scholarly journals Effectiveness of usual-care cognitive-behavioral therapy for adolescents with depressive disorders rated by parents and patients – an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Walter ◽  
Jana Buschsieweke ◽  
Lydia Dachs ◽  
Hildegard Goletz ◽  
Anja Goertz-Dorten ◽  
...  
Keyword(s):  
Observational Study ◽  
Cognitive Behavioral Therapy ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Effect Sizes ◽  
Parent Rating ◽  
Link Type ◽  
End Of Treatment ◽  
Wide Range

Abstract Background Depressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but studies examining the effectiveness of CBT in clinical settings are very rare . Methods In the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a clinical setting in terms of a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11–18 years with complete data were assessed for the main analysis. Results The analysis yielded small to large pre-post effect sizes (Cohen’s d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub) scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment. Conclusions These findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition. Trial registration DRKS, DRKS00021518. Registered 27 April 2020 - Retrospectively registered, http://drks.de

scholarly journals Effectiveness of Usual-Care Cognitive-Behavioral Therapy for Adolescents with Depressive Disorders Rated by Parents and Patients

2020 ◽  
Author(s):  
Daniel Walter ◽  
Jana Buschsieweke ◽  
Lydia Dachs ◽  
Hildegard Goletz ◽  
Anja Goertz-Dorten ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Effect Sizes ◽  
Control Group ◽  
Parent Rating ◽  
Wide Range

Abstract BackgroundDepressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but the effectiveness of CBT under routine care conditions remains unproven.MethodsIn the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11–18 years with complete data were assessed for the main analysis.ResultsThe analysis yielded small to large pre-post effect sizes (Cohen’s d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub)scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment.ConclusionsThese findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition.Trial registrationDRKS, DRKS00021518. Registered 27 April 2020 - Retrospectively registered, http://drks.de

scholarly journals Trauma informed interventions: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252747
Author(s):  
Hae-Ra Han ◽  
Hailey N. Miller ◽  
Manka Nkimbeng ◽  
Chakra Budhathoki ◽  
Tanya Mikhael ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Health Inequities ◽  
The United States ◽  
Psychological Outcomes ◽  
Cognitive Behavioral ◽  
Health Concern ◽  
Ptsd Symptoms ◽  
Wide Range ◽  
Trauma Informed

Background Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes. Methods We performed database searches— PubMed, Embase, CINAHL, SCOPUS and PsycINFO—to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria. Results More than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5). Conclusions There is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.

Cognitive Behavioral Therapy for Insomnia for Caregivers

2019 ◽  
pp. 201-218
Author(s):  
Kelly M. Shaffer ◽  
Patricia Carter ◽  
Sheila N. Garland ◽  
Allison J. Applebaum
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Contributing Factors ◽  
Compensatory Behaviors ◽  
Wide Range ◽  
Cancer Caregivers ◽  
Clinically Significant ◽  
Mental And Physical Health

Between 40% and 76% of cancer caregivers report clinically significant symptoms of insomnia, likely due in part to the unique responsibilities, stressors, and compensatory behaviors endemic to the role. Insomnia negatively affects one’s mental and physical health, is frequently chronic, and may impair the normal grieving process among bereaved caregivers. Cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment for insomnia and is well suited to address the multifaceted contributing factors unique to caregivers’ sleep disturbance. This chapter addresses the distinct presentation of insomnia among cancer caregivers and describes key modifications to standard CBT-I that address these specific needs to enhance sensitivity and feasibility. A case example demonstrates the implementation of CBT-I tailored to one caregiver’s presentation. Future research must demonstrate effectiveness and acceptability of CBT-I among active caregivers, as well as develop a wide range of effective CBT-I delivery modalities to best serve this vulnerable population.

Integrated Cognitive Behavioral Therapy Versus Twelve-Step Facilitation Therapy for Substance-Dependent Adults with Depressive Disorders

2006 ◽  
Vol 38 (4) ◽  
pp. 449-460 ◽  
Author(s):  
Sandra A. Brown ◽  
Suzette V. Glasner-Edwards ◽  
Susan R. Tate ◽  
John R. McQuaid ◽  
John Chalekian ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Twelve Step ◽  
Substance Dependent

scholarly journals Developing a data-driven algorithm for guiding selection between cognitive behavioral therapy, fluoxetine, and combination treatment for adolescent depression

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Meredith Gunlicks-Stoessel ◽  
Bonnie Klimes-Dougan ◽  
Adrienne VanZomeren ◽  
Sisi Ma
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Combination Treatment ◽  
Adolescent Depression ◽  
Behavioral Therapy ◽  
Individual Characteristics ◽  
Cognitive Behavioral ◽  
Treatment Type ◽  
Children’S Depression ◽  
Starting Point ◽  
Wide Range

