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Background: Children and young people with long‐term physical health conditions (LTC) are known to have higher levels of co‐morbid mental health problems than medically healthy children. Evidence‐based treatments for mental health problems are effective in children who also have an LTC. This study aimed to explore the factors associated with participants' perceived acceptability and impact of a transdiagnostic mental health centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long term physical conditions. Methods: One‐hundred twenty‐eight patients attending the drop‐in centre were invited to participate. Overall, 35 participated (31 parents/carers; 4 children and young people) in semi‐structured interviews (either in person or by phone) exploring their experience of the centre. Interviews were audio‐recorded, transcribed and checked. Framework analysis was then conducted on all transcripts. Results: Overall, participants found the drop‐in centre highly acceptable and reported a positive experience. Reasons for this varied but broadly focused around four themes: (1) efficient sufficiency; (2) autonomy; (3) fusion of process and content factors and (4) (dis)parities of esteems and 'seeing both sides of the coin'. Conclusions: Participants found the intervention acceptable. A mental health drop‐in centre in a paediatric hospital appears to be a positive and valued adjunct to supplement existing mental health services. [ABSTRACT FROM AUTHOR]

Background: Haemophilic arthropathy is one of the main causes of morbidity in people with haemophilia (PWH), inducing pain and reduced functionality. Therefore, PWH are complex patients and must be approached from a multidisciplinary perspective. Objectives: To evaluate the effectiveness of a therapeutic exercise and cognitive‐behavioural therapy (CBT) combined protocol on functionality, pain, and joint health of PWH, arthropathy and chronic pain. Treatment satisfaction was also evaluated. Methods: A single‐blinded clinical trial with 21 PWH in prophylactic regimen was carried out. Participants were divided into an experimental group (EG, n = 11) and a control group (CG, n = 10). The EG underwent a 4‐month programme of home‐based therapeutic exercise plus CBT, whilst CG performed their daily activities. Patients were evaluated at baseline, post‐intervention and after 12 additional weeks. Measures of functionality (Haemophilia Activities List, Timed Up and Go Test, 2‐Minutes‐Walking‐Test and Sit‐to‐Stand Test), pain (PainDETECT and Visual Analogue Scale) and joint health (Haemophilia Joint Health Score) were taken. Related dimensions of the A36 Haemophilia Quality of Life Questionnaire were calculated. Effects were calculated using a two‐factor ANOVA. Results: The EG showed significant improvements in function (p <.001), pain (p <.001), joint damage (p =.006), and satisfaction with the treatment (p =.006) dimensions of the A36 Haemophilia Quality of Life Questionnaire, as well as in pain measured with the Visual Analogue Scale (p =.008) and PainDETECT (p =.035). Conclusions: The combined physiotherapy and CBT protocol showed a partial improvement in functionality, pain and joint health of PWH, arthropathy and chronic pain. In addition, participants were satisfied with the treatment. [ABSTRACT FROM AUTHOR]

Background: Predatory sexual acts by adults cause concern worldwide. Patterns of distorted thinking and weakened self‐control are among the leading explanations. Amidst growing concerns about sexual offences in Nigeria, it might be that more psychologically informed interventions in prison could reduce the risks of further harm compared with the standard prison regime. Aims: To test the effectiveness of a cognitive behaviourally informed intervention (CBII) in reducing violent sexual attitudes among men in prison in Nigeria for a sexual offence. Methods: In a randomised controlled trial, men in two prisons who responded to in‐prison advertising about the trial were screened for nature of offence and willingness to participate. Those nearing their sentence end or in other psychological therapy were excluded. Sample size was confirmed by power calculation. The Compulsive Sexual Behaviour Inventory (CSBI‐22) and the Hypersexual Behaviour Inventory (HBI) were administered before, immediately after and 3 months after completion of a 12‐session (18 h) Cognitive Behavioural Informed Intervention or equivalent periods of 'treatment as usual' (TAU) alone. The CBII was designed to change sexual attitudes, and delivered by trained cognitive therapists to the men, as a group, in one of the prisons while the controls received only TAU in the other. Results: Before the intervention, the 39 men in each group had similar psychosocial histories and sexual attitude scores. Following CBII, the intervention group showed a significant reduction in scale scores that was sustained, whereas the TAU group showed no significant change in scores. An ANCOVA analysis confirmed between‐group differences immediately after the intervention and 3 months later. Conclusions: This randomised controlled trial adds to existing knowledge in the field because prior studies have been from high income countries, where interventions are generally delivered in more privacy and at greater length. Given that our study had to be limited to change in sexual attitudes as the main outcome, future research must focus on the extent to which such change maps on to changes in interpersonal behaviour among such men. If these findings can be extended in this way and replicated, this could pave the way for more cost‐efficient interventions in higher income countries too. [ABSTRACT FROM AUTHOR]

