scholarly journals Effects of Treatment Setting on Outcomes of Flexibly-Dosed Intensive Cognitive Behavioral Therapy for Pediatric OCD: A Randomized Controlled Pilot Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Robert R. Selles ◽  
Zainab Naqqash ◽  
John R. Best ◽  
Diana Franco-Yamin ◽  
Serene T. Qiu ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Phase I ◽  
Phase Ii ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Clinical Trial Registration ◽  
Pediatric Ocd ◽  
Individual Outcomes ◽  
Home Based

Introduction: Optimizing individual outcomes of cognitive-behavioral therapy (CBT) remains a priority.Methods: Youth were randomized to receive intensive CBT at a hospital clinic (n = 14) or within their home (n = 12). Youth completed 3 × 3 h sessions (Phase I) and up to four additional 3-h sessions as desired/needed (Phase II). An independent evaluator assessed youth after Phase I, Phase II (when applicable), and at 1- and 6-months post-treatment. A range of OCD-related (e.g., severity, impairment) and secondary (e.g., quality of life, comorbid symptoms) outcomes were assessed.Results: Families' satisfaction with the treatment program was high. Of study completers (n = 22), five youth (23%) utilized no Phase II sessions and 9 (41%) utilized all four (Median Phase II sessions: 2.5). Large improvements in OCD-related outcomes and small-to-moderate benefits across secondary domains were observed. Statistically-significant differences in primary outcomes were not observed between settings; however, minor benefits for home-based treatment were observed (e.g., maintenance of gains, youth comfort with treatment).Discussion: Intensive CBT is an efficacious treatment for pediatric OCD. Families opted for differing doses based on their needs. Home-based treatment, while not substantially superior to hospital care, may offer some value, particularly when desired/relevant.Clinical Trial Registration:www.ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT03672565, identifier: NCT03672565.

A pilot trial of bupropion added to cognitive behavioral therapy for smoking cessation in schizophrenia

2001 ◽  
Vol 3 (4) ◽  
pp. 397-403 ◽  
Author(s):  
A. Eden Evins ◽  
Virginia K. Mays ◽  
Nancy A. Rigotti ◽  
Thelma Tisdale ◽  
Corinne Cather ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral

scholarly journals Cognitive behavioral therapy for insomnia among young adults who are actively drinking: a randomized pilot trial

SLEEP ◽  
2020 ◽  
Author(s):  
Mary Beth Miller ◽  
Chelsea B Deroche ◽  
Lindsey K Freeman ◽  
Chan Jeong Park ◽  
Nicole A Hall ◽  
...  
Keyword(s):  
Young Adults ◽  
Alcohol Use ◽  
Cognitive Behavioral Therapy ◽  
Binge Drinking ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Wrist Actigraphy ◽  
Insomnia Severity

Abstract Study Objectives More than half of young adults at risk for alcohol-related harm report symptoms of insomnia. Insomnia symptoms, in turn, have been associated with alcohol-related problems. Yet one of the first-line treatments for insomnia (Cognitive Behavioral Therapy for Insomnia or CBT-I) has not been tested among individuals who are actively drinking. This study tested (1) the feasibility and short-term efficacy of CBT-I among binge-drinking young adults with insomnia and (2) improvement in insomnia as a predictor of improvement in alcohol use outcomes. Methods Young adults (ages 18–30 years, 75% female, 73% college students) who met criteria for Insomnia Disorder and reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomly assigned to 5 weekly sessions of CBT-I (n = 28) or single-session sleep hygiene (SH, n = 28). All participants wore wrist actigraphy and completed daily sleep surveys for 7+ days at baseline, posttreatment, and 1-month follow-up. Results Of those randomized, 43 (77%) completed posttreatment (19 CBT-I, 24 SH) and 48 (86%) completed 1-month follow-up (23 CBT-I, 25 SH). CBT-I participants reported greater posttreatment decreases in insomnia severity than those in SH (56% vs. 32% reduction in symptoms). CBT-I did not have a direct effect on alcohol use outcomes; however, mediation models indicated that CBT-I influenced change in alcohol-related consequences indirectly through its influence on posttreatment insomnia severity. Conclusions CBT-I is a viable intervention among individuals who are actively drinking. Research examining improvement in insomnia as a mechanism for improvement in alcohol-related consequences is warranted. Trial Registration U.S. National Library of Medicine, https://clinicaltrials.gov/ct2/show/NCT03627832, registration #NCT03627832

Telephone-Delivered Cognitive-Behavioral Therapy for Older, Rural Veterans with Depression and Anxiety in Home-Based Primary Care

