scholarly journals Enhancing In Vivo Exposure in the Treatment of Panic Disorder and Agoraphobia Using Location-Based Technologies: A Case Study

2019 ◽  
Vol 19 (2) ◽  
pp. 145-159 ◽  
Author(s):  
Ignacio Miralles ◽  
Carlos Granell ◽  
Azucena García-Palacios ◽  
Diana Castilla ◽  
Alberto González-Pérez ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Emotional Disorders ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Unified Protocol ◽  
High Satisfaction ◽  
Patient Reported ◽  
Underlying Mechanisms

Panic disorder (PD) is quite prevalent and often appears along with agoraphobia (PD/A). The treatment of choice is cognitive behavioral therapy (CBT). Transdiagnostic intervention, an emotion-focused, cognitive behavioral intervention that has led to the Unified Protocol (UP), emphasizes the common underlying mechanisms that contribute to the development and maintenance of emotional disorders such as PD/A. A core feature of this treatment approach is in vivo exposure (IVE) to feared situations, which aims to prevent avoidance behaviors and encourages the patient to confront feared situations gradually. It is a difficult component for patients, especially when implementing the exposure on their own. Different feedback formats can be used to increase adequate IVE and reduce overt or subtle avoidance. The use of smartphones is a very useful option to initiate and sustain exposure behavior. The purpose of this study is to describe the use of location-based technologies (LBTs) during the IVE component of the UP treatment of a 47-year-old patient with PD/A. The acceptability and usability of the system were assessed. The Symptoms platform was employed during the exposure module, using LBT with a smartphone app. The patient reported positive expectations, high satisfaction scores, and an overall satisfactory experience. Enhancing key therapeutic components during treatment through the development of media-based tools is a very promising future research aim, and the possibility of using advanced smartphone features should be explored.

Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: preliminary recommendations for future research

2014 ◽  
Vol 27 (7) ◽  
pp. 1217-1225 ◽  
Author(s):  
Sébastien Grenier ◽  
Hélène Forget ◽  
Stéphane Bouchard ◽  
Sébastien Isere ◽  
Sylvie Belleville ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Late Life ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Older Patient ◽  
Imaginal Exposure ◽  
Exposure Sessions ◽  
New Research

ABSTRACTCognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers (e.g. fear of illness). Indeed, imaginal exposure may become less effective as the person gets older since normal aging is characterized by the decline in cognitive functions involved in the creation of vivid/detailed mental images. One way to circumvent this difficulty is to expose the older patient to a virtual environment that does not require the ability to imagine the frightening situation. In virtuo exposure has proven to be efficient to treat anxiety in working-age people. In virtuo exposure could be employed to improve the efficacy of CBT with exposure sessions in the treatment of late-life anxiety? The current paper explores this question and suggests new research avenues.

Adding Cognitive-Behavioral Therapy to Pharmacotherapy for Panic Disorder: Issues and Strategies

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S12) ◽  
pp. 32-39 ◽  
Author(s):  
Michael W. Otto ◽  
Mark Powers ◽  
Jasper A. J. Smits
Keyword(s):  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Contextual Factors ◽  
Cognitive Behavioral ◽  
Ample Evidence ◽  
Treatment Principles

AbstractDespite ample evidence of the efficacy of cognitive-behavioral therapy (CBT) for the treatment of patients with panic disorder (PD), dissemination of this evidence is proceeding slowly. This article highlights some of the issues surrounding the dissemination of CBT for PD and suggests strategies for integrating CBT with pharmacotherapy. Treatment principles, with attention to the modification of CBT protocols for use in a brief-contact format, are reviewed. The principles and application of exposure interventions are discussed for both in vivo (situational) and interoceptive (feared anxiety sensations) exposure, with emphasis on the learning of safety in the context of feared sensations of anxiety. Contextual factors that may affect the success of exposure interventions and cognitive and informational interventions are also discussed.

Cognitive Processes in Panic Disorder: An Extension of Current Models

2001 ◽  
Vol 88 (1) ◽  
pp. 139-159 ◽  
Author(s):  
Carlos Goldberg
Keyword(s):  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Model ◽  
Relevant Information ◽  
Cognitive Behavioral ◽  
Information Processing Model ◽  
Interoceptive Exposure ◽  
General Studies

Beck and Clark's 1997 information processing model of panic was presented and evaluated. In general, studies using the Stroop task have shown panic patients have a cognitive bias toward negative and personally relevant information. Several studies have also shown that panic patients tend to have more catastrophic thoughts and are more likely to misinterpret bodily sensations. Further, cognitive-behavioral therapy is more effective than drug therapies. The limitations of the cognitive model and cognitive-behavioral therapy were discussed, and an extension of current models was proposed. The extension of current models combines cognitive-behavioral and psychodynamic concepts and techniques and suggests that exposure in vivo used for agoraphobic situations and interoceptive exposure used for panic should also be applied to the underlying themes of panic disorder.

scholarly journals Spider Phobia: Neural Networks Informing Diagnosis and (Virtual/Augmented Reality-Based) Cognitive Behavioral Psychotherapy—A Narrative Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Jonas Hinze ◽  
Anne Röder ◽  
Nicole Menzie ◽  
Ulf Müller ◽  
Katharina Domschke ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Brain Regions ◽  
Current Treatment ◽  
Narrative Review ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Spider Phobia

Recent fMRI studies on specific animal phobias, particularly spider phobia (arachnophobia), have identified a large variety of specific brain regions involved in normal and disturbed fear processing. Both functional and structural brain abnormalities have been identified among phobic patients. Current research suggests that both conscious and subconscious fear processing play a crucial role in phobic disorders. Cognitive behavioral therapy has been identified as an effective treatment for specific phobias and has been associated with neuroplastic effects which can be evaluated using current neuroimaging techniques. Recent research suggests that new approaches using virtual (VR) or augmented reality (AR) tend to be similarly effective as traditional “in vivo” therapy methods and could expand treatment options for different medical or individual scenarios. This narrative review elaborates on neural structures and particularities of arachnophobia. Current treatment options are discussed and future research questions are highlighted.