Several in-person and remote delivery formats of cognitive-behavioural therapy (CBT) for panic disorder are available, but up-to-date and comprehensive evidence on their comparative efficacy and acceptability is lacking. Our aim was to evaluate the comparative efficacy and acceptability of all CBT delivery formats to treat panic disorder. To answer our question we performed a systematic review and network meta-analysis of randomised controlled trials. We searched MEDLINE, Embase, PsycINFO, and CENTRAL, from inception to 1st January 2022. Pairwise and network meta-analyses were conducted using a random-effects model. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). The protocol was published in a peer-reviewed journal and in PROSPERO. We found a total of 74 trials with 6699 participants. Evidence suggests that face-to-face group [standardised mean differences (s.m.d.) −0.47, 95% confidence interval (CI) −0.87 to −0.07; CINeMA = moderate], face-to-face individual (s.m.d. −0.43, 95% CI −0.70 to −0.15; CINeMA = Moderate), and guided self-help (SMD −0.42, 95% CI −0.77 to −0.07; CINeMA = low), are superior to treatment as usual in terms of efficacy, whilst unguided self-help is not (SMD −0.21, 95% CI −0.58 to −0.16; CINeMA = low). In terms of acceptability (i.e. all-cause discontinuation from the trial) CBT delivery formats did not differ significantly from each other. Our findings are clear in that there are no efficacy differences between CBT delivered as guided self-help, or in the face-to-face individual or group format in the treatment of panic disorder. No CBT delivery format provided high confidence in the evidence at the CINeMA evaluation. [ABSTRACT FROM AUTHOR]

Avoidant/restrictive food intake disorder (ARFID) is a new diagnosis introduced in DSM-5 in 2013. It is characterised by an insufficient intake of food in volume and/or variety. The difficulty in food intake can be motivated by sensory sensitivity towards certain categories of foods; worrying about the negative consequences of eating (i.e. choking or vomiting); or a lack of interest in food. It is associated with medical, nutritional, and/or psychosocial impairment. Therefore, it requires therapeutic management on a medical and psychological level. This paper analyses the data regarding the prevalence of the disorder, aetiology, clinical characteristics, and comorbidities. It investigates the presence of theoretical models of the functioning of the disorder. It also evaluates the assessment methods and intervention techniques that are currently being validated. To date, new data are emerging that indicate a significant presence of this problem. However, the current data is neither univocal nor sufficient and treatment is still at a preliminary stage. Therefore, it is essential for research to analyse and increase the data, to improve the recognition of this pathology and to structure effective therapies for ARFID. [ABSTRACT FROM AUTHOR]

Intolerance of uncertainty (IU) is a vulnerability factor for several psychological disorders and may be an important target for transdiagnostic interventions (Shihata et al., 2016). The current pilot study aimed to evaluate the effectiveness of a transdiagnostic cognitive-behavioural group intervention delivered to 7 university students. These students reported difficulties tolerating uncertainty aside from the presence of a psychological disorder and type of disorder. A single-case experimental design in 3 phases (baseline, 8-week intervention, 8-week follow-up) had as primary outcome an ad-hoc daily self-monitoring questionnaire. The secondary outcomes were scores on the self-report questionnaires Intolerance of Uncertainty Scale-Revised and Depression Anxiety Stress Scales-21, which were administered at baseline, end of intervention and followup. Overall, perceived uncertainty and associated distress decreased - especially between intervention and follow-up; conversely, confidence in the ability to manage uncertainty increased across the three phases. Scores on self-report questionnaires showed a progressive decrease in IU and general distress. Although only preliminarily, these findings support the effectiveness of a transdiagnostic group intervention focused on IU in university students. However, it would be highly recommendable to conduct randomized control trials to provide stronger and more generalizable evidence. [ABSTRACT FROM AUTHOR]

Patients feel more vulnerable when accessing community mental health programs for the first time or after being discharged from psychiatric inpatient units. Long wait times for follow-up appointments, shortage of mental health professionals, lack of service integration, and scarcity of tailored support can weaken their connection to the health care system. As a result, patients can present low adherence, dissatisfaction with treatment, and recurrent hospitalizations. Finding solutions to avoid unnecessary high-cost services and providing tailored and cost-effective mental health interventions may reduce the health system burden and augment patient support. We propose implementing an add-on, supportive text messaging service (Text4Support), developed using cognitive–behavioural therapy (CBT) principles to augment mental health support for patients attending to or being discharged from psychiatric care in Nova Scotia, Canada. This randomized controlled trial aims to investigate the effectiveness of Text4Support in improving mental health outcomes and overall mental well-being compared with usual care. We also will examine the intervention's impact on health services utilization and patient satisfaction. The results from this study will provide evidence on stepped and technology-based mental health care, which will contribute to generating new knowledge about mental health innovations in various clinical contexts, which is not only helpful for the local context but to other jurisdictions in Canada and abroad that are seeking to improve their health care. [ABSTRACT FROM AUTHOR]

