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Cognitive restructuring (CR) is an efficacious intervention for reducing transdiagnostic hostility. However, evidence suggests that the efficacy of CR can be further improved. A promising candidate for improving the efficacy of CR is mental imagery. Previous work showed that that enriching CR with mental imagery (I-CR) increased its efficacy in terms of reducing hostile beliefs and aggressive inclinations. In this article, we describe the rationale of the I-CR procedure, how to use it, and illustrate it with case examples. Our clinical experience underlines that imagery seems to capture both the hostile as well as helpful thoughts in a more effective way than verbal formulations. Future studies need to explore whether using this protocol is helpful for patients with clinical levels of hostility.

Systematic reviews have shown the efficacy of religion-adapted cognitive behavioral therapy (R-CBT); however, many clinicians lack practical knowledge of these protocols. We describe here the techniques of religious adaptation to CBT that have proved effective. We selected randomized clinical trials comparing R-CBT with control conditions in clients with a diagnosis of a psychiatric disorder and extracted the information from their adapted manuals. The most frequent religious adaptations were the integration of religious content to perform cognitive restructuring, psychoeducation and motivation; engagement in religious activities such as behavioral activation, meditation, or prayer to help cognitive restructuring, using religious values and coping strategies. A description of these techniques is presented here, as well as some practical examples.

This study reports a qualitative analysis of patient experiences following cognitive therapy (CT), mindfulness meditation (MM), or mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). It aimed to investigate the procedural elements reported by participants as important across these approaches, as well as the role of treatment-related change processes and common factors. Research Method/Design: A qualitative analysis of posttreatment semistructured interviews was conducted with participants who enrolled in a randomized controlled trial comparing MM, CT, and MBCT (N = 57 adults with CLBP). A thematic analysis of transcribed interviews was undertaken by two independent coders; emerging themes, subthemes, and direct quotes were collated, and thematic maps were created. Procedural elements that were both unique (e.g., "cognitive restructuring" in CT) and shared among the three treatments (e.g., "knowledge gained" on pain-related topics) were reported as important. Each treatment was associated with a small number of unique therapeutic processes that were consistent with theoretical tenets underlying the interventions (e.g., "staying in the present moment" in MM). A large number of shared processes and common factors also emerged as important across all three treatments. These first-person accounts provide insight into those participant-identified therapeutic procedures and change processes that were most valued by individuals completing cognitive and mindfulness-based interventions for CLBP. Early identification of treatment barriers and strategies to overcome these barriers is necessary. Further, therapeutic rapport and training participants in coping skills they themselves can use were critical, as was engendering changes in cognitive, emotional, and behavioral mechanisms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objetivo: Identificar na literatura a existência de estudos primários e secundários que avaliem a eficácia da Restruturação Cognitiva no contexto da redução do abuso de álcool.Método:Revisão integrativa de artigos publicados entre o ano de 2010 a 2020 através de buscas na Medline, Lilacs, Scielo, Ebesco, CINAHL a partir da pergunta norteadora: Qual a eficácia do uso da terapia cognitiva na redução do abuso de álcool?Resultados: Dos 4 artigos analisados observou-se que existe evidências que o uso baseado na Terapia Cognitivo-Comportamental e nomeadamente a Reestruturação Cognitiva pode ajudar os clientes com problemas do álcool na redução do consumo do mesmo. Conclusão:A escassez de artigos pode estar relacionada com o fato da abordagem TCC, mais especificamente a Restruturação Cognitiva, ser recente e ainda em expansão no campo da Psicologia e no tratamento da dependência do álcool. Diante disso, o resultado encontrado sugere o desenvolvimento de estudos a respeito dessa alternativa terapêutica, visando o tratamento dessa dependência.

This case study describes the treatment of a patient with a blood-injection-injury type phobia including fainting and severe avoidance behavior, with the use of Virtual Reality Exposure Therapy (VRET). The patient has been treated over the course of 10 sessions. A variety of techniques from Cognitive Behavioral Therapy such as psychoeducation, cognitive restructuring, relaxation exercises and exposure therapy with pictures, videos and a Virtual Reality (VR) blood draw have been used. Results: Over the course of the treatment, the fear was significantly reduced leading to a successful blood draw two days after the last session. In the year following the treatment the patient did several successful blood draws, all without fainting and without a significant fear response.

In this qualitative study, 28 Latino social work graduate students were trained on Mindfulness Cognitive Behavioral Therapy (MCBT) through experiential learning. The students explored their self-pe...

