The Relationship Between Cognitive Behavioral Therapy Maintenance Processes, Emotional Distress, and Positive Psychotic Symptoms: Evidence That CBT Is “Not a Quasi-Neuroleptic”

2014 ◽  
Vol 28 (2) ◽  
pp. 101-116 ◽  
Author(s):  
Robert Brockman ◽  
Michael Kiernan ◽  
Vlasios Brakoulias ◽  
Elizabeth Murrell
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Empirical Evidence ◽  
Outcome Measures ◽  
Emotional Distress ◽  
Behavioral Therapy ◽  
Control Strategies ◽  
Cognitive Behavioral ◽  
Psychotic Symptoms ◽  
Change Processes ◽  
The Relationship

Cognitive behavioral therapy for psychosis (CBTp) has enjoyed a steep rise in popularity over the past 15 years; however, recent systematic reviews and meta-analyses have concluded that CBTp has only modest effects on psychotic syndrome outcomes and that empirical evidence of its superiority over other psychosocial treatments is poor. And although it has been argued by some prominent authors that CBTp is not designed to alleviate the “psychotic syndrome,” there is little empirical evidence linking CBTp change mechanisms with syndrome versus single-symptom outcome measures. This study investigated the relationship between CBTp change processes, beliefs about voices, and thought control strategies, with a range of outcome measures including global positive psychotic symptoms in a sample of 40 voice hearers with established diagnosis of psychotic disorder. Consistent with the assertions of Birchwood and Trower (2006), global positive symptoms were found to be generally poorly related to CBTp change processes. Conversely, these CBTp change processes were found to be generally strongly related to measures of emotional distress and some measures of single psychotic symptoms. The implications for past and future CBTp treatment outcome studies are discussed.

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.

scholarly journals Meta-analysis and Meta-regression of Cognitive Behavioral Therapy for Psychosis (CBTp) Across Time: The Effectiveness of CBTp has Improved for Delusions

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Katarzyna Sitko ◽  
Bridgette M Bewick ◽  
David Owens ◽  
Ciara Masterson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Medium Effects ◽  
Treatment As Usual ◽  
Meta Analyses

Abstract Published research shows small-to-medium effects of Cognitive Behavioral Therapy for Psychosis (CBTp) on reducing psychotic symptoms. Given the on-going development of CBTp interventions, the aim of this systematic review is to examine whether the effectiveness of CBTp has changed across time. MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for randomized controlled trials examining CBTp interventions targeting positive and/or negative symptoms vs treatment as usual. Four meta-analyses were carried out to examine the effectiveness of CBTp for: positive symptoms; delusions; hallucinations; and negative symptoms. Four meta-regressions examined whether the effectiveness of CBTp changed across time for these groups of symptoms. A total of 28 studies (n = 2698) yielded a pooled g of −0.24 (95% confidence interval [CI] −0.32, −0.16, P < .001) favoring CBTp for positive symptoms, with nonsignificant heterogeneity (Q = 26.87, P = .47; I2 =0%); 13 studies (n = 890) yielded a pooled g of −0.36 (95% CI −0.59, −0.13, P = .002) for delusions, with substantial heterogeneity (Q = 31.99, P = .001; I2 =62%); 16 studies (n = 849) yielded a pooled g of −0.26 (95% CI −0.42, −0.11, P < .001) for hallucinations, with nonsignificant heterogeneity (Q = 18.10, P = .26; I2 =17%); 19 studies (n = 1761) yielded a pooled g of −0.22 (95% CI −0.33, −0.12, P < .001) for negative symptoms, with nonsignificant heterogeneity (Q = 20.32, P = .32, I2 =11%). Meta-regressions indicated a significant effect of year on the effectiveness of CBTp only for delusions (F[1, 11] = 5.99, P = .032; R2 = 0.594); methodological quality did not effect this finding. Findings indicate small-to-medium effects of CBTp for psychotic symptoms, with increasing effectiveness across time for delusions.

scholarly journals TACTICS OF PSYCHOLOGICAL TESTING AND PSYCHOTHERAPY OF SLEEP DISORDERS DURING THE COVID-19 PANDEMIC

2021 ◽  
Vol 9 (3) ◽  
pp. 259-276
Author(s):  
A.I. Melehin ◽  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Sleep Disorders ◽  
Mental State ◽  
Behavioral Therapy ◽  
Health Anxiety ◽  
Cognitive Behavioral ◽  
Number Of Factors ◽  
The Moment ◽  
First Time ◽  
The Relationship