Aim: To investigate group metacognitive training and cognitive–behavioural therapy (MCT/CBT) prospectively in a young population with various psychiatric disorders, including psychotic and mood disorders. Methods: This was a prospective study to investigate the effectiveness of group MCT/CBT on quality of life, psychotic symptoms, depression, self‐esteem, perceived stress, social function and social cognition. The objective measures included the Positive and Negative Syndrome Scale (PANSS), clinical global impression (CGI), personal and social performance scale for social functioning, a computerized continuous performance test for sustained attention and a computerized emotional recognition test for social cognition. Self‐report measures administered included the Subjective Well‐being under Neuroleptics for quality of life, Ambiguous Intentions Hostility Questionnaire for suspiciousness, Drug Attitude Inventory, Beck Depression Inventory, Perceived Stress Scale, Brief Resilience Scale, Rosenberg Self‐esteem Scale and visual analogue scale for the EQ‐5D. Results: Among 110 young patients with early psychosis and mood disorders who participated, 82 (74.5%) completed the study. Social functioning, quality of life, self‐esteem, resilience, depression, suspiciousness, social cognition, sustained attention and scores on the PANSS and CGI improved significantly after completing group MCT/CBT. Perceived stress, resilience and suspiciousness improved significantly only in participants with a non‐psychotic disorder. Improvements in subjective well‐being of the participants were associated with increases in self‐esteem and resilience and decreases in depression and perceived stress. Conclusions: Our study showed that group transdiagnostic MCT/CBT for young patients with mental illness improved subjective wellbeing, self‐esteem, resilience, social cognition and social functioning and significantly diminished suspiciousness, perceived stress and depression. [ABSTRACT FROM AUTHOR]

Group Transcending Self Therapy (TST) is a new psychotherapeutic approach designed for the treatment of addictions, based on cognitive-behavioural therapy. The aim of the study was to compare the effectiveness of this approach with the treatment as usual (TAU) in patients entering outpatient treatment for alcohol use disorder. The study involved 79 participants (33% women) with a mean age of 46.8 years (SD = 12.5). Patients were provided with either TST (n = 39) or TAU (n = 40). The groups were compared in terms of relapse rate, retention in treatment, level of psychopathology and quality of life. After 20 weeks of treatment, there were no differences in treatment efficacy between TST and TAU. We discuss the results of the study through the optics of known factors influencing the effectiveness of psychotherapy. [ABSTRACT FROM AUTHOR]

BackgroundTreatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.AimsWe aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive-behavioural therapy (G-CBT).MethodWe randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3-25). Predictors of treatment response were examined.ResultsG-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = -1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004).ConclusionsPeer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.Declaration of interestC.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers' honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.

In the Western context, virtual reality (VR)-based treatments had been suggested as an intervention for anxiety disorder. Despite its potential efficacy, there is a lack of study which using VR as an intervention, especially for obsessive-compulsive disorder (OCD) in Asian countries. Therefore, the present study aimed to examine what elements are required to design VR and the suitability of VR as an intervention in OCD for the local context. To address this, six clinicians, consisting of three clinical psychologists and three psychiatrists, were interviewed. They were interviewed using a semi-structured interview protocol related to their perception on VR as an intervention for OCD patients, as well as the cognitive behaviour therapy (CBT) elements that can be incorporated in VR. The findings showed that all clinicians anonymously supported CBT to be augmented into VR as part of intervention for OCD to overcome logistics issues, the interactive nature of the virtual environment and the sense of presence similar to a real-life situation. The side effects of VR also need to be studied before employing these new interventions. In conclusion, VR can be used as an intervention for OCD. CBT-VR intervention can be applied in the Asian context by using similar CBT modules which should be modified according to cultural context. [ABSTRACT FROM AUTHOR]

Psychotherapy theorists can often become fervent advocates of the schools they follow and place the doctrines of the theories they adopt above all else. This situation can sometimes turn into a war of theories between researchers as well. However, therapists should not aim to shape therapy sessions according to their methods but to use them in line with clients' needs. Although it is emphasised that the integration of both psychoanalytic and cognitive behavioural therapy techniques, which is going to be named dynamic cognitive behavioural therapy (DCBT) in this case report, will provide more effective and permanent treatment, a discernible gap exists regarding the integration of these theories and their use in psychotherapy. Taking into account this gap, it is considered important to use this approach with a client who has a social anxiety disorder (SAD). Therefore, this study aims to describe the almost forgotten DCBT approach step by step through a case report and reveal the effectiveness of this approach. As a result, DCBT seems to be effective in the treatment of SAD. [ABSTRACT FROM AUTHOR]

