scholarly journals Cognitive Behavioral Therapy of Patients with Somatic Symptoms—Diagnostic and Therapeutic Difficulties

2021 ◽  
Vol 10 (14) ◽  
pp. 3159
Author(s):  
Agata Orzechowska ◽  
Paulina Maruszewska ◽  
Piotr Gałecki
Keyword(s):  
Mental Health Problems ◽  
Mental Disease ◽  
Behavioral Therapy ◽  
Physical Symptoms ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Diagnostic Dilemma ◽  
Number Of Patients ◽  
Psychological Element ◽  
Somatic Diseases

In every somatic disease we can find a psychological element, just as it is not uncommon for numerous physical symptoms to occur in a mental disease. Nowadays, the patient is no longer just the “owner” of the sick organ but is considered and treated as a “whole”. The interpenetration of somatic manifestations with mental health problems forces patients who experience subjective suffering, including mental suffering, from current symptoms to visit specialists from different fields of medicine, and their treatment does not bring about any improvement. Cognitive behavioral psychotherapy (CBT) is one form of therapy that attempts to respond to the needs of an increasing—in recent years—number of patients who demonstrate somatic disorders of a multifaceted nature. The co-occurrence of physical and mental disorders repeatedly makes it impossible to determine which symptoms were the cause and which were the effect; hence, it is difficult to establish clear boundaries between the categories of these disorders and diseases. The therapist, to whom the patient with somatic diseases is eventually referred, may be faced with a diagnostic dilemma, the solution of which will give direction to further psychotherapeutic work. The common feature of this group of patients is a strong focus on physical ailments, while omitting or almost completely ignoring the psychological factors involved. The purpose of this paper is to present the causally diverse circumstances in which a patient with physical symptoms needs diagnosis and therapeutic support from the perspective of a cognitive behavioral approach.

Individual Versus Group Cognitive-Behavioral Therapy for Partner-Violent Men: A Preliminary Randomized Trial

2017 ◽  
Vol 35 (15-16) ◽  
pp. 2846-2868 ◽  
Author(s):  
Christopher M. Murphy ◽  
Christopher I. Eckhardt ◽  
Judith M. Clifford ◽  
Adam D. LaMotte ◽  
Laura A. Meis
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Skills Training ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Medium Effect ◽  
Individual Treatment ◽  
Small Scale ◽  
Relationship Functioning ◽  
Significant Difference

A randomized clinical trial tested the hypothesis that a flexible, case formulation–based, individual treatment approach integrating motivational interviewing strategies with cognitive-behavioral therapy (ICBT) is more efficacious than a standardized group cognitive-behavioral approach (GCBT) for perpetrators of intimate partner violence (IPV). Forty-two men presenting for services at a community domestic violence agency were randomized to receive 20 sessions of ICBT or a 20-week group cognitive-behavioral therapy (CBT) program. Participants and their relationship partners completed assessments of relationship abuse and relationship functioning at baseline and quarterly follow-ups for 1 year. Treatment uptake and session attendance were significantly higher in ICBT than GCBT. However, contrary to the study hypothesis, GCBT produced consistently equivalent or greater benefits than ICBT. Participant self-reports revealed significant reductions in abusive behavior and injuries across conditions with no differential benefits between conditions. Victim partner reports revealed more favorable outcomes for group treatment, including a statistically significant difference in psychological aggression, and differences exceeding a medium effect size for physical assault, emotional abuse, and partner relationship adjustment. In response to hypothetical relationship scenarios, GCBT was associated with greater reductions than ICBT (exceeding a medium effect) in articulated cognitive distortions and aggressive intentions. Treatment competence ratings suggest that flexible, individualized administration of CBT creates challenges in session agenda setting, homework implementation, and formal aspects of relationship skills training. Although caution is needed in generalizing findings from this small-scale trial, the results suggest that the mutual support and positive social influence available in group intervention may be particularly helpful for IPV perpetrators.

scholarly journals Terapia cognitivo-conductual en la fibromialgia

2020 ◽  
Vol 4 (1) ◽  
pp. 19
Author(s):  
Bárbara Dinorah Hidalgo Martínez ◽  
Viorkis Pérez Ortiz ◽  
María Caridad Olivera Cardoso ◽  
Lidia López Aristica ◽  
Liset Betancourt Castellanos ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Psychological Impact ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Palabras Clave ◽  
Before And After ◽  
Cognitive Alterations