In this article, I respond to the thoughtful commentaries and critiques offered by James Mahalik (2020), Ethan Hoffman and Michael Addis (2020), and Ginelle Wolfe and Ron Levant (2020) on my hybrid case study of "Tommy" (Dewey, 2020), a college freshman exhibiting symptoms of depression, alcohol use concerns, and inflexibly enacted traditional masculinity norms (IE-TMNs) during a time of difficult transitions and loss in his life. These commentaries have reaffirmed many of my beliefs about best practices for working with boys and men in therapy, while also expanding my knowledge of the psychology of men and masculinities (PMM) and introducing me to conceptual frameworks and therapeutic goals not directly explored in my original case study. Additionally, these three commentaries underscored areas of particular importance that I would like to discuss in further detail, including, (a) Hoffman and Addis’s differentiation between reconstructing and deconstructing masculinity as treatment aims when working with boys and men in therapy; (b) the benefits of employing Interpersonal Theory to better conceptualize presenting concerns related to traditional masculinity norms as highlighted by Mahalik; (c) constructive criticism from Wolfe and Levant and from Addis and Hoffman about the need for closer examination of social justice themes that arise when addressing masculinity in treatment; and (d) concerns about the generalizability of the case study raised by all three commentaries.

Men’s psychological well-being has in recent decades garnered increasing attention in research, clinical practice, and larger society. Dewey’s insightful case study provides an occasion for reflecting on the multiple conceptual lenses that can be used to understand and work with masculinity in psychotherapy. In this commentary, we discuss how these conceptualizations of masculinity facilitate different approaches to psychotherapy at the levels of treatment planning and intervention. We offer our own approach to masculine identity work, noting specific points of contrast with the approach illustrated by Dewey. Finally, we critically explore the clinical and societal implications of concepts like "toxic masculinity" and "healthy masculinity" in light of social justice pursuits for gender equality. Throughout, we emphasize the importance for clinicians to make deliberate choices about how masculinity is conceptualized and to consider the pragmatic consequences of these conceptual choices.

The purpose of this study was to find and describe various spiritual problems along with the completion of counseling guidance for high school students. The method used in this study was a Systematical Literature Review. The technique of collecting data is by collecting articles from several online journals. The author examines journal articles published between 2012-2020. The author found that there were 15 articles with 12 different problems. The results of this study show that various problems in the spiritual field include low religious tolerance, learning difficulties, high levels of anxiety, low levels of spiritual intelligence, lack of Islamic personality, low levels of interpersonal intelligence, low levels of religiosity, lack of noble morals, low self-esteem, bullying, juvenile delinquency, and smoking behavior that can be solved with Gestalt Prophetic (G-Pro) guidance and counseling, religiosity-based counseling guidance model, mind bubble meditation relaxation, integrative group counseling model, counseling guidance and spiritual intelligence, Islamic counseling approach, guidance theistic, group guidance, Al-Ghazali thought-based guidance and counseling, spirituality cognitive restructuring technique group counseling, Islamic intervention program model, Anwar Sutoyo's Islamic counseling guidance model, SEFT therapy (Spiritual Emotional Freedom Technique), ode mind map.

In questo lavoro viene descritto il caso di un ragazzo di 16 anni, giunto in terapia con una diagnosi di disturbo ossessivo compulsivo, per la quale aveva già intrapreso una psicoterapia, con presa in carico farmacologica, senza miglioramento dei sintomi. La sintomatologia ossessiva è associata al timore di essere contaminato dall'alito materno. Tuttavia, fin dai primi incontri, emerge con chiarezza una maggiore complessità del quadro, per la presenza in comorbilità di un disturbo schizotipico di personalità, caratterizzato da comportamenti bizzarri e responsabile di una grave compromissione del funzionamento sociale e scolastico. L'intervento è stato realizzato attivando due setting e ha visto coinvolti Luca (20 incontri) e i genitori (10 incontri). Nell'articolo descriveremo la formulazione del caso, differenziando gli interventi sui sintomi ossessivi dalle procedure utilizzate per fronteggiare la sintomatologia schizotipica. Il miglioramento del disturbo ossessivo compulsivo è stato osservato già in fase di condivisione del profilo interno e lavorando sul timore di contaminazione con interventi di ristrutturazione cognitiva. Parallelamente, il trattamento si è focalizzato sull'aumento della cura di sé e la modifica delle abitudini disfunzionali, con un effetto determinante sulla riduzione dei rituali, un aumento della percezione di autoefficacia e una diminuzione sensibile del ritiro sociale. L'intervento con i genitori si è focalizzato sulla riduzione della critica e degli atteggiamenti sprezzanti verso Luca, tramite interventi di ristrutturazione cognitiva e tecniche di validazione che hanno portato a una parziale riduzione degli stessi. Come obiettivi contestuali, favorire la comprensione e l'accettazione del funzionamento di Luca, oltre che il riconoscimento dei suoi bisogni emotivi.

INTRODUCTION: Despite extensive ethnographic and qualitative research on traditional healers in Nepal, the role of traditional healers in relation to mental health has not been synthesized. METHODS: We focused on the following clinically based research question, “What are the processes by which Nepali traditional healers address mental well-being?” We adopted a scoping review methodology to maximize the available literature base and conducted a modified thematic analysis rooted in grounded theory, ethnography, and phenomenology. We searched five databases using terms related to traditional healers and mental health. We contacted key authors and reviewed references for additional literature. RESULTS: Our scoping review yielded 86 eligible studies, 65 of which relied solely on classical qualitative study designs. The reviewed literature suggests that traditional healers use a wide range of interventions that utilize magico-religious explanatory models to invoke symbolic transference, manipulation of local illness narratives, roles, and relationships, cognitive restructuring, meaning-making, and catharsis. DISCUSSION: Traditional healers’ perceived impact appears greatest for mild to moderate forms of psychological distress. However, the methodological and sample heterogeneity preclude uniform conclusions about traditional healing. Further research should employ methods which are both empirically sound and culturally adapted to explore the role of traditional healers in mental health.