Objective: Cognitive-behavioural therapy is recommended as the first-line treatment for children and adolescents with anxiety. Despite its efficacy, a recent United Kingdom study indicated that few children with anxiety disorders receive cognitive-behavioural therapy. The primary aim of this study was to examine the receipt of cognitive-behavioural therapy for children and adolescents with elevated anxiety symptoms in Australia. Second, this study also examined whether there was a difference in the type of treatment received based on socioeconomic status and geographical location. Method: Using self-reported questionnaires, parents of children aged 4–18 years and children aged 12–18 years (N = 784; elevated anxiety symptom sample n = 169) were recruited from four samples: community (n = 164), school (n = 177), clinic (n = 16) and online panel provider (n = 427). Participants reported on the child's anxiety symptoms and the type of treatment (if any) the child received for their anxiety symptoms. Results: Results indicated that 19.5% of children and adolescents with elevated anxiety symptoms received evidence-based treatment (e.g. cognitive-behavioural therapy). Of those families who did seek help for anxiety in Australia, the majority (66.3%) did not receive cognitive-behavioural therapy. In addition, neither socioeconomic status (which was based on the Australian Index of Community Socio-Educational Advantage [ICSEA]) nor location (metropolitan vs regional/remote) affected whether individuals received evidence-based care or non-evidence-based care. Conclusion: Overall, children and adolescents in this study seeking support for their anxiety symptoms were not receiving adequate evidence-based care, regardless of socioeconomic status and location. These findings indicate there is a need to increase the receipt of cognitive-behavioural therapy for children and adolescents with anxiety symptoms. The findings should tentatively be interpreted, given data were collected during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had major impacts in many different spheres, including mental health. Children and adolescents are especially vulnerable because their central nervous system is still in development and they have fewer coping resources than do adults. Increases in the prevalence of depressive and anxiety symptomatology have been reported worldwide. However, access to mental health care is limited, especially for the paediatric population and in low- and middle-income countries. Therefore, we developed a brief internet-delivered cognitive-behavioural intervention for children and adolescents with symptoms of anxiety and depression. The aim of this proposed study is to test the efficacy of the intervention. Methods: We will conduct a two-arm, parallel randomised controlled trial involving children and adolescents (8–11 and 12–17 years of age, respectively) with symptoms of anxiety, depression or both, according to the 25-item Revised Child Anxiety and Depression Scale (t-score > 70). A total of 280 participants will be randomised to the intervention group or the active control group, in a 1:1 ratio. Those in the intervention group will receive five weekly sessions of cognitive-behavioural therapy via teleconference. The sessions will focus on stress responses, family communication, diaphragmatic breathing, emotions, anger management, behavioural activation and cognitive restructuring. Participants in both groups will have access to 15 videos covering the same topics. Participant-guardian pairs will be expected to attend the sessions (intervention group), watch the videos (control group) or both (intervention group only). A blinded assessor will collect data on symptoms of anxiety, depression and irritability, at baseline, at the end of the intervention and 30 days thereafter. Adolescents with access to a smartphone will also be invited to participate in an ecological momentary assessment of emotional problems in the week before and the week after the intervention, as well as in passive data collection from existing smartphone sensors throughout the study. Discussion: Internet-delivered interventions play a major role in increasing access to mental health care. A brief, manualised, internet-delivered intervention might help children and adolescents with anxiety or depressive symptomatology, even outside the context of the COVID-19 pandemic. Trial registration: ClinicalTrials.gov NCT05139433. Registered prospectively in November 2021. Minor amendments made in July 2022. [ABSTRACT FROM AUTHOR]

The relationships between atypical sensory behavior, intolerance to uncertainty and emotional regulation as generators of anxiety disorders in autistic children are analyzed in narrative form. The aim is to study the origin of anxiety in autistic children in order to determine the most appropriate intervention procedures. Some of the most widely used cognitive-behavioral intervention for autistic children and the adaptations made to them have been reviewed. A gap is observed between school psychoeducational programs and clinical intervention programs for the treatment of anxiety. In conclusion, it is recommended that school psychoeducational programs incorporate proactive actions in the form of cognitive-behavioral intervention programs to prevent or reduce the negative effects of anxiety on the learning and school inclusion of autistic children. [ABSTRACT FROM AUTHOR]