  La fibromialgia es una enfermedad con fuerte impacto psicológico, de evolución crónica que provoca dolor, rigidez e hipersensibilidad en músculos, tendones y articulaciones por más de tres meses de evolución. Generalmente está asociada a alteraciones cognitivas, disminución del sueño, astenia, ansiedad y depresión a diferentes grados. Aunque la etiología no se conoce con exactitud, el diagnóstico es clínico por exclusión. En este estudio se determinó la eficacia de la terapia cognitivo-conductual (TCC) en pacientes con fibromialgia en el Hospital Básico Miguel H. Alcívar de Bahía de Caráquez, Ecuador. El estudio fue descriptivo y prospectivo en 30 pacientes diagnosticados de fibromialgia, en el periodo de mayo a septiembre de 2017. La mayoría de los pacientes fueron mujeres entre 30 y 40 años de edad, cuyo síntoma principal fue el dolor generalizado, con espectro ansioso-depresivo. Se utilizó el test de ansiedad y depresión hospitalaria para diagnosticar la presencia de ansiedad y depresión antes y después de la terapia. Los pacientes con fibromialgia fueron tratados con hipnosis, con un enfoque cognitivo conductual, en el 70,1 % los síntomas desaparecieron o mejoraron durante los meses en los que mantuvieron el tratamiento, lo cual demuestra la efectividad del tratamiento con TCC en pacientes con fibromialgia.   Palabras clave: Fibromialgia, depresión, ansiedad, terapia cognitivo-conductual, hipnosis.   Abstract Fibromyalgia is a disease with a strong psychological impact, of chronic evolution that causes pain, stiffness and hypersensitivity in muscles, tendons and joints, for more than three months of evolution. It is generally associated with cognitive alterations, decreased sleep, asthenia, anxiety and depression to different degrees. Although the etiology is not exactly known, the diagnosis is clinical by exclusion. In this study, the efficacy of cognitive-behavioral therapy (CBT) was determined in patients with fibromyalgia at the Basic Hospital Miguel H. Alcívar de Bahía de Caráquez, Ecuador. The study was descriptive and prospective in 30 patients diagnosed with fibromyalgia, in the period from May to September 2017. Most of the patients were women between 30 and 40 years of age, whose main symptom was generalized pain, with an anxious spectrum- depressant. The hospital anxiety and depression test was used to diagnose the presence of anxiety and depression before and after therapy. Fibromyalgia patients were treated with hypnosis, with a cognitive behavioral approach, in 70.1% the symptoms disappeared or improved during the months in which they maintained the treatment, which demonstrates the effectiveness of CBT treatment in patients with fibromyalgia.   Keywords: Fibromyalgia, depression, anxiety, cognitive-behavioral therapy, hypnosis.

scholarly journals Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Tomas Nygren ◽  
Matilda Berg ◽  
Ali Sarkohi ◽  
Gerhard Andersson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Focus Groups ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Cognitive Behavioral ◽  
Care Providers ◽  
Self Help ◽  
Arabic Speaking

BACKGROUND Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers. OBJECTIVE This study aims to describe the process of developing a transdiagnostic internet-based cognitive behavioral therapy self-help program in Arabic for mild to moderate symptoms of common psychological problems such as anxiety, depression, and insomnia. METHODS The iterative development process, including feedback from 105 pilot users as well as 2 focus groups, is described. RESULTS Overall, the modules were rated as acceptable by the pilot users, with overall ratings ranging from 3 to 4 points on average for the respective modules on a 5-point Likert scale. Feedback from the 2 focus groups was overall positive with regard to the content and structure of the program but also included suggestions for improving the Arabic translation as well as the usability of the material. CONCLUSIONS An internet-based self-help program that is deemed acceptable by an Arabic-speaking audience can be successfully developed, thus providing increased access to psychological help for an at-risk population. However, further research regarding the efficacy of this type of intervention is warranted.