2016 ◽  
Vol 40 (2) ◽  
pp. 114-123 ◽  
Author(s):  
Terri L. Barrera ◽  
Jeremy P. Cummings ◽  
Maria Armento ◽  
Jeffrey A. Cully ◽  
Amber Bush Amspoker ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
Home Based Primary Care ◽  
Home Based

scholarly journals Optimizing Smartphone-Delivered Cognitive Behavioral Therapy for Body Dysmorphic Disorder Using Passive Smartphone Data: Initial Insights From an Open Pilot Trial

10.2196/16350 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16350
Author(s):  
Hilary Weingarden ◽  
Aleksandar Matic ◽  
Roger Garriga Calleja ◽  
Jennifer L Greenberg ◽  
Oliver Harrison ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Symptom Severity ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Sensor Data ◽  
Mobility Patterns ◽  
Insight Into ◽  
Open Pilot

Background Smartphone-delivered cognitive behavioral therapy (CBT) is becoming more common, but research on the topic remains in its infancy. Little is known about how people typically engage with smartphone CBT or which engagement and mobility patterns may optimize treatment. Passive smartphone data offer a unique opportunity to gain insight into these knowledge gaps. Objective This study aimed to examine passive smartphone data across a pilot course of smartphone CBT for body dysmorphic disorder (BDD), a psychiatric illness characterized by a preoccupation with a perceived defect in physical appearance, to inform hypothesis generation and the design of subsequent, larger trials. Methods A total of 10 adults with primary diagnoses of BDD were recruited nationally and completed telehealth clinician assessments with a reliable evaluator. In a 12-week open pilot trial of smartphone CBT, we initially characterized natural patterns of engagement with the treatment and tested how engagement and mobility patterns across treatment corresponded with treatment response. Results Most participants interacted briefly and frequently with smartphone-delivered treatment. More frequent app usage (r=–0.57), as opposed to greater usage duration (r=–0.084), correlated strongly with response. GPS-detected time at home, a potential digital marker of avoidance, decreased across treatment and correlated moderately with BDD severity (r=0.49). Conclusions The sample was small in this pilot study; thus, results should be used to inform the hypotheses and design of subsequent trials. The results provide initial evidence that frequent (even if brief) practice of CBT skills may optimize response to smartphone CBT and that mobility patterns may serve as useful passive markers of symptom severity. This is one of the first studies to examine the value that passively collected sensor data may contribute to understanding and optimizing users’ response to smartphone CBT. With further validation, the results can inform how to enhance smartphone CBT design.

scholarly journals Feasibility, Acceptability, and Effectiveness of Enhanced Cognitive Behavioral Therapy (eCBT) for Children and Adolescents With Obsessive-Compulsive Disorder: Protocol for an Open Trial and Therapeutic Intervention (Preprint)

2020 ◽  
Author(s):  
Lidewij H Wolters ◽  
Bernhard Weidle ◽  
Lucía Babiano-Espinosa ◽  
Norbert Skokauskas
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Children And Adolescents ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Face To Face ◽  
Compulsive Disorder ◽  
Pediatric Ocd ◽  
Treatment Package

BACKGROUND Although the evidence base of cognitive behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been broadly established, the treatment is hampered by limited access, poor compliance, and nonresponse. New technologies offer the opportunity to improve the accessibility, user friendliness, and effectiveness of traditional office-based CBT. By employing an integrated and age-appropriate technologically enhanced treatment package, we aim to execute a more focused and attractive application of CBT principles to increase the treatment effect for pediatric OCD. OBJECTIVE The aim of this open study is to explore the acceptability, feasibility, and effectiveness of a newly developed enhanced CBT (eCBT) package for pediatric OCD. METHODS This study is an open trial using a historical control design conducted at the outpatient clinic of the Department of Child and Adolescent Psychiatry at St. Olavs University Hospital (Trondheim) or at BUP Klinikk (Aalesund). Participants are 30 children (age 7-17 years) with a primary Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnosis of OCD, and their parents. All participants receive eCBT. eCBT consists of the usual evidence-based CBT for pediatric OCD in an “enhanced” format. Enhancements include videoconferencing sessions (supervision and guided exposure exercises at home) in addition to face-to-face sessions; an app system of interconnected apps for the child, the parents, and the therapist; psychoeducative videos; and frequent online self-assessments with direct feedback to patients and the therapist. Primary outcome measures are the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) (effectiveness), the Client Satisfaction Questionnaire-8 (acceptability), and treatment drop out (feasibility). Assessments are conducted pretreatment, posttreatment, and at 3- and 6-month follow-ups. A 12-month follow-up assessment is envisioned. The treatment outcome (CY-BOCS) will be compared to traditional face-to-face CBT (data collected in the Nordic Long-term OCD Treatment Study). RESULTS Ethical approval has been obtained (2016/716/REK nord). Inclusion started on September 04, 2017. Data collection is ongoing. CONCLUSIONS This study is the first step in testing the acceptability, feasibility, and preliminary effectiveness of eCBT. In case of positive results, future steps include improving the eCBT treatment package based on feedback from service users, examining cost-effectiveness in a randomized controlled trial, and making the package available to clinicians and other service providers treating OCD in children and adolescents. CLINICALTRIAL ISRCTN, ISRCTN37530113; registered on January 31, 2020 (retrospectively registered); https://www.isrctn.com/ISRCTN37530113. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24057