Copyright of Man - Disability - Society / Człowiek – Niepełnosprawność – Społeczeństwo is the property of Akademia Pedagogiki Specjalnej im Marii Grzegorzewskiej and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pre-clinical and clinical evidence proposes that creatine monohydrate, an affordable nutraceutical, could be a useful adjunct to conventional antidepressant treatments. In this pilot feasibility and exploratory study, we investigate the 8-week effects of creatine in addition to cognitive-behavioural therapy (CBT) versus placebo plus CBT in depression. For the primary efficacy outcome of change in Patient Health Questionnaire-9 depression score at study endpoint, we used mixed-model repeated measures analysis of covariance. Logistic regressions were employed to assess acceptability (any-cause dropouts), tolerability (dropouts for adverse events), and safety (patients experiencing one or more adverse events). We calculated effect sizes adjusted for age, sex, and baseline depression score. One-hundred participants (50 females, mean age= 30.4 ± 7.4 years) with depression (mean PHQ-9 = 17.6 ± 6.3) were randomised to either creatine+CBT (N = 50) or placebo+CBT (N = 50). At 8 weeks, PHQ-9 scores were lower in both study arms, but significantly more so in participants taking creatine (mean difference= -5.12). Treatment discontinuations due to any cause and to adverse events, and proportion of participants with at least one adverse event were comparable between study arms. This hypothesis-generating trial suggests that creatine could be a useful and safe supplement to CBT for depression. Longer and larger clinical trials are warranted., Competing Interests: Declaration of competing interest The authors declare none., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Up to 10% of children and young people have a specific phobia that can significantly affect their mental health, development and daily functioning. Cognitive–behavioural therapy-based interventions remain the dominant treatment, but limitations to their provision warrant investigation into low-intensity alternatives. One-session treatment is one such alternative that shares cognitive–behavioural therapy principles but has a shorter treatment period. Objective: This research investigated the non-inferiority of one-session treatment to cognitive–behavioural therapy for treating specific phobias in children and young people. The acceptability and cost-effectiveness of one-session treatment were examined. Design: A pragmatic, multicentre, non-inferiority randomised controlled trial, with embedded economic and qualitative evaluations. Settings: There were 26 sites, including 12 NHS trusts. Participants: Participants were aged 7–16 years and had a specific phobia defined in accordance with established international clinical criteria. Interventions: Participants were randomised 1 : 1 to receive one-session treatment or usual-care cognitive–behavioural therapy, and were stratified according to age and phobia severity. Outcome assessors remained blind to treatment allocation. Main outcome measures: The primary outcome measure was the Behavioural Avoidance Task at 6 months’ follow-up. Secondary outcomes included the Anxiety Disorder Interview Schedule, Child Anxiety Impact Scale, Revised Children’s Anxiety and Depression Scale, a goal-based outcome measure, Child Health Utility 9D, EuroQol-5 Dimensions Youth version and resource usage. Treatment fidelity was assessed using the Cognitive Behaviour Therapy Scale for Children and Young People and the One-Session Treatment Rating Scale. Results: A total of 274 participants were recruited, with 268 participants randomised to one-session treatment (n = 134) or cognitive–behavioural therapy (n = 134). A total of 197 participants contributed some data, with 149 participants in the intention-to-treat analysis and 113 in the per-protocol analysis. Mean Behavioural Avoidance Task scores at 6 months were similar across treatment groups when both intention-to-treat and per-protocol analyses were applied [cognitive–behavioural therapy: 7.1 (intention to treat), 7.4 (per protocol); one-session treatment: 7.4 (intention to treat), 7.6 (per protocol); on the standardised scale adjusted mean difference for cognitive–behavioural therapy compared with one-session treatment –0.123, 95% confidence interval –0.449 to 0.202 (intention to treat), mean difference –0.204, 95% confidence interval –0.579 to 0.171 (per protocol)]. These findings were wholly below the standardised non-inferiority limit of 0.4, which suggests that one-session treatment is non-inferior to cognitive–behavioural therapy. No between-group differences in secondary outcome measures were found. The health economics evaluation suggested that, compared with cognitive–behavioural therapy, one-session treatment marginally decreased the mean service use costs and maintained similar mean quality-adjusted life-year improvement. Nested qualitative evaluation found one-session treatment to be considered acceptable by those who received it, their parents/guardians and clinicians. No adverse events occurred as a result of phobia treatment. Limitations: The COVID-19 pandemic meant that 48 children and young people could not complete the primary outcome measure. Service waiting times resulted in some participants not starting therapy before follow-up. Conclusions: One-session treatment for specific phobia in UK-based child mental health treatment centres is as clinically effective as multisession cognitive–behavioural therapy and highly likely to be cost-saving. Future work could involve improving the implementation of one-session treatment through training and commissioning of improved care pathways. Trial registration: This trial is registered as ISRCTN19883421. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 42. See the NIHR Journals Library website for further project information.

Objective: People who experience distressing voices frequently report negative (e.g. abusive or threatening) voice content and this is a key driver of distress. There has also been recognition that positive (e.g. reassuring, or guiding) voice content contributes to better outcomes. Despite this, voice content has been neglected as a standalone outcome in evaluations of psychological therapies for distressing voices. We aimed to examine whether a modular cognitive‐behavioural therapy (CBT) intervention for voices led to changes in negative and positive voice content. Design/Methods: In a naturalistic, uncontrolled pre‐ and post‐ service evaluation study, 32 clients at an outpatient psychology service for distressing voices received eight sessions of CBT for distressing voices and completed self‐report measures of negative and positive voice content at pre‐, mid‐ and post‐ therapy. Results: There was no significant change in positive voice content. There was no significant change in negative voice content from pre‐ to post‐therapy; however, there was a significant change in negative voice content between mid and post‐treatment in which the cognitive therapy component was delivered. The CBT treatment was also associated with significant changes in routinely reported outcomes of voice‐related distress and voice severity. Conclusions: The cognitive component of CBT for distressing voices may be associated with changes in negative, but not positive, voice content. There may be benefit to enhancing these effects by developing treatments targeting specific processes involved in negative and positive voice content and further exploring efficacy in well‐powered, controlled trials with more comprehensive measures of voice content. [ABSTRACT FROM AUTHOR]

