What Are the Primary Goals of Cognitive Behavior Therapy for Psychosis? A Theoretical and Empirical Review

Despite a rise in the popularity of cognitive behavior therapy for psychosis (CBTp) over the past 15 years, 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 (Jones, Hacker, Meaden, Cormac, & Irving, 2012; Wykes, Steel, Everitt, & Tarrier, 2008). However, for some time now, some authors prominent in the development of CBTp have argued the primary goals of CBTp not to be global syndrome reduction but the amelioration of emotional distress and behavioral disturbance in relation to individual psychotic symptoms (Birchwood & Trower, 2006). A review of the theoretical and empirical literature related to CBTp reveals broad support for this position. Implications and recommendations for research into the efficacy of CBTp are discussed.

Download Full-text

Identifying the “Therapy Targets” for Treating the Negative Symptoms of Psychosis Using Cognitive Behavioral Therapy

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.32.3.203 ◽

2018 ◽

Vol 32 (3) ◽

pp. 203-220 ◽

Cited By ~ 1

Author(s):

Monica F. Tomlinson ◽

Joshua D. Wright

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Negative Symptoms ◽

Critical Discussion ◽

Cognitive Behavioral ◽

Empirical Literature ◽

Psychotic Symptoms ◽

Cognitive Behavior ◽

Positive Symptoms ◽

Treatment Targets

The division of psychotic symptoms into positive and negative categories has largely divided the research on them. While the research on positive symptoms of psychosis has rapidly developed over the last three decades, the literature on negative symptoms has noticeably lagged behind. Negative symptoms have likely been ignored in the treatment literature because they were previously thought to remit following the treatment of positive symptoms. Recent evidence does not consistently support this theory and indicates that the different manifestations of negative symptoms require distinct approaches to treatment. The current review provides a re-evaluation of the theoretical literature on negative symptoms to inform and identify “treatment targets” to reduce them. The “treatment targets” are then translated into intervention strategies using a cognitive behavioral framework. A review of the empirical literature on cognitive behavior therapy for treating negative symptoms is then offered along with a critical discussion of where cognitive behavior therapy stands compared to other interventions and what research is still needed.

Download Full-text

Cognitive Processes Underlying the Behavior Change in Cognitive Behavior Therapy with Childhood Disorders: A Review of Experimental Evidence

Behavioural and Cognitive Psychotherapy ◽

10.1017/s0141347300013288 ◽

1991 ◽

Vol 19 (3) ◽

pp. 247-266 ◽

Cited By ~ 10

Author(s):

Martine B. Powell ◽

Tian P. S. Oei

Keyword(s):

Behavior Change ◽

Experimental Evidence ◽

Empirical Evidence ◽

Behavior Therapy ◽

Cognitive Processes ◽

Cognitive Behavior Therapy ◽

Cognitive Models ◽

Cognitive Behavior ◽

Childhood Disorders

While Cognitive Behavior Therapy (CBT) has been widely used for treatment of childhood disorders, the process underlying the success of CBT in this area is still unclear. This paper attempts to examine empirically the above issue, using the literature from 1974 to 1989 to see whether there is support for the underlying changes in cognitive processes that are assumed to mediate the therapy. The results show that while CBT is relatively effective in treating some childhood disorders, there is little empirical evidence to support the underlying cognitive models of childhood disorders.

Download Full-text

Cognitive-Behavioral Techniques and Family System Therapy

Counseling Psychology and Psychotherapy ◽

10.17759/cpp.2021290305 ◽

2021 ◽

Vol 29 (3) ◽

pp. 58-68

Author(s):

F.M. Dattilio

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Family System ◽

Cognitive Behavioral ◽

Empirical Literature ◽

Cognitive Behavior ◽

Family Therapists ◽

Systemic Movement ◽

System Therapy ◽

Behavioral Techniques

This article addresses the integration of cognitive-behavior therapy with families within the systemic movement. It reviews some of the updated empirical literature that supports its strategies as well as its attractiveness to systemic family therapists in Russia and across the globe.