Abstract Treating adolescent depression effectively requires providing interventions that are optimally suited to patients’ individual characteristics and needs. Therefore, we aim to develop an algorithm that matches patients with optimal treatment among cognitive-behavioral therapy (CBT), fluoxetine (FLX), and combination treatment (COMB). We leveraged data from a completed clinical trial, the Treatment for adolescents with depression study, where a wide range of demographic, clinical, and psychosocial measures were collected from adolescents diagnosed with major depressive disorder prior to treatment. Machine-learning techniques were employed to derive a model that predicts treatment response (week 12 children’s depression rating scale-revised [CDRS-R]) to CBT, FLX, and COMB. The resulting model successfully identified subgroups of patients that respond preferentially to specific types of treatment. Specifically, our model identified a subgroup of patients (25%) that achieved on average a 16.9 point benefit on the CDRS-R from FLX compared to CBT. The model also identified a subgroup of patients (50%) that achieved an average benefit up to 19.0 points from COMB compared to CBT. Physical illness and disability were identified as overall predictors of response to treatment, regardless of treatment type, whereas baseline CDRS-R, psychosomatic symptoms, school missed, view of self, treatment expectations, and attention problems determined the patients’ response to specific treatments. The model developed in this study provides a critical starting point for personalized treatment planning for adolescent depression.

Suitability for Short-Term Cognitive-Behavioral Therapy

2007 ◽  
Vol 21 (4) ◽  
pp. 334-345 ◽  
Author(s):  
Gail Myhr ◽  
Jeanne Talbot ◽  
Lawrence Annable ◽  
Gilbert Pinard
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Linear Regression Analysis ◽  
Cognitive Behavioral ◽  
Reliable Change Index ◽  
Short Term ◽  
Variable Model ◽  
Wide Range

The Suitability for Short-Term Cognitive Therapy Rating Scale (SRS) defines 10 criteria to assess suitability for short-term cognitive-behavioral therapy (CBT). This study examines the relationships between pretreatment SRS scores and outcome of 113 patients treated with short-term CBT for a wide range of disorders. Using the reliable change index (RCI) as a measure of outcome, 65 individuals (57.5%) of the sample experienced statistically reliable improvement. Married status, employed status, female gender, and anxiety disorder as a primary diagnosis were positively correlated with posttreatment RCI. Awareness of emotion and security operations were the SRS items most strongly correlated with outcome. Also correlated were the two alliance potential items (in-session and out-of-session evidence) and the acceptance of personal responsibility for change. Hierarchical multiple linear regression analysis resulted in a three-variable model where married status, primary anxiety disorder, and mean SRS score accounted for 20% of the variance in RCI scores. We conclude that the SRS adds predictive value to the assessment of potential to succeed in CBT.

scholarly journals Randomized Controlled Trial of a Cognitive-Behavioral Therapy Plus Hypnosis Intervention to Control Fatigue in Patients Undergoing Radiotherapy for Breast Cancer

2014 ◽  
Vol 32 (6) ◽  
pp. 557-563 ◽  
Author(s):  
Guy H. Montgomery ◽  
Daniel David ◽  
Maria Kangas ◽  
Sheryl Green ◽  
Madalina Sucala ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Behavioral Therapy ◽  
Muscle Weakness ◽  
Behavioral Therapy ◽  
Attention Control ◽  
Cognitive Behavioral ◽  
Control Group ◽  
End Of Treatment ◽  
Vas Scores

Purpose The objective of this study was to test the efficacy of cognitive-behavioral therapy plus hypnosis (CBTH) to control fatigue in patients with breast cancer undergoing radiotherapy. We hypothesized that patients in the CBTH group receiving radiotherapy would have lower levels of fatigue than patients in an attention control group. Patients and Methods Patients (n = 200) were randomly assigned to either the CBTH (n = 100; mean age, 55.59 years) or attention control (n = 100; mean age, 55.97 years) group. Fatigue was measured at four time points (baseline, end of radiotherapy, 4 weeks, and 6 months after radiotherapy). Fatigue was measured using the Functional Assessment of Chronic Illness Therapy (FACIT) –Fatigue subscale and Visual Analog Scales (VASs; Fatigue and Muscle Weakness). Results The CBTH group had significantly lower levels of fatigue (FACIT) at the end of radiotherapy (z, 6.73; P < .001), 4-week follow-up (z, 6.98; P < .001), and 6-month follow-up (z, 7.99; P < .001) assessments. Fatigue VAS scores were significantly lower in the CBTH group at the end of treatment (z, 5.81; P < .001) and at the 6-month follow-up (z, 4.56; P < .001), but not at the 4-week follow-up (P < .07). Muscle Weakness VAS scores were significantly lower in the CBTH group at the end of treatment (z, 9.30; P < .001) and at the 6-month follow-up (z, 3.10; P < .02), but not at the 4-week follow-up (P < .13). Conclusion The results support CBTH as an evidence-based intervention to control fatigue in patients undergoing radiotherapy for breast cancer. CBTH is noninvasive, has no adverse effects, and its beneficial effects persist long after the last intervention session. CBTH seems to be a candidate for future dissemination and implementation.

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