Overcoming ADHD in Adolescence

2020 ◽  
Author(s):  
Susan Sprich ◽  
Steven A. Safren
Keyword(s):  
Goal Setting ◽  
Behavioral Therapy ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Adhd Symptoms ◽  
Therapeutic Approaches ◽  
Hyperactivity Disorder ◽  
Assessment Measure ◽  
And Function ◽  
Made In

This Client Workbook is an accompaniment to the Therapist Guide, Overcoming ADHD in Adolescence: A Cognitive Behavioral Approach. The treatment and manuals are designed for clients to complete with the help of a therapist who is familiar with cognitive behavioral therapy (CBT) and/or other structured therapeutic approaches. The program is designed to help adolescent clients with attention-deficit/hyperactivity disorder (ADHD) learn skills to help them cope with their ADHD symptoms. Core modules on organizing and planning, reducing distractibility, and adaptive thinking are included, as is an optional module on reducing procrastination. The emphasis is primarily on teaching the adolescent how to learn skills to combat ADHD and function independently. Information is provided regarding how to include parents in the treatment: inviting a parent or parents in at the end of sessions, including parents in goal setting in joint sessions with the adolescent, and optional coaching sessions without the adolescent present. The guide concludes with a discussion of how to help clients maintain the gains that they have made in treatment. The client workbook and therapist guide include a discussion of how to incorporate technology into the treatment and a “signposts of change” section in each chapter. The manuals include many worksheets and forms, as well as a link to an assessment measure that can be used repeatedly to gauge progress in treatment.

A Systematic Meta-Review of Internet-Based Cognitive Behavioral Therapy (ICBT)

2018 ◽  
Author(s):  
Quincy J. J. Wong ◽  
Alison L. Calear ◽  
Helen Christensen
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Is Implementation ◽  
Treatment And Prevention ◽  
Meta Review ◽  
Adolescents And Adults ◽  
Meta Analyses

Internet-based cognitive behavioral therapy (ICBT) is the provision of cognitive behavioral therapy (CBT) using the Internet as a platform for delivery. The advantage of ICBT is its ability to overcome barriers to treatment associated with traditional face-to-face CBT, such as poor access, remote locations, stigmas around help-seeking, the wish to handle the problem alone, the preference for anonymity, and costs (time and financial). A large number of randomized controlled trials (RCTs) have tested the acceptability, efficacy, and cost-effectiveness of ICBT for anxiety disorders, mood disorders, and associated suicidality. A meta-review was conducted by searching PsycINFO and PubMed for previous systematic reviews and meta-analyses of ICBT programs for anxiety, depression, and suicidality in children, adolescents, and adults. The results of the meta-review indicated that ICBT is effective in the treatment and prevention of mental health problems in adults and the treatment of these problems in youth. Issues of adherence and privacy have been raised. However, the major challenge for ICBT is implementation and uptake in the “real world.” The challenge is to find the best methods to embed, deliver, and implement ICBT routinely in complex health and education environments.

Cognitive Behavioral Therapy in a Group of Militaries With Posttraumatic Stress Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S513-S513
Author(s):  
H. El Kefi ◽  
W. Abdelghaffar ◽  
A. Baatout ◽  
C. Bechikh Brahim ◽  
W. Krir ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Cognitive Behavioral Therapy ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Behavioral Therapy ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Relaxation Techniques ◽  
Competing Interest

IntroductionPosttraumatic stress disorder (PTSD) has a high prevalence and severe impact in military populations. Cognitive behavioral therapy (CBT) is indicated in this condition but it is a structured therapy that requires patients’ motivation and doctors’ availability.Objectives and aimsAssess feasibility and effectiveness of CBT in a military group with PTSD.MethodsA group of six militaries that witnessed the same traumatic event (an armed attack) and were diagnosed with PTSD were involved in a structured individual session CBT with one therapist. An assessment using the PTSD checklist for DSM (PCL) was performed initially and in halfway therapy. The therapy included an education about PTSD, a cognitive restructuring, a behavioral approach via home tasks and relaxation techniques.ResultsThe initial PCL scores varied from 25 to 55. All patients were initially on sick leave. Five patients had adjunctive antidepressant medications and one patient was only on therapy. Three patients showed no motivation and were excluded after 3 sessions. Two patients have had 7 weekly sessions and were able to return to work in the same place. One patient with severe PTSD had 2 sessions monthly, he had slight clinical improvement and could not come back to military work. The three patients who are still in therapy have improved PCL scores.ConclusionsCBT can be effective in PTSD. The outcome depends on initial severity of PTSD and assiduity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Views of Implementers and Nonimplementers of Internet-Administered Cognitive Behavioral Therapy for Depression and Anxiety: Survey of Primary Care Decision Makers in Sweden

10.2196/18033 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18033
Author(s):  
Anders Brantnell ◽  
Joanne Woodford ◽  
Enrico Baraldi ◽  
Theo van Achterberg ◽  
Louise von Essen
Keyword(s):  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Decision Makers ◽  
Barriers And Facilitators ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
National Guidelines ◽  
Technical Problems ◽  
Number Of Patients