Due to the high prevalence of sleep disorders during the second and third waves, the question of the relationship between the incidence of coronavirus, acute respiratory distress syndrome and sleep is still open. The article describes for the first time the specifics of the phenomenon of COVID-SOMNIA or covid-associated sleep disorders, which includes a spectrum of changes in sleep from insomnia, restless legs syndrome to behavior disorders during the REM sleep phase. Various effects of COVID-19 on sleep disorders in patients have been shown. Different infections have different effects on the mental state and on a person’s sleep — these are sleep disorders caused by viral load. Specific clinical and psychological manifestations of covid-associated sleep disorders are described. For the first time in Russia, a model of the relationship between covid-associated anxiety, insomnia and suicidal thinking is presented. The psychological factors influencing the occurrence of the phenomenon of COVID-somnia in patients are systematized. It is shown that the risks of developing insomnia during the COVID-19 pandemic consist of the presence of a number of factors in the patient: tolerance to uncertainty, covid-associated anxiety, feelings of loneliness, the presence of symptoms of depression and anxiety earlier and at the moment. For clinical psychologists, the general tactics of psychological examination of an infected patient who has undergone COVID-19, who have post-ovoid syndrome in the presence of changes in the mental state and quality of sleep are described. In short, the protocols of remote cognitive behavioral therapy of anxiety associated with the COVID-19 pandemic are based on a psychological model of health anxiety and hypochondria (somatosensory amlification). It is recommended that we use cognitive refocusing therapy for insomnia (cognitive refocusing treatment) and a protocol for short-term remote cognitive behavioral therapy of anxiety associated with the COVID-19 pandemic in everyday clinical practice.

scholarly journals Single Session Real-time fMRI Neurofeedback has a Lasting Impact on Cognitive Behavioral Therapy Strategies

2018 ◽  
Author(s):  
Katherine E. MacDuffie ◽  
Jeff MacInnes ◽  
Kathryn C. Dickerson ◽  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Real Time ◽  
Behavioral Therapy ◽  
Control Strategies ◽  
Learning Experience ◽  
Anterior Cingulate ◽  
Cognitive Behavioral ◽  
Fmri Session ◽  
The Impact ◽  
Experimental Strategies

AbstractTo benefit from cognitive behavioral therapy (CBT), individuals must not only learn new skills but also strategically implement them outside the session. Here, we tested a novel technique for personalizing CBT skills and facilitating their generalization to daily life. We hypothesized that showing participants the impact of specific CBT strategies on their own brain function using real-time functional magnetic imaging (rt-fMRI) neurofeedback would increase their metacognitive awareness, help them identify effective strategies, and motivate real-world use. In a within-subjects design, participants who had completed a clinical trial of a standardized course of CBT created a personal repertoire of negative autobiographical stimuli and mood regulation strategies. From each participant’s repertoire, a set of experimental and control strategies were identified; only experimental strategies were practiced in the scanner. During the rt-fMRI neurofeedback session, participants used negative stimuli and strategies from their repertoire to manipulate activation in the anterior cingulate cortex, a region implicated in emotional distress. The primary outcome measures were changes in participant ratings of strategy difficulty, efficacy, and frequency of use. As predicted, ratings for unscanned control strategies were stable across observations, whereas ratings for experimental strategies changed after neurofeedback. At follow-up one month after the session, efficacy and frequency ratings for scanned strategies were predicted by neurofeedback during the rt-fMRI session. These results suggest that rt-fMRI neurofeedback created a salient and durable learning experience for patients, extending beyond the clinic to guide and motivate CBT skill use weeks later. This metacognitive approach to neurofeedback offers a promising model for increasing clinical benefits from cognitive-behavioral therapy by personalizing skills and facilitating generalization.

Cognitive-behavioral therapy

2020 ◽  
pp. 514-523
Author(s):  
Tania Lincoln ◽  
Alison Brabban
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Interventions ◽  
Negative Symptoms ◽  
Treatment Guidelines ◽  
Behavioral Therapy ◽  
Well Being ◽  
Cognitive Behavioral ◽  
Psychotic Symptoms ◽  
Case Formulation ◽  
Intervention Trials

The view that psychotic symptoms lie on a continuum with normal experiences and can be explained by normal psychological processes has provided the basis for adapting cognitive-behavioral interventions for psychosis. Cognitive-behavioral therapy for psychosis (CBTp) focuses on reframing appraisals and modifying behavior related to psychotic symptoms to reduce distress and improve functioning and well-being. To date, the efficacy and effectiveness of CBTp has been demonstrated in over 30 intervention trials and it is widely recommended in various national treatment guidelines. This introduction to CBTp provides an overview of the main strategies employed including interventions for building rapport, developing and working with a shared case formulation, enhancing patients’ use of coping strategies for disabling and distressing symptoms, working with beliefs seen as maintaining hallucinations, delusions and negative symptoms as well as strategies for preventing relapse. It also briefly summarizes the current evidence base for CBTp and point out further developments.

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