Posttraumatic stress disorder (PTSD) is a serious disorder with high rates of chronicity and significant functional impairment. There is strong research support for several psychotherapies that focus on trauma, and these are recommended as first-line treatments. However, many patients are reluctant or unwilling to engage in treatments that focus on trauma, and some desire treatment for other pressing issues. As such, there is a need for effective alternative treatment options. The purpose of this review is to describe existing non-trauma-focused psychotherapies and summarize the available evidence for these treatments. A large number of studies have examined the efficacy of non-trauma-focused therapies. Present-centered therapy (PCT), interpersonal psychotherapy (IPT), and several cognitive-behavioral approaches that focus on skills training and/or cognitive restructuring, and to a lesser extent, acceptance and commitment therapy (ACT) have empirical support from comparisons with wait-list or minimal attention controls and/or comparisons with trauma-focused therapies. Additional promising non-trauma-focused approaches with less evidence include mindfulness and meditation approaches and Skills Training for Affective and Interpersonal Regulation (STAIR). Although the evidence for trauma-focused therapy for PTSD remains the strongest, there is evidence supporting the use of these non-trauma-focused therapies for PTSD.

The treatment of depression can become complicated because of the mix of symptoms and the range of interventions that are available. Furthermore, treatment works best when adapted to the unique needs of each client. A simple A-B-C’S framework can help therapists address several key domains that are relevant to the treatment of most depressed clients. Acceptance refers to the process whereby a therapist helps clients to understand and accept their emotional reactions, learning how to express negative emotions in a more constructive manner. Behavioral activation involves the use of structured activities to help clients make specific changes in their daily routine. Cognitive restructuring confronts the negative attitudes and pessimistic expectations that often underlie depressed moods. Social involvement refers to the process whereby the client examines social interactions and interpersonal reactions. Together, the A-B-C’S framework can help to ensure that therapists address several core domains that are relevant to most depressed clients.

In utilising cognitive restructuring techniques to treat mental distress, cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT) highlight the causal relationship between perception and experience. CBT and ACT however presume there is a separation: that the occurrence of an emotion, event, or other reality exists apart from and independent of its observation. As such, CBT and ACT are ontologically dualistic. This paper reports on a possible non-dualistic alternative to these treatment programs. The potential alternative examined is A Course in Miracles (ACIM): a creed of non-dualism that contains a self-study program of 365 workbook lessons aimed at restoring mental health through reframing and discontinuing dualistic perception. Effectiveness of this alternative was evaluated through 33 one-on-one interviews with participants (sourced through ACIM Meetup groups) who had completed the ACIM Workbook component. Findings report significant positive change for all interviewees regarding their attitudinal, emotional, and social lived experience.

Dr. Albert Ellis, father of rational emotive behavior therapy (REBT), authored a response to mindfulness-based stress reduction (MBSR), an emerging mindfulness-based therapy, in 2006. Since, practice and research on mindfulness has emerged with much attention being given to mindfulness-based therapies at large. By revisiting Ellis’s words and insights through the lens of the last decade of research, this article aims to uncover core similarities and differences between REBT and MBSR. Such themes of philosophical underpinnings, acceptance, and homework link these approaches, while present moment attention, cognitive restructuring, and meditation distinguish them. Moreover, research comparing mindfulness to cognitive-behavioral approaches has opened up an evidence-base for deciphering the utility and clinical effectiveness of these therapies. Further exploration can help uncover and better support the proposed similarities and differences between them. Through examining Ellis’s words and the associated research, this article serves to assist in clarifying and highlighting critical aspects of these therapies and interaction amongst them.

Cognitive dysregulation, often characterized by extreme, nondialectical thinking, is a core problem area identified in dialectical behavior therapy (DBT) and is posited to contribute to pervasive emotional and behavioral dysregulation. However, cognitive flexibility is understudied and rarely considered a direct treatment target in DBT. This paper provides clinical guidelines for increasing dialectical thinking with patients in DBT. We review the historical context of dialectical thinking in DBT and present the results of a survey examining DBT therapists’ perspectives on nondialectical thinking as a treatment focus. We describe cognitive restructuring strategies from cognitive therapy models, and compare these with techniques targeting cognitive dysregulation in DBT. We highlight the rationale for incorporating dialectical thinking as a direct treatment focus in DBT, and offer strategies derived from cognitive restructuring to incorporate directly targeting dialectical thinking in conceptualization, treatment planning, and in session. These strategies are demonstrated with clinical vignettes and examples.