Objective: the aim of the present study was to compare the outcome data in two groups of patients with bipolar disorder followed at the public mental health service with a follow-up period of at least two years. A first group was treated with drug therapy alone and a group treated in an integrated manner, drug therapy and cognitive-behavioural therapy provided through synergistic collaboration with specialist training schools and thus without further costs for the national health service. Method: the medical records of 74 users of the mental health center were analyzed to verify the number of admissions, relapses, weight of medication; the efficacy was also analyzed through the specific Clinical Global Impression score. Results: compared to the group treated with drug therapy alone, the group of patients treated with the combination of pharmacotherapy and cognitive-behavioural psychotherapy showed fewer relapses and hospitalizations as well as a lower weight of medication and a higher global efficacy index. Conclusions: implementing pharmacological therapy with cognitive behavioural therapy allows a treatment pathway characterized by greater success both from an economic point of view for the service and in terms of the individual's overall health. [ABSTRACT FROM AUTHOR]

Summary: Background: Irritable bowel syndrome (IBS) is a heterogeneous disorder of gut‐brain interaction (DGBI) maintained by interacting biological, psychological, and social processes. Interestingly, there are two contrasting yet evidence‐based treatment approaches for reducing IBS symptoms: exclusion diets such as those low in fermentable oligo‐, di‐, monosaccharides and polyols (FODMAPs) and exposure‐based cognitive‐behavioural therapy (CBT). Exclusion diets recommend patients avoid foods thought to be symptom‐inducing, whereas exposure‐based CBT encourages patients to expose themselves to foods. Aims: To address the paradox of conceptually opposite exclusion diets and exposure‐based CBT for IBS. Methods: In this conceptual review, we describe the rationale, practical implementation, evidence base and strengths and weaknesses of each treatment. We conducted up‐to‐date literature search concerning the low FODMAP diet and CBT, and performed a secondary analysis of a previously conducted trial to illustrate a key point in our review. Results: The low FODMAP diet has demonstrated efficacy, but problems with adherence, nutritional compromise, and heightened gastrointestinal‐specific anxiety raise caution. Exposure‐based CBT has demonstrated efficacy with substantial evidence for gastrointestinal‐specific anxiety as a key mechanism of action. Mediation analysis also showed that increased FODMAP intake mediated decreased symptom severity in exposure‐based CBT. However, there is minimal evidence supporting which treatment "works best for whom" and how these approaches could be best integrated. Conclusions: Even though exclusion diets and exposure‐based CBT are conceptually opposite, they each have proven efficacy. Clinicians should familiarise themselves with both treatments. Further research is needed on predictors, mechanisms and moderators of treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Cognitive-behavioural therapy (CBT) is frequently used as an umbrella term to include a variety of psychological interventions. It remains unclear whether more complex CBT contributes to greater depression reduction.Aims: To (a) compare the effectiveness of core, complex and ultra-complex CBT against other psychological intervention, medication, treatment-as-usual and no treatment in reducing depression at post-treatment and in the long term and (b) explore important factors that could moderate the effectiveness of these interventions.Method: MEDLINE, PsycInfo, Embase, Web of Science and the Cochrane Register of Controlled Trials were searched to November 2021. Only randomised controlled trials were eligible for the subsequent network meta-analysis.Results: We included 107 studies based on 15 248 participants. Core (s.m.d. = -1.14, 95% credible interval (CrI) -1.72 to -0.55 [m.d. = -8.44]), complex (s.m.d. = -1.24, 95% CrI -1.85 to -0.64 [m.d. = -9.18]) and ultra-complex CBT (s.m.d. = -1.45, 95% CrI -1.88 to -1.02 [m.d. = -10.73]) were all significant in reducing depression up to 6 months from treatment onset. The significant benefits of the ultra-complex (s.m.d. = -1.09, 95% CrI -1.61 to -0.56 [m.d. = -8.07]) and complex CBT (s.m.d. = -0.73, 95% CrI -1.36 to -0.11 [m.d. = -5.40]) extended beyond 6 months. Ultra-complex CBT was most effective in individuals presenting comorbid mental health problems and when delivered by non-mental health specialists. Ultra-complex and complex CBT were more effective for people younger than 59 years.Conclusions: For people without comorbid conditions healthcare and policy organisations should invest in core CBT. For people <59 years of age with comorbid conditions investments should focus on ultra-complex and complex CBT delivered without the help of mental health professionals. [ABSTRACT FROM AUTHOR]

