A Cognitive Behavioural Intervention for Overweight and Obese Adolescents Illustrated by Four Case Studies

2009 ◽  
Vol 26 (3) ◽  
pp. 190-213 ◽  
Author(s):  
Leah Brennan ◽  
Jeff Walkley ◽  
Sarah Lukeis ◽  
Anica Risteska ◽  
Lisa Archer ◽  
...  
Keyword(s):  
Case Studies ◽  
Health Behaviours ◽  
Cardiovascular Fitness ◽  
Overweight And Obesity ◽  
Dietary Quality ◽  
Behavioural Intervention ◽  
Clinical Tool ◽  
Obese Adolescents ◽  
Psychosocial Wellbeing ◽  
Cognitive Behavioural

AbstractThis article reports four case studies illustrating the implementation of the ChooseHealthProgram, a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Participants were an overweight (12 years) and obese (15 years) female, and an overweight (14 years) and obese (12 years) male. The program was delivered by provisional psychologists with program specific training and supervision. All participants demonstrated improvements in body composition, and maintained or improved dietary quality and psychosocial wellbeing. The program had variable effects on physical activity and minimal effect on cardiovascular fitness for three of the four participants. While parents and adolescents required considerable assistance to develop and monitor long term program goals, these goals were a useful clinical tool to support the adolescent and parent to recognise the improvements they had made. Identification and monitoring of specific, measurable, and realistic behaviour change strategies was particularly important in assisting adolescents and their parents to translate session information into improved health behaviours. Results indicate that an adolescent overweight and obesity treatment program that promotes adolescent responsibility and autonomy, and emphasises the importance of parent support and family change is both effective and highly acceptable to both adolescents and parents.

Pain Management in Rheumatoid Arthritis: A Cognitive-Behavioural Intervention

1993 ◽  
Vol 23 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Sean Germond ◽  
Hein Helgo Schomer ◽  
Orlando Llewellyn Meyers ◽  
Lindsay Weight
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Studies ◽  
Psychological Adjustment ◽  
Psychological Health ◽  
Treatment Effects ◽  
Disease Status ◽  
Complex Nature ◽  
Behavioural Intervention ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention

Psychological adjustment is thought to play an important role in determining pain experience, disease status, and immune function in rheumatoid arthritis (RA). Fourteen female RA out-patients were tested longitudinally in a matched-random assigned two-groups design with cognitive-behavioural intervention designed to improve pain and stress management skills. Pre-intervention correlational analyses tested the extent to which mood disturbance, self-perceptions of coping efficacy, health locus of control, and stressful life experience were related to pain, disease activity, functional status and lymphocyte proliferation rate variables. Intra- and inter-group analyses were conducted to determine treatment effects, and case studies were conducted. RA was characterized more by poor psychological health status than physical disability, with pain more a function of psychological adjustment than actual disease status. No significant treatment effects were observed. Case studies indicated the complex nature of the individual disease experience. The value of cognitive-behavioural intervention in RA, and implications for future-related research are discussed in terms of such findings.

Self-Monitoring in the Treatment of Overweight Adolescents

2011 ◽  
Vol 28 (2) ◽  
pp. 97-109
Author(s):  
Mary Sandilands ◽  
Leah Brennan ◽  
Jeff Walkley ◽  
Steve F. Fraser ◽  
Kate Greenway
Keyword(s):  
Physical Activity ◽  
Behavioural Intervention ◽  
Food Groups ◽  
Self Monitoring ◽  
Obese Adolescents ◽  
Cognitive Behavioural ◽  
Complete Treatment ◽  
Cognitive Behavioural Intervention ◽  
Food And Drink

AbstractThe aim of this study was to explore the relationship between the quantity and quality of self-monitoring and per cent fat loss in overweight and obese adolescents participating in a weight-loss intervention. Participants were 55 (33F) over-weight and obese adolescents taking part in a 20-week cognitive–behavioural intervention aimed at improving eating and physical activity behaviours. Food and physical activity self-monitoring from the first 9 weeks of the intervention was coded using 24 components assessing the quantity (20) and quality (4) of self-monitoring. Those who completed treatment (n= 42) were split into groups: Losers (n= 30) and Gainers (n= 12) of per cent body fat as measured by DXA. Group analyses showed that Losers and Gainers could be differentiated by both quantitative and qualitative measures of self-monitoring. The strongest associations were with the classifications of food and drink items into food groups. The number of days monitored and the average number of items recorded did not differentiate the groups. Quantity and quality measures of self-monitoring completed early in treatment could also differentiate those who completed treatment and those who did not complete treatment (n= 13), and the strongest associations were with the amounts of food and drink items recorded, an association not found with treatment outcome. The results indicate that both quantity and quality of self-monitoring may be important predictors of both treatment completion and outcome. Based on these findings a framework of self-monitoring requirements is offered to reduce homework burden while maximising treatment efficacy.

