norepinephrine Reuptake

As with depressive disorders, the two most common treatments for anxiety are psychotropic medication and psychotherapy, either individually or in conjunction. Psychotherapy is often the preferred first line of treatment unless the youth is a danger to self or others or is significantly unable to function. This chapter provides an overview of the classes of antianxiety and antidepressant medications (i.e., selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, benzodiazepines) used for treating different anxiety disorders along with brief information on their side effects. Descriptions are provided of the core components of curriculum and non-curriculum evidence-based and promising practices, including child–parent psychotherapy, trauma-focused cognitive-behavioral therapy, and two computerized therapies. The chapter ends by revisiting the case studies from Chapter 7, reviewing the actual outcomes of the cases and posing questions to prompt further discussion.

The Psychological Treatment of Victims of Interpersonal Violence

2015 ◽  
Author(s):  
Monica M. Fitzgerald ◽  
Nyla Nasser
Keyword(s):  
Behavioral Problems ◽  
Interpersonal Violence ◽  
Stress Disorder ◽  
Psychological Treatment ◽  
Treatment Programs ◽  
Empirically Supported Treatment ◽  
Therapeutic Environment ◽  
The Core ◽  
Empirically Supported ◽  
Interpersonal Victimization

This chapter provides a brief overview of empirically supported psychosocial treatments for adults who have developed serious clinical psychiatric disorders, such as posttraumatic stress disorder (PTSD), and other psychosocial and behavioral problems as a result of exposure to interpersonal victimization and violence. In this chapter, we will describe important aspects of creating a safe and therapeutic environment for victims of interpersonal violence and the evidence-based core treatment components and strategies for use with adult victims of interpersonal violence with PTSD. Finally, we will introduce three empirically supported treatment programs incorporating some or all of the core treatment components discussed. We will also discuss emerging and novel interventions for the treatment of PTSD in adults that have varying levels of theoretical and empirical evidence.

An Evaluation of Cognitive Behavioral Therapy for Insomnia: A Systematic Review and Application of Tolin’s Criteria for Empirically Supported Treatments

2019 ◽  
Author(s):  
Cassandra L. Boness ◽  
Rachel Hershenberg ◽  
Joanna Kaye ◽  
Margaret-Anne Mackintosh ◽  
Damion Grasso ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Empirically Supported Treatments ◽  
Inclusion Criteria ◽  
American Psychological ◽  
Strong Recommendation ◽  
Empirically Supported ◽  
High Quality Evidence

The American Psychological Association’s Society of Clinical Psychology recently adopted the “Tolin Criteria” to evaluate empirically supported treatments. These criteria better account for strength and quality of rapidly accumulating evidence bases for various treatments. Here we apply this framework to Cognitive Behavioral Therapy for Insomnia (CBT-I). Following procedures outlined by Tolin and colleagues (2015), Step 1 included an examination of quantitative systematic reviews; nine met inclusion criteria. Step 2 evaluated review quality and effect size data. We found high-quality evidence that CBT-I produces clinically and statistically significant effects on insomnia and other sleep-related outcomes. Based on the Tolin Criteria, the literature merits a “strong” recommendation for CBT-I. This report is a working model for subsequent applications of the Tolin Criteria.

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