Download Full-text

What is the minimal dose of cognitive behavior therapy for psychosis? An approximation using repeated assessments over 45 sessions

European Psychiatry ◽

10.1016/j.eurpsy.2016.05.004 ◽

2016 ◽

Vol 38 ◽

pp. 31-39 ◽

Cited By ~ 14

Author(s):

T.M. Lincoln ◽

E. Jung ◽

M. Wiesjahn ◽

B. Schlier

Keyword(s):

Clinical Practice ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Negative Symptoms ◽

Optimal Dose ◽

Symptom Distress ◽

Psychotic Symptoms ◽

Symptom Improvement ◽

Cognitive Behavior ◽

And Coping

AbstractBackgroundThe general efficacy of cognitive behavior therapy for psychosis (CBTp) is well established. Although guidelines recommend that CBTp should be offered over a minimum of 16 sessions, the minimal number of sessions required to achieve significant changes in psychopathology has not been systematically investigated. Empirically informed knowledge of the minimal and optimal dose of CBTp is relevant in terms of dissemination and cost-effectiveness.MethodsWe approached the question of what constitutes an appropriate dose by investigating the dose (duration of CBTp) × response (symptomatic improvement) relationship for positive symptoms, negative symptoms and depression. Patients with psychotic disorders (n = 58) were assessed over the course of 45 sessions of CBTp in a clinical practice setting. At baseline and after session 5, 15, 25, and 45, general psychopathology, psychotic symptoms, symptom distress and coping were assessed with self-report questionnaires. Additionally, individually defined target symptoms and coping were assessed after each session.ResultsSignificant symptom improvement and reduction of symptom distress took place by session 15, and stayed fairly stable thereafter. The frequency of positive and negative symptoms reached a minimum by session 25.ConclusionsOur findings support recommendations to provide CBTp over a minimum of 16 sessions and indicate that these recommendations are generalizable to clinical practice settings. However, the findings also imply that 25 sessions are the more appropriate dose. This study contributes to an empirically informed discussion on the minimal and optimal dose of CBTp. It also provides a basis for planning randomized trials comparing briefer and longer versions of CBTp.

Download Full-text

Cognitive Behavior Therapy at the Crossroads

International Journal of Cognitive Therapy ◽

10.1007/s41811-021-00104-y ◽

2021 ◽

Vol 14 (1) ◽

pp. 1-22

Author(s):

Simon E. Blackwell ◽

Thomas Heidenreich

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Behavior ◽

Special Issue ◽

World Congress ◽

The Past ◽

Unified Field ◽

Recent Developments ◽

History Of ◽

Cognitive Therapies

AbstractThe early development of cognitive behavior therapy (CBT) can be characterized by the coming together of behavioral and cognitive traditions. However, the past decades have arguably seen more divergences than convergences within the field. The 9th World Congress of Behavioural and Cognitive Therapies was held in Berlin in July 2019 with the congress theme “CBT at the Crossroads.” This title reflected in part the coming together of people from all over the world, but also the fact that recent developments raise important questions about the future of CBT, including whether we can in fact treat it as a unified field. In this paper, we briefly trace the history of CBT, then introduce a special issue featuring a series of articles exploring different aspects of the past, present, and future of CBT. Finally, we reflect on the possible routes ahead.

Download Full-text

A Treatment Most Foul: Handling Disgust in Cognitive-Behavior Therapy

Journal of Cognitive Psychotherapy ◽

10.1891/jcop.2005.19.4.355 ◽

2005 ◽

Vol 19 (4) ◽

pp. 355-367 ◽

Cited By ~ 21

Author(s):

Dean McKay ◽

Steven D. Tsao

Keyword(s):

General Theory ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Biases ◽

Evaluative Conditioning ◽

Empirical Literature ◽

Cognitive Behavior

The nature of disgust as it relates to psychopathology is described. Evaluative conditioning, an important theory for understanding the acquisition and maintenance of disgust reactions, is discussed, and linked with the general theory of disgust by Rozin and Fallon (1987). The empirical literature on the role of disgust in psychopathology, primarily phobias and general problems of fearful avoidance, is covered, as well as cognitive biases and distortions. Finally, a hierarchy of psychopathology influenced by disgust is presented.

Download Full-text

Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy

International Journal of Cognitive Therapy ◽

10.1007/s41811-020-00090-7 ◽

2020 ◽

Cited By ~ 1

Author(s):

Philip Lindner

Keyword(s):

Virtual Reality ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Paradigm Shift ◽

Evidence Base ◽

Cognitive Behavior ◽

Perceptual Illusion ◽

The Past ◽

Clinical Potential ◽

Immersive Technology

Abstract Virtual reality (VR) is an immersive technology capable of creating a powerful, perceptual illusion of being present in a virtual environment. VR technology has been used in cognitive behavior therapy since the 1990s and accumulated an impressive evidence base, yet with the recent release of consumer VR platforms came a true paradigm shift in the capabilities and scalability of VR for mental health. This narrative review summarizes the past, present, and future of the field, including milestone studies and discussions on the clinical potential of alternative embodiment, gamification, avatar therapists, virtual gatherings, immersive storytelling, and more. Although the future is hard to predict, clinical VR has and will continue to be inherently intertwined with what are now rapid developments in technology, presenting both challenges and exciting opportunities to do what is not possible in the real world.

Download Full-text