scholarly journals Treatment Acceptability and Psychosocial Outcomes of a Randomised Controlled Trial of a Cognitive Behavioural Lifestyle Intervention for Overweight and Obese Adolescents

2012 ◽  
Vol 29 (1) ◽  
pp. 36-62 ◽  
Author(s):  
Leah Brennan ◽  
Ray Wilks ◽  
Jeff Walkley ◽  
Steve F. Fraser ◽  
Kate Greenway
Keyword(s):  
Social Support ◽  
Family Functioning ◽  
Psychosocial Functioning ◽  
Treatment Acceptability ◽  
Self Report ◽  
Behavioural Intervention ◽  
Wait List ◽  
Obese Adolescents ◽  
Cognitive Behavioural ◽  
The Impact

This study explores the impact of a cognitive behavioural lifestyle program, theChoose HealthProgram, on psychosocial wellbeing in overweight and obese adolescents. The sample comprised 29 male and 34 female adolescents aged 11.5 to 18.9 years (M= 14.3,SD= 1.9) and classified as overweight (n= 15) or obese (n= 48). Participants were randomly allocated to treatment or wait-list control conditions; participants allocated the wait-list condition were offered treatment after 6 months. Adolescents and parents completed self-report measures of psychopathology, psychosocial and family functioning. Treatment did not have detrimental effects on the psychosocial factors assessed. It resulted in significant improvements in weight control behaviour, impulse regulation, social support from family and parent–adolescent problem communication (p< .05). Similar results were obtained with completer and intention-to-treat analyses. Treatment acceptability was high, with all respondents indicating that they made progress. Combined, results indicate that treatment did not have detrimental effects on psychopathology, psychosocial functioning, or family functioning. Treatment resulted in significant improvements in impulse regulation, social support from family and parent–adolescent communication. Thus, parents and professionals can be assured that a comprehensive, multifaceted, parent-supported, cognitive behavioural intervention for overweight and obese adolescents does not cause psychological harm.

scholarly journals Maternal dietary quality, inflammatory potential and offspring adiposity throughout childhood: a pooled analysis of 7 European cohorts (ALPHABET consortium)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ling-Wei Chen ◽  
Adrien Aubert ◽  
Jonathan Y. Bernard ◽  
Cyrus Cooper ◽  
Liesbeth Duijts ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Overweight And Obesity ◽  
Fat Free Mass ◽  
Data Availability ◽  
Dietary Quality ◽  
Late Childhood ◽  
Dash Score ◽  
Inverse Association ◽  
Offspring Adiposity ◽  
Age And Sex

AbstractIntroductionThe foetal programming hypothesis posits that optimising early life factors e.g. maternal diets can help avert the burden of adverse childhood outcomes e.g. childhood obesity. To improve applicability to public health messaging, we investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity in a large consortium.MethodsWe harmonized and pooled individual participant data from up to 8,769 mother-child pairs in 7 European mother-offspring cohorts. Maternal early-, late-, and whole-pregnancy dietary quality and inflammatory potential were assessed with Dietary Approaches to Stop Hypertension (DASH) and energy-adjusted Dietary Inflammatory Index (E-DII), respectively. Primary outcome was childhood overweight and obesity (OWOB), defined as age- and sex-specific body-mass-index-z score (BMIz) > 85th percentile based on WHO growth standard. Secondary outcomes were sum-of-skinfold-thickness (SST), fat-mass-index (FMI) and fat-free-mass-index (FFMI) in available cohorts. Outcomes were assessed in early- [mean (SD) age: 2.8 (0.3) y], mid- [6.2 (0.6) y], and late-childhood [10.6 (1.2) y]. We used multivariable regression analyses to assess the associations of maternal E-DII and DASH with offspring adiposity outcomes in cohort-specific analyses, with subsequent random-effects meta-analyses. Analyses were adjusted for maternal age, pre-pregnancy BMI, parity, lifestyle factors, energy intake, educational attainment, offspring age and sex.ResultsA more pro-inflammatory maternal diet, indicated by higher E-DII, was associated with a higher risk of offspring late-childhood OWOB [pooled-OR (95% CI) comparing highest vs. lowest E-DII quartiles: 1.22 (1.01,1.47) for whole-pregnancy and 1.38 (1.05,1.83) for early-pregnancy; both P < 0.05]. Moreover, higher late-pregnancy E-DII was associated with higher mid-childhood FMI [pooled-β (95% CI): 0.11 (0.003,0.22) kg/m2; P < 0.05]; trending association was observed for whole-pregnancy E-DII [0.12 (-0.01,0.25) kg/m2; P = 0.07]. A higher maternal dietary quality, indicated by higher DASH score, showed a trending inverse association with late-childhood OWOB (pooled-OR (95% CI) comparing highest vs. lowest DASH quartiles: 0.58 (0.32,1.02; P = 0.06). Higher early-pregnancy DASH was associated with lower late-childhood SST [pooled-β (95% CI): -1.9 (-3.6,-0.1) cm; P < 0.05] and tended to be associated with lower late-childhood FMI [-0.34 (-0.71,0.04) kg/m2; P = 0.08]. Higher whole-pregnancy DASH tended to associate with lower early-childhood SST [-0.33 (-0.72,0.06) cm; P = 0.10]. Results were similar when modelling DASH and E-DII continuously.DiscussionAnalysis of pooled data suggests that pro-inflammatory, low-quality maternal antenatal diets may influence offspring body composition and obesity risk, especially during mid- or late-childhood. Due to variation of data availability at each timepoint, our results should be interpreted with caution. Because most associations were observed at mid-childhood or later, future studies will benefit from a longer follow-up.