Background Internet-administered cognitive behavioral therapy (ICBT) has been demonstrated to be an effective intervention for adults with depression and/or anxiety and is recommended in national guidelines for provision within Swedish primary care. However, the number and type of organizations that have implemented ICBT within primary care in Sweden is currently unclear. Further, there is a lack of knowledge concerning barriers and facilitators to ICBT implementation. Objective The two primary objectives were to identify and describe primary care organizations providing ICBT in Sweden and compare decision makers’ (ie, directors of primary care organizations) views on barriers and facilitators to implementation of ICBT among ICBT implementers (ie, organizations that offered ICBT) and nonimplementers (ie, organizations that did not offer ICBT). Methods An online survey based on a checklist for identifying barriers and facilitators to implementation was developed and made accessible to decision makers from all primary care organizations in Sweden. The survey consisted of background questions (eg, provision of ICBT and number of persons working with ICBT) and barriers and facilitators relating to the following categories: users, therapists, ICBT programs, organizations, and wider society. Results The participation rate was 35.75% (404/1130). The majority (250/404, 61.8%) of participants were health care center directors and had backgrounds in nursing. Altogether, 89.8% (363/404) of the participating organizations provided CBT. A minority (83/404, 20.5%) of organizations offered ICBT. Most professionals delivering ICBT were psychologists (67/83, 80%) and social workers (31/83, 37%). The majority (61/83, 73%) of organizations had 1 to 2 persons delivering ICBT interventions. The number of patients treated with ICBT during the last 12 months was 1 to 10 in 65% (54/83) of the organizations, ranging between 1 and 400 treated patients across the whole sample. There were 9 significant (P<.05) differences out of 37 possible between implementers and nonimplementers. For example, more implementers (48/51, 94%) than nonimplementers (107/139, 76.9%) perceived few technical problems (P<.001), and more implementers (53/77, 68%) than nonimplementers (103/215, 47.9%) considered that their organization has resources to offer ICBT programs (P<.001). Conclusions Despite research demonstrating the effectiveness of ICBT for depression and anxiety and national guidelines recommending its use, ICBT is implemented in few primary care organizations in Sweden. Several interesting differences between implementers and nonimplementers were identified, which may help inform interventions focusing on facilitating the implementation of ICBT.

scholarly journals Views of Implementers and Nonimplementers of Internet-Administered Cognitive Behavioral Therapy for Depression and Anxiety: Survey of Primary Care Decision Makers in Sweden (Preprint)

2020 ◽  
Author(s):  
Anders Brantnell ◽  
Joanne Woodford ◽  
Enrico Baraldi ◽  
Theo van Achterberg ◽  
Louise von Essen
Keyword(s):  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Decision Makers ◽  
Barriers And Facilitators ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
National Guidelines ◽  
Technical Problems ◽  
Number Of Patients

BACKGROUND Internet-administered cognitive behavioral therapy (ICBT) has been demonstrated to be an effective intervention for adults with depression and/or anxiety and is recommended in national guidelines for provision within Swedish primary care. However, the number and type of organizations that have implemented ICBT within primary care in Sweden is currently unclear. Further, there is a lack of knowledge concerning barriers and facilitators to ICBT implementation. OBJECTIVE The two primary objectives were to identify and describe primary care organizations providing ICBT in Sweden and compare decision makers’ (ie, directors of primary care organizations) views on barriers and facilitators to implementation of ICBT among ICBT implementers (ie, organizations that offered ICBT) and nonimplementers (ie, organizations that did not offer ICBT). METHODS An online survey based on a checklist for identifying barriers and facilitators to implementation was developed and made accessible to decision makers from all primary care organizations in Sweden. The survey consisted of background questions (eg, provision of ICBT and number of persons working with ICBT) and barriers and facilitators relating to the following categories: users, therapists, ICBT programs, organizations, and wider society. RESULTS The participation rate was 35.75% (404/1130). The majority (250/404, 61.8%) of participants were health care center directors and had backgrounds in nursing. Altogether, 89.8% (363/404) of the participating organizations provided CBT. A minority (83/404, 20.5%) of organizations offered ICBT. Most professionals delivering ICBT were psychologists (67/83, 80%) and social workers (31/83, 37%). The majority (61/83, 73%) of organizations had 1 to 2 persons delivering ICBT interventions. The number of patients treated with ICBT during the last 12 months was 1 to 10 in 65% (54/83) of the organizations, ranging between 1 and 400 treated patients across the whole sample. There were 9 significant (<i>P</i>&lt;.05) differences out of 37 possible between implementers and nonimplementers. For example, more implementers (48/51, 94%) than nonimplementers (107/139, 76.9%) perceived few technical problems (<i>P</i>&lt;.001), and more implementers (53/77, 68%) than nonimplementers (103/215, 47.9%) considered that their organization has resources to offer ICBT programs (<i>P</i>&lt;.001). CONCLUSIONS Despite research demonstrating the effectiveness of ICBT for depression and anxiety and national guidelines recommending its use, ICBT is implemented in few primary care organizations in Sweden. Several interesting differences between implementers and nonimplementers were identified, which may help inform interventions focusing on facilitating the implementation of ICBT.