scholarly journals Comparative Effectiveness of Cheonwangbosimdan (Tian Wang Bu Xin Dan) Versus Cognitive-Behavioral Therapy for Insomnia in Cancer Patients: A Randomized, Controlled, Open-Label, Parallel-Group, Pilot Trial

2020 ◽  
Vol 19 ◽  
pp. 153473542093564
Author(s):  
Sun-Young Moon ◽  
Ui Min Jerng ◽  
O-Jin Kwon ◽  
So-Young Jung ◽  
Jee Young Lee ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Cancer Patients ◽  
Group Performance ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Eastern Cooperative Oncology Group ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Group Score ◽  
Significant Difference

Cancer patients have a 2 times higher prevalence of insomnia than healthy populations and cancer-related insomnia has received minimal attention while insomnia can aggravate the rehabilitation of cancer patients. Cheonwangbosimdan is a Korean herbal medicine generally used to relieve sleep deprivation, however, few studies presented the effects of Cheonwangbosimdan on cancer-related insomnia. The purpose of study is to examine the feasibility of Cheonwangbosimdan treatments for cancer patients. Twenty-two participants were allocated into a Cheonwangbosimdan or cognitive-behavioral therapy for insomnia (CBT-I) control group by equal number. The intervention group took Cheonwangbosimdan liquid once in a day and attend visits once a week for 4 weeks. The CBT-I group underwent individualized behavioral therapy 4 times in 4 weeks. The primary outcome is changes in the Insomnia Severity Index (ISI) from baseline to the end of the trial. Responses to the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Zung Self-Rating Anxiety Scale (SAS), Brief Fatigue Inventory (BFI), Euroqol-5 Dimensions-5 Levels (EQ-5D-5L), and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were secondary outcomes used to evaluate the quality of sleep. Outcomes were measured at a follow-up visit (visit 5) in the fifth week of the trial. There is no difference between 2 groups, but both groups showed tendency to alleviate cancer insomnia symptoms. SAS-K showed significant difference between the 2 groups (P < .001), as treatment group score was highly lowered than control group score. The study can contribute to more attentive care for insomnia in cancer patients.

scholarly journals Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Lucía Babiano-Espinosa ◽  
Lidewij H. Wolters ◽  
Bernhard Weidle ◽  
Vivian op de Beek ◽  
Sindre A. Pedersen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Case Series ◽  
Cognitive Behavioral ◽  
Inclusion Criteria ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Pediatric Ocd

Abstract Background Obsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by recurring obsessions and compulsions affecting 1–3% of children and adolescents. Current treatment options are limited by accessibility, availability, and quality of care. New technologies provide opportunities to address at least some of these challenges. This paper aims to investigate the acceptability, feasibility, and efficacy of traditional cognitive behavioral therapy with Internet cognitive behavioral therapy (iCBT) for pediatric OCD according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Method We searched EMBASE, Medline, PsycINFO, CENTRAL, LILACS, CINAHL, and Scopus. Results include articles from 1987 to March 2018. Main inclusion criteria were patients aged 4–18, primary diagnosis of OCD, and iCBT. Results Of the 2323 unique articles identified during the initial search, six studies with a total of 96 participants met our inclusion criteria: three randomized controlled trials, one single-case multiple-baseline design, one open-label trial, and one case series. Four studies reported a significant decrease in OCD severity on the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) following iCBT, one study reported significant decrease in CY-BOCS scores for iCBT relative to waitlist, and the case series reported (some) symptom reduction in all participants. Six studies reported high rates of feasibility, and five studies reported good acceptability of iCBT. Conclusion At present, evidence regarding acceptability, feasibility, and efficacy of iCBT for pediatric OCD is limited. Results are promising but need to be confirmed and refined in further research. Systematic review registration PROSPERO CRD4201808587

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