Copyright of Der Schmerz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Cognitive‐behavioural therapy (CBT) delivered face‐to‐face and via the internet reduces bulimia nervosa (BN) symptoms. However, our empirical understanding of factors affecting patient outcomes is limited. Method: Using data from a randomised, controlled trial comparing internet‐based (CBT4BN, n = 78) with face‐to‐face (CBTF2F, n = 71) group CBT (97% female, M = 28 years), we examined general treatment (across conditions) and modality‐specific predictors of end‐treatment and 1‐year outcomes (abstinence, binge‐eating frequency, purging frequency). Results: Improved eating disorder‐related quality of life (EDQOL) during treatment and follow‐up predicted abstinence at end‐treatment and 1‐year assessments. Improved EDQOL, disordered eating cognitions, and anxiety symptoms predicted less frequent binge eating and purging. Previous CBT and being employed predicted more frequent binge eating and purging at both assessments. Higher self‐transcendence and self‐directedness predicted less frequent binge eating. More severe binge eating and purging at baseline and end‐treatment predicted more frequent binge eating and purging at subsequent assessments. Improved EDQOL was more strongly associated with positive outcome in CBT4BN; improved depressive symptoms and health‐related QOL predicted positive outcome in CBT4BN but not CBTF2F. Discussion: Symptom improvement and certain character traits predicted positive outcome, whereas more severe presentation and prior CBT experience predicted poorer outcome. Consideration of intreatment symptom improvement may facilitate care recommendations, particularly for internet‐based modalities. Highlights: This study examined predictors of end‐treatment and 1‐year outcome from a randomised controlled trial comparing internet‐based (CBT4BN) with face‐to‐face (CBTF2F) cognitive‐behavioural therapy (CBT) for bulimia nervosa.Improvement in eating disorder‐related quality of life, disordered eating cognitions, and anxiety symptoms were the most consistent predictors of positive response to treatment.Relations between associated symptom improvement, namely general‐ and eating disorder‐related quality of life and depressive symptoms, and positive outcome were most evident in CBT4BN.Being employed, greater binge‐eating and purging severity, and a previous course of CBT most consistently predicted poor outcome.The character traits self‐directedness and self‐transcendence predicted less frequent binge eating at both outcome assessments. [ABSTRACT FROM AUTHOR]

Perfectionism has a strong association with eating disorders, anxiety and depression. Unguided internet cognitive behaviour therapy for perfectionism has demonstrated efficacy in female adolescents without elevated eating disorder symptoms. No research to date has examined unguided internet cognitive behaviour therapy for perfectionism for adolescents with elevated eating disorder symptoms as an indicated prevention for eating disorders and co-occurring symptoms of anxiety and depression. The protocol outlines the plan for a randomised controlled trial of a co-designed, unguided internet cognitive behaviour therapy for perfectionism with female adolescents with elevated symptoms of eating disorders. The intervention will be a 4-week programme compared to a waitlist control. Outcomes on eating disorder symptoms, anxiety and depression will be measured pre and post intervention and follow-up. Trial registration: This trial was registered on 23 September 2020 with the Australian New Zealand Clinical Trials Registry (ACTRN12620000951954P).

Cognitive Behavioural Therapy (CBT) self-help interventions have become a popular tool in High-Income Countries (HIC) to support people living with psychosis. There is limited research of this in Low– and Middle-Income Country (LMIC) contexts. We report findings of a qualitative investigation of a self-help book for psychosis in Nicaragua in Central America. Ten service users who self-identified as having psychosis were recruited from a mental health non-governmental organisation (NGO). Participants were given a Spanish version of a popular self-help book developed in the UK. They had four weeks to familiarise themselves with the book. Following this, we asked participants about their experiences of the book via an open ended questionnaire and a focus group discussion. We conducted an inductive content analysis on the data. Evaluations of the book were positive. The book was considered easy to understand. The exercises were useful for coping with symptoms, as well as for recognising and managing relapse. Case studies were perceived useful in terms of reducing stigma and promoting self-acceptance. The data highlight potential acceptability of CBT self-help books in the Nicaraguan context. We make recommendations for further research and evaluation to build on this signal of acceptability. [ABSTRACT FROM AUTHOR]

Aim: To assess the effectiveness of perioperative psychological interventions provided to patients with clinically severe obesity undergoing bariatric surgery regarding weight loss, BMI, quality of life, and psychosocial health using the Bayesian approach. Methods: We considered randomised trials that assessed the beneficial and harmful effects of perioperative psychological interventions in people with clinically severe obesity undergoing bariatric surgery. We searched four data sources from inception to 3 October 2021. The authors independently selected studies for inclusion, extracted data, and assessed the risk of bias. We conducted a meta-analysis using a Bayesian approach. PROSPERO: CRD42017077724. Results: Of 13,355 identified records, we included nine studies (published in 27 papers with 1060 participants (365 males; 693 females, 2 people with missing data)). Perioperative psychological interventions may provide little or no benefit for BMI (the last reported follow-up: MD [95% credible intervals] = −0.58 [−1.32, 0.15]; BF01 = 0.65; 7 studies; very low certainty of evidence) and weight loss (the last reported follow-up: MD = −0.50 [−2.21, 0.77]; BF01 = 1.24, 9 studies, very low certainty of evidence). Regarding psychosocial outcomes, the direction of the effect was mainly inconsistent, and the certainty of the evidence was low to very low. Conclusions: Evidence is anecdotal according to Bayesian factors and uncertain whether perioperative psychological interventions may affect weight-related and psychosocial outcomes in people with clinically severe obesity undergoing bariatric surgery. As the results are ambiguous, we suggest conducting more high-quality studies in the field to estimate the true effect, its direction, and improve confidence in the body of evidence. [ABSTRACT FROM AUTHOR]