Introduction: Psychopharmacotherapy and Cognitive Behavioral Therapy (CBT) are commonly used in the treatment of Obsessive Compulsive Disorder (OCD) although the use of relaxation training as a separate protocol for enhancing treatment motivation is not very common. This case report focuses the application of CBT with the combination of relaxation training and low-doze psychofarmacotherapy with an OCD patient. Case: The patient was in her forties and she had ten years history of OCD, whose basic obsessions were about contamination, suspiciousness and observance to specific rules. She performed compulsions to neutralize the anxiety which were created by her obsessions. Psychopharmacotherapy as an outpatient was the primer choice of treatment, although doze increment was not possible due to serious side effects. Therefore, a combined treatment model was planned. The first phase of the treatment was conducted as a 6-session relaxation training and psychoeducation right after 2 sessions of psychological assessment and case formulation. Then 12 sessions of CBT model was conducted that include cognitive restructuring, exposure, response prevention, social skills training and imaginary techniques. The patient sustained in remission in the follow-up sessions after the treatment had ended. Results: It is assumed that the combination of relaxation training for enhancing motivation with CBT through case formulation is a contributive component of treatment in OCD. [JCBPR 2019; 8(1.000): 63-68]

Chemical dependency is a multifactorial problem that brings constant challenges to the professionals involved in its treatment, being necessary to seek effective intervention strategies. This article presents a case study of crack dependence. The objective of this paper was to describe the application of Cognitive-Behavioral Therapy (CBT) in the treatment of chemical dependency, the techniques used and the results obtained. The method consisted of the accomplishment of the diagnostic evaluation, the treatment plan and the intervention. The data analysis indicated the improvement of mood, cognitive restructuring, improvements on cope with relapse risk, problem solving, social skills and abstinence maintenance. The results suggest the effectiveness of CBT in the chemical dependence treatment.

Maladaptive daydreaming (MD) is an immersive fantasy activity that leads to distress and socio-occupational dysfunction. MD has many features suggestive of behavioural addiction, but research exploring the phenomenology of this clinical construct is limited. MD has also been purported to be a maladaptive strategy to cope with distress, but often leads to uncontrollable absorption in fantasy world, social withdrawal and neglected aspects of everyday life. In this paper, we report the case of a 16-year-old boy who developed internet gaming disorder and MD after experiencing cyberbullying from his peers. The patient engaged in vivid, fanciful imagery that lasted for hours, leading to social dysfunction and academic deterioration. Baseline assessment revealed a Maladaptive Daydreaming Scale-16 score of 65 (cut-off 50) and an Internet Gaming Test-20 score of 86 (cut-off 71). The patient was managed primarily with psychological intervention. The therapy focused on behaviour modification and cognitive restructuring. Patients in clinical setting should be questioned about MD when presenting with excessive use of technology or other forms of behavioural addictions. Further studies are necessary to determine the biopsychosocial factors of MD and its correlates. There is also a need to study treatment and management approaches for treating MD.

Il est d’usage, au cours d’un traitement, d’aider les joueurs pathologiques à développer et à mettre en pratique différentes stratégies pour prévenir les rechutes. Le traitement du jeu pathologique a connu des avancées dans les dernières années en utilisant la réalité virtuelle (RV) pour exposer les joueurs à leur envie de jouer. L’influence de cette modalité de traitement sur les stratégies de prévention des rechutes reste toutefois à évaluer. Notre étude visait donc à identifier et à classifier les stratégies proposées par les joueurs pour gérer leur envie de jouer lorsqu’ils sont confrontés à des situations à risque d’une exposition à la RV. Des enregistrements de dix joueurs pathologiques ayant pris part à une séance de prévention de la rechute en RV ont été transformés en verbatim. Le contenu du verbatim a fait l’objet d’une analyse de type déductif et inductif validée par une procédure d’accord interjuges. Les résultats ont révélé six stratégies comportementales et sept stratégies cognitives proposées par les joueurs, avec une moyenne de dix stratégies différentes par joueur. Les stratégies cognitives montrent l’influence possible de la restructuration cognitive qui a eu lieu lors de la thérapie. De plus, l’évitement semble être l’une des stratégies comportementales clés pour les participants, lorsque confrontés à un environnement de bar. Cette étude appuie le potentiel de RV en prévention de la rechute. La spécificité des stratégies provenant de la RV, en comparaison avec l’exposition en imagination, ainsi que l’efficacité des stratégies abordées en séance de RV devraient faire l’objet d’autres études.AbstractIt is common practice, during treatment, to help pathological gamblers develop and implement different strategies to prevent relapses. Treatment for pathological gambling has made progress in recent years and now uses virtual reality (VR) to make gamblers aware of their gambling urges. However, the impact of this treatment method on relapse prevention strategies has yet to be evaluated. This study aims to identify and classify strategies to manage gambling urges as proposed by gamblers when faced with risky situations during exposure in virtual reality. Recordings taken of ten pathological gamblers during a virtual reality relapse prevention session were transcribed verbatim. The verbatim was the subject of a deductive and inductive analysis validated by a procedure agreed upon by the judges. The results reveal six behavioural and seven cognitive strategies proposed by the players with an average of ten strategies per player. The cognitive strategies show that the cognitive restructuring used during treatment had a possible impact. Furthermore, in bars, avoidance seems to be one of the key behavioural strategies for the participants. This study supports the potential of virtual reality in relapse prevention. The specificity of the strategies proposed during VR exposure compared with imaginary exposure as well as the effectiveness of the strategies addressed in VR sessions should be studied further.