Emotion Regulation and Anxiety

2017 ◽  
pp. 154-170
Author(s):  
Dagmar Kr. Hannesdóttir ◽  
Thomas H. Ollendick
Keyword(s):  
Emotion Regulation ◽  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Behavioral Therapy ◽  
Future Research ◽  
Childhood And Adolescence ◽  
Success Rates ◽  
Treatment As Usual ◽  
Unified Protocol ◽  
Clinically Significant

Chapter 8 reviews anxiety disorders of childhood and adolescence, investigating the role of emotion regulation in onset, maintenance and propagation. Based on DSM-5 criteria anxiety disorders have the following core features: Excessive, persisting anxious arousal and clinically significant symptoms causing distress or dysfunction in social, academic or other domains of functioning. Currently, CBT interventions have been created for school-aged children with anxiety including the Coping Cat and the Cool Kids programs. Despite relatively high success rates, children remaining symptomatic after treatment may benefit from emotion-focused approaches, such as Emotion-Focused Cognitive-Behavioral Therapy and the Unified Protocol for the Treatment of Emotional Disorders in Youth. In addition, novel therapies have been devised targeting parents and their emotion regulation deficits like the Supportive Parenting for Anxious Childhood Emotions (SPACE) program. Future research should employ randomized control trials comparing the novel treatment approaches, treatment as usual, and standard CBT determining best practice protocols.

349 Cognitive Behavioral Therapy for Insomnia in Patients with Chronic Pain - A Systematic Review and Meta-Analysis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A139-A140
Author(s):  
Janannii Selvanathan ◽  
Chi Pham ◽  
Mahesh Nagappa ◽  
Philip Peng ◽  
Marina Englesakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioral Therapy ◽  
Cancer Pain ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Comorbid Insomnia ◽  
Patient Reported

Abstract Introduction Patients with chronic non-cancer pain often report insomnia as a significant comorbidity. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment for insomnia, and several randomized controlled trials (RCTs) have examined the efficacy of CBT-I on various health outcomes in patients with comorbid insomnia and chronic non-cancer pain. We conducted a systematic review and meta-analysis on the effectiveness of CBT-I on sleep, pain, depression, anxiety and fatigue in adults with comorbid insomnia and chronic non-cancer pain. Methods A systematic search was conducted using ten electronic databases. The duration of the search was set between database inception to April 2020. Included studies must be RCTs assessing the effects of CBT-I on at least patient-reported sleep outcomes in adults with chronic non-cancer pain. Quality of the studies was assessed using the Cochrane risk of bias assessment and Yates quality rating scale. Continuous data were extracted and summarized using standard mean difference (SMD) with 95% confidence intervals (CIs). Results The literature search resulted in 7,772 articles, of which 14 RCTs met the inclusion criteria. Twelve of these articles were included in the meta-analysis. The meta-analysis comprised 762 participants. CBT-I demonstrated a large significant effect on patient-reported sleep (SMD = 0.87, 95% CI [0.55–1.20], p < 0.00001) at post-treatment and final follow-up (up to 9 months) (0.59 [0.31–0.86], p < 0.0001); and moderate effects on pain (SMD = 0.20 [0.06, 0.34], p = 0.006) and depression (0.44 [0.09–0.79], p= 0.01) at post-treatment. The probability of improving sleep and pain following CBT-I at post-treatment was 81% and 58%, respectively. The probability of improving sleep and pain at final follow-up was 73% and 57%, respectively. There were no statistically significant effects on anxiety and fatigue. Conclusion This systematic review and meta-analysis showed that CBT-I is effective for improving sleep in adults with comorbid insomnia and chronic non-cancer pain. Further, CBT-I may lead to short-term moderate improvements in pain and depression. However, there is a need for further RCTs with adequate power, longer follow-up periods, CBT for both insomnia and pain, and consistent scoring systems for assessing patient outcomes. Support (if any):

TF-CBT Group Intervention for Children in High Conflict Custody Disputes

2021 ◽  
pp. 106648072110057
Author(s):  
Kelli Anderson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Group Intervention ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Ethical Implications ◽  
High Conflict ◽  
Custody Disputes ◽  
The Relationship ◽  
Traumatic Symptoms

This article proposes a conceptual group approach using trauma-based cognitive behavioral therapy for children involved in high conflict custody disputes. Traditionally, interventions for this population have focused on repairing the relationship between parent and child and less on addressing the traumatic symptoms with which the child is suffering. The proposed intervention focuses solely on the needs of the child and provides an outline for seven sessions during which the PRACTICE model of trauma-focused cognitive behavioral therapy is used. Additionally, ethical implications and directions for future research are discussed.

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