scholarly journals 1186 Developing And Testing A Web-based Provider Training For Cognitive Behavioral Therapy Of Insomnia

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A453-A453
Author(s):  
D Taylor ◽  
B Bunnell ◽  
C Calhoun ◽  
K Pruiksma ◽  
J Dietch ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Knowledge Acquisition ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Provider Training ◽  
Web Based ◽  
Website Usability ◽  
Time Interaction ◽  
Beta Testing

Abstract Introduction Chronic insomnia is a common, debilitating disorder and a risk factor for significant medical morbidity, mental health problems, and workplace difficulties. Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for insomnia. However, few providers are trained in CBT-I, in part due to a bottleneck in training availability and the time and cost associated with current training platforms. To address this training deficit, our team developed and evaluated CBTIweb.org, a web-based provider training course for CBT-I. Methods Feedback from alpha- and beta-testing of CBTIweb.org was collected and used to optimize course content and functionality. Then, a comparison study was conducted in which licensed providers were randomized to complete either the online CBTIweb.org course (n=21) or an in-person CBT-I training (n=23). During all phases of development, providers completed a Computer System Usability Questionnaire (CSUQ), investigator-developed website usability and content questionnaires, and pre/post-training competency assessments. Results Independent samples t-tests indicated significant improvements in CSUQ, and website usability and content questionnaires responses from alpha- to beta-testing (all ps &lt; .05). Linear mixed-effects modeling revealed significant within-subject increases in knowledge acquisition (F(34.7) = 65.4, p &lt; 0.001; baseline = 69% correct, post-training = 92% correct) when collapsed across in-person and web-based groups. The interaction group by time interaction was non-significant (F(34.7) = 1.7, p = 0.204), indicating similar gains in knowledge (i.e., equivalence) between the in-person and the CBTIweb.org training formats. Conclusion Alpha and beta testers of CBTIweb.org reported high levels of satisfaction while also noting areas for improvement, which were used to update the site. Findings suggest the final CBTIweb.org product successfully trained clinicians compared to an in-person workshop, given knowledge acquisition improvements. CBTIweb.org is an efficient and effective training platform for clinicians to gain knowledge and competence in the most effective treatment for insomnia. Support W81XWH-17-1-0165

Treating Adolescent Misophonia With Cognitive Behavioral Therapy: Considerations for Including Exposure

2021 ◽  
pp. 153465012110457
Author(s):  
Jennifer L. Cecilione ◽  
Stephanie A. Hitti ◽  
Scott R. Vrana
Keyword(s):  
Adolescent Girl ◽  
Behavioral Therapy ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Evidence Based ◽  
Treatment Protocols ◽  
Evidence Based Treatment ◽  
Assessment And Treatment ◽  
No Gold Standard

Although misophonia is not yet included in the primary diagnostic manuals used by psychologists or psychiatrists, proposed criteria suggest that this condition is characterized by a strong negative reaction to and avoidance of certain trigger sounds. Misophonic trigger sounds are largely human-made (e.g., chewing and slurping) and evoke responses such as disgust, irritation, and/or anger that are out of proportion to the situation and cause distress and/or impairment. Currently, there is no gold standard evidence-based treatment for misophonia. As the misophonia treatment literature grows, several important questions are arising: (1) should exposure to aversive sound triggers be included in treatment for misophonia and (2) how can clinicians best assess misophonia symptoms. This case offers one example of misophonia being successfully treated with a cognitive-behavioral approach to treatment (including exposures) in an adolescent girl. This case also offers an example of how clinicians may conduct a comprehensive assessment of misophonia symptoms. Theoretically and empirically derived recommendations for including exposure in misophonia treatment are presented. Information from this case may be helpful in informing future research, as there is a paucity of evidence-based assessment and treatment protocols for misophonia.

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