Purpose The purpose of this review article is to provide an overview of the current evidence base for the behavioral management of stuttering and associated social anxiety. Method We overview recent research about stuttering and social anxiety in the context of contemporary cognitive models of social anxiety disorder. That emerging evidence for self-focused attention and safety behavior use with those who stutter is considered in relation to current treatment approaches for stuttering: speech restructuring and social anxiety management. Results The emerging information about social anxiety and stuttering suggests a conflict between the two clinical approaches. For those clients who wish to control their stuttering and where speech restructuring is deemed the most suitable approach, it is possible that speech restructuring may (a) induce or increase self-focused attention, (b) promote the use of safety behaviors, and (c) become a safety behavior itself. This conflict needs to be explored further within clinical and research contexts. Conclusions The issues raised in this review article are complex. It appears that evidence-based speech treatment procedures are in conflict with current best-practice treatment procedures that deal with social anxiety. In this review article, we propose directions for future research to inform the development of improved treatments for those who stutter and recommendations for interim clinical management of stuttering.

In this work 112 studies were reviewed and 21 of them were considered as more reliable and more credible. It is well known that Cognitive-Behavioural Therapy (CBT) is the most valid approach regarding its effectiveness. There are many variations of CBT used in patients with tinnitus, but the most effective appears to be the Cognitive-Behavioural Acceptance and Commitment Therapy. Also, treatment-variations consist in the use of hearing aids, and psycho-education. The Acceptance and Commitment Therapy is a third-generation psychological intervention invented by Steven Hayes in 1986. This therapy also applies to the treatment of many psychological problems, such as depression, anxiety, psychoses and substance use problems, and chronic diseases. The purpose of this therapy is not to reduce symptoms, but to improve health and behaviour changes in order for the patient to accept the inevitable pain involved in his/her condition. There are other forms of therapy that come from the broader spectrum of CBT, such as book-therapy (self-help method), rehabilitation treatment of tinnitus, and the Axiological Model based solely on cognitive psychotherapy inspired by the CBT founder, Aaron Beck. Because the latter treatment is at its first steps, there is no literature yet, and it must be considered as an experimental model. It is also well known that intervention with CBT could significantly reduce the anxiety and stress caused by tinnitus. The CBT technique incorporates many elements used to treat tinnitus, such as self-assessment, applied relaxation, cognitive restructuring, behavioral activation, and positive mental imagery. Finally, it becomes apparent that the tinnitus problem, which is serious for these patients, is increasingly affecting the psychiatric and psychotherapeutic communities.

The following represents our response to the chapter “How B-C Connection and Negotiation of F allow the Design and Implementation of a Cooperative and Effective Disputing in Rational Emotive Behavior Therapy” submitted by Ruggiero, Caselli, and Sassaroli regarding critical aspects of Rational Emotive Behavior theory and practice. We expand on several points made in their chapter, including the importance of a solid therapeutic alliance and strategies to attain this, common factors in psychotherapy as they relate to REBT, the often overlooked and/or underrecognized behavioral consequences of irrational beliefs, important aspects of assessment and how it contributes to case conceptualization, how REBT in most cases involves a simultaneous process of assessment and treatment, a method that often deviates from many other CBT approaches, and important considerations of cognitive process and content domain. The importance of progress monitoring for REBT trainees as well as seasoned practitioners is also reviewed. We agree with the authors that a component of REBT practice is eliciting any doubts or reservations clients may have about aspects of the theory or specific clinical interventions and strategies. Many new REBT therapists fail to elicit this from clients, leading either to a rupture in the therapeutic alliance or serves as an obstacle in the development of an alliance. Finally, it is important to note that historically REBT has received criticism by others in the field for what is perceived to be an aggressive therapeutic approach. The authors of this chapter accurately explain the importance of preparation of disputation of irrational beliefs by establishing a clear emotional and/or behavioral goal and ensuring an understanding of the B-C connection on the part of clients. This preparation allows for an organic process of cognitive restructuring and helps to circumvent a counterproductive style of therapy practice.

The ability to regulate emotions is important for human function and health. That emotion regulation can be achieved through cognitive change is predicated on the notion of cognitive mediation. However, the extent to which individuals believe that their emotions are cognitively mediated (C-M), or in contrast, that their emotions occur via stimulus-response (S-R), is underexplored, and whether C-M and S-R beliefs shape emotion reactivity is not yet known. Research that addresses these empirical needs could inform emotion regulation interventions such as cognitive behavioural therapies (CBTs). The current paper reports the development and initial validity testing of the cognitive mediation beliefs questionnaire (CMBQ). Five studies report the factor structure, the construct and criterion validity, and the test-retest reliability of the CMBQ. The CMBQ was found to have a correlated two-factor structure (C-M change beliefs, and S-R generation beliefs). Higher C-M change beliefs and lower S-R generation beliefs were related to greater emotion regulation, greater thought control ability, higher positive mental health, and lower emotion reactivity. The CMBQ also demonstrated acceptable test-retest reliability. Initial testing indicates that the CMBQ is a valid and reliable questionnaire for psychometric use in adult populations, including those with a diagnosed mental health condition.