Improving perinatal sleep via a scalable cognitive behavioural intervention: findings from a randomised controlled trial from pregnancy to 2 years postpartum

2021 ◽  
pp. 1-11
Author(s):  
Bei Bei ◽  
Donna M. Pinnington ◽  
Nina Quin ◽  
Lin Shen ◽  
Michelle Blumfield ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Sleep Disturbance ◽  
Controlled Trial ◽  
Perinatal Care ◽  
Group Differences ◽  
Behavioural Intervention ◽  
Cognitive Behavioural ◽  
Pregnancy And Postpartum ◽  
Randomised Controlled ◽  
Insomnia Symptoms

Abstract Background Sleep disturbance is common in gestational parents during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. Methods This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous females without severe medical/psychiatric conditions were randomised 1:1 to CBT or attention- and time-matched control. All participants received a 1 h telephone session and automated multimedia emails from the third trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12 and 24. Results In total, 163 eligible participants (age M ± s.d. = 33.35 ± 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p values ⩽ 0.001), as well as at 24 months postpartum (p ranges 0.012–0.052). Group differences across the first postpartum year were non-significant. Participants with elevated insomnia symptoms at baseline benefitted substantially more from CBT (v. control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were non-significant. Conclusions A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy and benefitted sleep at 2-year postpartum, especially for individuals with insomnia symptoms during pregnancy. The intervention holds promise for implementation into routine perinatal care.

scholarly journals Randomised controlled trial of CD–ROM-based cognitive–behavioural self-care for bulimia nervosa

2008 ◽  
Vol 193 (6) ◽  
pp. 493-500 ◽  
Author(s):  
U. Schmidt ◽  
M. Andiappan ◽  
M. Grover ◽  
S. Robinson ◽  
S. Perkins ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Self Care ◽  
Waiting List ◽  
Behavioural Intervention ◽  
Significant Group ◽  
Cd Rom ◽  
Cognitive Behavioural

BackgroundCognitive–behavioural self-care is advocated as a first step in the treatment of bulimia nervosa.AimsTo examine the effectiveness of a CD–ROM-based cognitive–behavioural intervention in bulimia nervosa and eating disorder not otherwise specified (NOS) (bulimic type) in a routine setting.MethodNinety-seven people with bulimia nervosa or eating disorder NOS were randomised to either CD–ROM without support for 3 months followed by a flexible number of therapist sessions or to a 3-month waiting list followed by 15 sessions of therapist cognitive–behavioural therapy (CBT) (ISRCTN51564819). Clinical symptoms were assessed at pre-treatment 3 months and 7 months.ResultsOnly two-thirds of participants started treatment. Although there were significant group × time interactions for bingeing and vomiting, favouring the CD–ROM group at 3 months and the waiting-list group at 7 months, post hoc group comparisons at 3 and 7 months found no significant differences for bingeing or vomiting. CD–ROM-based delivery of this intervention, without support from a clinician, may not be the best way of exploiting its benefits.

scholarly journals Assessing competence in cognitive-behavioural therapy

2008 ◽  
Vol 193 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Andrew J. A. Keen ◽  
Mark H. Freeston
Keyword(s):  
Clinical Practice ◽  
Case Studies ◽  
Cognitive Behavioural Therapy ◽  
Clinical Work ◽  
Behavioural Therapy ◽  
High Stakes ◽  
Cognitive Behavioural ◽  
Reliable Assessment

BackgroundPostgraduate courses on cognitive-behavioural therapy (CBT) assess various competencies using essays, case studies and audiotapes or videotapes of clinical workAimsTo evaluate how reliably a well-established postgraduate course assesses CBT competenciesMethodData were collected on two cohorts of trainees (n=52). Two examiners marked trainees on: (a) two videotapes of clinical practice; (b) two case studies; and (c) three essaysResultsEssay examinations were more reliable than case studies, which in turn were more reliable than videotaped assessments. The reliability of the latter two assessments was considerably lower than that commonly expected of high-stakes examinations. To assess reliably standard CBT competencies, postgraduate courses would need to examine about 5 essays, 12 case studies and 19 videotapesConclusionsReliable assessment of standard competencies is complex and resource intensive. There would need to be a marked increase in the number of samples of clinical work assessed to be able to make reliable judgements about proficiency

Sign in / Sign up

Export Citation Format

Share Document