Cognitive Behavioral Therapy (CBT) is one of the most well-studied, effective interventions for an array of child and adolescent problems. One of the strengths of CBT is that it is comprehensive, flexible, adaptable, and problem-focused. In its approach, CBT incorporates a variety of techniques that focus on changing related maladaptive thought processes and behaviors. Elements of behavioral parent training, school–home communication, psychoeducation, relaxation strategies, cognitive restructuring, and exposure are presented in this case study of a high school student with anxiety.

In this nonconcurrent, multiple-baseline, single-subject research study, the authors conducted a preliminary exploration of whether mindfulness-based cognitive therapy (MBCT) can be expanded to the treatment of math anxiety. Three high school students who were assessed with high levels of math anxiety met individually twice a week for 6 weeks with the school counselor who used a manualized MBCT treatment for anxiety as the intervention. A weekly administration of a math anxiety measurement tool showed a decrease in math anxiety for all three participants.

There is a great need for training in cognitive behavioral therapy (CBT) for community clinicians who work in public mental health systems where resources are low and demands are high. Researchers have found that simply attending intensive CBT workshops will not result in adherent or competent CBT being delivered, rather ongoing CBT supervision/consultation has been found to be associated with the best training outcomes. Psychotherapy-based approaches to supervision have recently received some attention for their value in providing experiential learning. What follows is a case example of a community clinician who had little previous training in CBT and following an intensive training and 16 weeks of CBT supervision had substantial gains in her CBT adherence and competency ratings. Recommendations such as the value of experiential learning are discussed.

Euthymia is generally conceived in negative terms (absence of psychiatric disorders), yet it may also indicate a trans-diagnostic construct where lack of mood disturbances is associated with positive affects and psychological well-being (flexibility, consistency and resilience). Specific strategies for the assessment of euthymia are available, including both observer- and self-rated instruments that may be applied within a clinimetric framework encompassing macro-analysis and staging. Self-observation of psychological distress in a diary is the basic, neglected method of cognitive and behavioral strategies. Self-observation of instances of well-being may become the source of psychotherapeutic work geared to euthymia, combined with cognitive restructuring, homework assignments and clinical interaction. Well-Being Therapy (WBT) specifically pursues this approach. It may be incorporated in a therapeutic plan based on clinical reasoning and case formulation. The target of euthymia may also be accomplished by other psychotherapeutic strategies, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Clinical applications encompass decreasing vulnerability to relapse, increasing the level of recovery and modulating mood. The practice of self-observation of psychological well-being in a diary, as manualized in WBT, may trigger important developments in clinical assessment and in other psychotherapeutic techniques geared to a state of euthymia.

Routinely prescribed psychological therapies for depression are not always effective. Arts therapies, particularly Dance Movement Psychotherapy, may offer additional therapeutic mechanisms for depression. Therefore, client-reported helpful factors from various therapy types, along with client preferences, are key in devising new therapeutic interventions. We present a framework for a new pluralistic “meta-approach” of therapy for depression, based on an interdisciplinary thematic synthesis (Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8(1), 45) of active ingredients from both talking therapies and creative approaches. Lastly, we offer an example group therapy workshop based on this approach, to be piloted with clients and practitioners within an NHS mental health service. Further research is required to evaluate this pilot and to devise a full treatment for trialling within the service.

Several studies have shown that cognitive behavioral therapy (CBT) is efficacious for the treatment of anxiety disorders (Ellard and Chronopoulos, Cognitive behavioral therapy for anxiety disorders. In: The Massachusetts General Hospital handbook of cognitive behavioral therapy. Humana Press, New York, p 43–61, 2016; Hofmann et al., Cogn Ther Res, 36:427–440, 2012; Kessler et al., Arch Gen Psychiatry, 62:593–602, 2005). The core components of CBT for anxiety disorders include aspects derived from behavioral and cognitive therapies such as exposure exercises and cognitive restructuring, respectively (Sprich et al. In: Stern TA, Fava M, Rosenbaum JF, Wilens TE (eds) Massachusetts General Hospital comprehensive clinical psychiatry. Elsevier Health Sciences, p 152–64, 2016). This chapter discusses the history and development of CBT for anxiety disorders, giving an overview of both behavioral and cognitive therapies, and examines the core principles and practice of CBT for anxiety disorders in general as well as how CBT has been adjusted to target the symptoms of each anxiety disorder. Additionally, this chapter examines the efficacy and accessibility of CBT, discussing the potential for new delivery methods and cultural adaptations to increase accessibility and generalizability. Lastly, this chapter explores modifications of traditional CBT and future directions.

Background Metaphors may provide clarity or identify hidden similarities between two ideas, and their use in cognitive restructuring can help maximise the effect of therapy information. This study aimed to determine whether metaphorical cognitive restructuring would produce a greater intervention effect in targeted mood and cognition than non-metaphorical restructuring. Methods Eighty-eight participants chose 25 problems of interest and wrote a self-report distress problem and were then randomly divided into a metaphorical restructuring group (N = 29), a literal restructuring group (N = 30), or a no restructuring problem restating group (N = 29). Participants first read a description of psychological distress ("problem") and then read a solution within one micro-counseling scenario. They were asked to evaluate their insightfulness during the intervention and evaluated mental distress and self-efficacy before and after the intervention. Results The mental distress of the metaphorical restructuring group significantly decreased after the intervention. Further, this group had greater insightfulness during the intervention, and this insightfulness could predict the reduction of negative affect after the intervention. Conclusions The use of metaphors can be of great value in eliciting a salient cognitive restructuring process and in alleviating mental distress.

A growing body of research suggests that hope and other positive emotions are important in disrupting the cycle of pain and negative emotionality common to chronic pain sufferers. This qualitative ...

The behavior of a human being in sexual matters is often a prototype for the whole of his other modes of reaction in life. 1 Erectile dysfunction due to psychogenic cause has been a highly researched area. Psychoanalytically, it has been seen as a symptom of an underlying conflict due to early developmental experiences. The attitude of parents especially at the time of a child’s emerging sexuality is considered important in perpetuating sexual inhibition and symptom. Sexual dysfunction has been found to be closely linked to anxiety and guilt and fears of punishment. This pattern of disturbance permeates into other areas of a person’s life and may continue to perpetuate his symptoms. Negative body attitude and shame have been found closely linked to sexual dissatisfaction. In this paper, a case is discussed where a patient is undergoing psychodynamic psychotherapy for depression reported along with erectile dysfunction. Distorted cognitions related to his and the partner’s body were addressed along with both current and past conflicts related to his current symptomatology.

ResumenEste trabajo describe la intervención de caso único con un luchador de la selección española de lucha grecorromana. El objetivo de esta intervención fue disminuir la ansiedad precompetitiva para incrementar el rendimiento deportivo mediante un programa de habilidades psicológicas basado en técnicas de visualización, parada de pensamiento, reestructuración cognitiva y establecimiento de rutinas precompetitivas. Se utilizó el CSAI-2R antes, durante y después de la intervención como medida de la ansiedad. También se utilizaron registros para la visualización, parada de pensamiento, reestructuración cognitiva y rutinas precompetitivos específicamente diseñados para el caso. Los resultados muestran que, tras la intervención, los niveles de ansiedad precompetitiva disminuyeron notablemente y el rendimiento deportivo aumentó con buenos resultados durante las competiciones. AbstractThis paper describes a single-case psychological intervention with a Spanish National Greco-Roman Wrestling Team wrestler. The aim of the intervention was to reduce pre-competitive anxiety in order to increase his athletic performance through a psychological skills program based on mental imagery, thought stopping, cognitive restructuring and pre-competitive routines. The CSAI-2R was used before, during and after the intervention for assessing anxiety. Self-monitoring registers for mental imagery, thought stopping, cognitive restructuration and precompetitive routines specifically designed for this case were also used. Results showed the athlete highly reduced precompetitive anxiety and increase athletic performance.

This study aimed to evaluate the transportability of cognitive therapy (CT) for rape survivors with PTSD to South African conditions. Ten local treatment outcome studies investigating the transportability of CT were identified and appraised. The common elements of CT for PTSD including psychoeducation, exposure therapy and cognitive restructuring of trauma-related appraisals were found to be transportable to local contexts. Contextual factors that can complicate treatment delivery were also identified namely exposure to multiple traumatic events, HIV, absence of safety and support in the external environment and language barriers. The augmentations made to an existing evidence-based treatment protocol to address these contextual factors are described.Keywords: Cognitive treatment, PTSD, Rape survivors, South Africa, Transportability

This article reviews the extant literature on mediators of change in cognitive behavioral therapy (CBT) for anxiety and depression. The authors briefly discuss the efficacy of CBT for anxiety and depression and methods of mediation analysis and detection. Then the authors discuss fear extinction in anxiety treatment and cognitive change in depression treatment.

Objective To examine the long-term effects of telephone-delivered cognitive-behavioral therapy (CBT-T) compared with nondirective supportive therapy (NST-T) in rural older adults with generalized anxiety disorder (GAD). Methods 141 adults aged 60 years and older with a principal/co-principal diagnosis of GAD were randomized to either CBT-T or NST-T. CBT-T consisted of up to 11 sessions (9 were required) focused on recognition of anxiety symptoms, relaxation, cognitive restructuring and use of coping statements, problem-solving, worry control, behavioral activation, exposure therapy, and relapse prevention, with optional chapters on sleep and pain. NST-T consisted of 10 sessions focused on providing a supportive atmosphere in which participants could share and discuss their feelings and did not provide any direct suggestions. Primary outcomes included interviewer-rated anxiety severity and self-report worry severity measured at 9 months and 15 months after randomization. Mood-specific secondary outcomes included self-report GAD symptoms and depressive symptoms. Results At 15 months, after adjustment for multiple testing, there was a significantly greater decline in general anxiety symptoms (difference in improvement: 3.31; 95% CI: 0.45–6.17; t = 2.29; df = 136; p = 0.024) and worry (difference in improvement: 3.13; 95% CI: 0.59–5.68; t = 2.43; df = 136; p = 0.016) among participants in CBT-T compared with those in the NST-T group. There were no significant differences between the conditions in terms of depressive symptoms (difference in improvement: 2.88; 95% CI: 0.17–5.60; t = 2.10; df = 136; p = 0.0376) and GAD symptoms (difference in improvement: 1.65; 95% CI: −0.20 to 3.50; t = 1.76; df = 136; p = 0.080). Conclusions CBT-T is superior to NST-T in reducing worry and anxiety symptoms 1 year after completing treatment.

Purpose: Hope and meaning in life are essential components of personal growth and happiness. Built on the recovery model, this study attempted to evaluate the effects of a recovery-oriented cognitive–behavior approach (CBA) in enhancing hope and meaning in life among a group of people with severe mental illness in Hong Kong. Method: A matched-pair comparison approach was adopted. Twenty-seven experimental group participants received recovery-oriented CBA, while 25 participants received standard counseling services. Assessments were administered at preintervention and at 6 and 12 months of intervention. Results: Repeated measures analyses of covariance indicated that the recovery-oriented CBA was more effective than the control condition in improving the mental health recovery process (basic functioning, finding new potentials, and spirituality) and a sense of hope (planning in achieving goals). Conclusion: Given these initial positive results, more vigorous studies and refinement of this recovery-oriented CBA are needed to ascertain the effectiveness of this combined intervention approach.

This article presents an integrative framework for using cognitive behavior therapy through the lens of relational cultural theory. The authors provide an overview of cognitive behavior therapy and relational cultural theory, followed by suggestions on how to facilitate cognitive behavior therapy using the principles of relational cultural theory in college counseling. A case illustration is used to demonstrate the integration of cognitive behavior therapy and relational cultural theory.

Mindfulness, which is best understood as nonjudgmental, present-centered awareness, originated in ancient Eastern traditions but has been adapted for use in Western, secular settings. The present article reviews the quickly burgeoning field of mindfulness research for teachers of psychology, including the most common mindfulness-based treatments and exercises. It also includes an overview of settings outside of traditional mental health treatment in which mindfulness has been used. Because mindfulness is appropriate within the context of a variety of courses, we have also included recommendations for teaching psychology students about mindfulness.

The bygone notion of a “fixed idea” has evolved into an appreciation for overvalued beliefs, automatic thoughts, irrational beliefs, and dysfunctional attitudes and the role they can play in the lives of many clients. Overvalued beliefs are common and can be destructive when they guide the client toward extreme emotional reactions, disruptive behavioral patterns or create negative views of self or others. Overvalued beliefs become problematic when they are not aligned with commonly accepted views of reality, they are rigidly maintained despite insufficient evidence, and they create maladaptive self-perpetuating patterns. A metaphor is used to explain how minor puddles can evolve into major potholes, creating lasting damage. The destructive power of puddles shares some similarities with the subtle influence of overvalued beliefs on a client’s emotional and interpersonal functioning. Psychotherapy can help clients to confront the misguided accuracy, limited utility, and exaggerated potency of their beliefs. Therapy can help clients to disengage from the directive power of their beliefs, learning to tolerate various thoughts without reacting at an emotional or behavioral level.

Meta-analytic studies have extracted 4 common elements among effective posttraumatic stress disorder treatments: cognitive restructuring and psychoeducation, a deliberate and continually improving therapeutic relationship, relaxation and self-regulation, and exposure via narrative of traumatic experiences. The authors present a clinical treatment structure catalyzing these active ingredients into discrete therapeutic tasks that counselors can focus on to maximize treatment effectiveness. The 4 tasks represent an attempt to identify critical competencies and baseline standards for the field of trauma counseling.

Cognitive restructuring is one of the most widely used techniques among psychologists of different orientations. However, there is a lack of clarity in what concerns its precise definition, functioning, effectiveness, and components.To obtain precise information on how psychotherapists use cognitive restructuring in their clinical practice in Spain.A survey study was conducted following a descriptive quantitative methodology, with a cross-sectional design and a non-random sampling method. Three hundred and twenty psychotherapists responded to a questionnaire, created ad hoc, on cognitive restructuring.Cognitive restructuring is widely used by therapists with different levels of experience, training, and following different psychotherapeutic approaches. Furthermore, it is applied to address a wide variety of psychological problems. There exist relevant differences in the use of the technique depending on the therapists' level of experience.This study has shown, for the first time, how cognitive restructuring is applied in daily clinical practice. The main implications of these results are discussed, and new lines of inquiry are proposed. Clinical or methodological significance of this article: This study has contributed to bringing the clinical reality of cognitive restructuring closer to the scientific community, by identifying which of the elements and procedures that are taught or researched are actually applied in daily practice.