Objective: Psychotherapy fragmentation constitutes a significant barrier to progress. In the present article, we argue that emotion regulation processes operate across psychotherapy approaches, serving as an overarching meta-factor of therapeutic change. Method: Two major therapeutic approaches - psychodynamic and cognitivebehavioural - were examined through the lens of emotion regulation theory. In particular, key constructs within each approach were analyzed in terms of relevant emotion regulation processes. Results: Emotion regulation processes are an overarching meta-factor relevant to a wide range of therapeutic constructs (e.g., defence mechanisms, internal working models, coping strategies, ruptures/reparations of alliance). Different clinical traditions emphasize different aspects of emotion regulation, mainly in terms of implicit vs explicit emotion regulation processes. Conclusions: An integrative emotion regulation perspective contributes to our understanding of the core change mechanisms of psychotherapy, with significant implications both for research and clinical practice. [ABSTRACT FROM AUTHOR]

Chronic pain remains a very difficult condition to manage for healthcare workers and patients. Different options are being considered and a biopsychosocial approach seems to have the most benefit, since chronic pain influences biological, psychological and social factors. A conservative approach with medication is the most common type of treatment in chronic pain patients; however, a lot of side effects are often induced. Therefore, a premium is set on novel nonpharmacological therapy options for chronic pain, such as psychological interventions. Previous research has demonstrated that resilience is a very important aspect in coping with chronic pain. A more recent type of cognitive-behavioural therapy is Acceptance and Commitment Therapy, in which psychological flexibility is intended to be the end result. In this manuscript, current evidence is used to explain why and how a comprehensive and multimodal treatment for patients with chronic pain can be applied in clinical practice. This multimodal treatment consists of a combination of pain neuroscience education and cognitive-behavioural therapy, more specifically Acceptance and Commitment Therapy. The aim is to provide a clinical guideline on how to contribute to greater flexibility and resilience in patients with chronic pain. [ABSTRACT FROM AUTHOR]

Abstract Background There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. Method Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). Results Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p

Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders. However, few efforts have been made to summarize the impact of specific intervention-related variables on therapeutic outcomes in different-aged youth with a separation anxiety disorder (SAD). PRISMA guidelines were followed to provide an efficacy overview of different disorder-specific CBT protocols against transdiagnostic ones among youth with SAD. Literature search was conducted in Pubmed, EBSCOhost, PsychInfo, PsycArticles, PSYNDEX, Medline, and ERIC. In total, 9 papers met the eligibility criteria. Overall, preschoolers benefited more from disorder-specific CBT protocols, whereas school-aged children and adolescents from transdiagnostic ones. Interventions aimed at removing SAD maintenance factors, by including parent-sessions, were efficacious, especially among younger children. Psychotherapy had higher efficacy than drug treatments, with individual- and group-CBT addressing SAD symptoms similarly. Findings support CBT as the golden standard for SAD in youth, impacting on the core symptoms in a time-limited, goal-directed way, with long-term effects. [ABSTRACT FROM AUTHOR]

In recent decades there has been a progressive increase in the elderly population worldwide. Parallel to the lengthening of life expectancy, chronic degenerative diseases have increased in people over 60. By examining several studies on the health of the elderly, it was found that in addition to Alzheimer’s disease and other forms of dementia, depression is the mental illness that frequently occurs in this population. It is often underdiagnosed and untreated and causes psychological, social, and disability malaise. New epidemiological data show the impact of late-life depression in terms of mortality and social isolation. Consequently, the scientific literature underlines the urgency of evidence-based psychotherapeutic protocols in old age. Therefore, the study aims to analyze clinical manifestations of late-life depression, paying attention to the differential diagnosis between depression in old age and dementia. Finally, the present study examines the current protocols used in cognitive-behavioral therapy in late-life depression. [ABSTRACT FROM AUTHOR]

The paper focuses on the problem of scrupulosity in the context of cognitive-behavioural therapy. The disorder has long aroused the curiosity of both psychologists and theologians. Advances in clinical psychology have directed the attention of researchers and therapists to the aetiology and nosological classification of this psychological/moral phenomenon. For many years, the variety of psychological approaches and the ambiguities of treatment strategies have aroused controversy, with treatment outcomes considered only negligible, resulting in scepticism among patients. The change was brought about by the conceptualisation of the disorder in the cognitive-behavioural paradigm. This paper briefly discusses the evolution of therapeutic models and techniques used in patients diagnosed with scrupulosity. Reference was made to the epidemiology of the phenomenon in the context of its place in the group of obsessive-compulsive disorders. The changes in the conceptualisation of problems experienced by scrupulous individuals are also presented, taking into account the cognitive-behavioural models of an obsessive-compulsive disorder, the subtype of which is nowadays scrupulosity, most often cited in psychological-medical literature. The cognitive-behavioural model of the disorder, which is not widely discussed in Polish literature, and its implications for clinical practice, as well as modifications in the standard protocol for treating patients diagnosed with obsessivecompulsive disorder, introduced to adjust for the needs of patients presenting with the moral-religious aspect of the disease, are also discussed. The aim of the article is also to promote knowledge about scrupulosity among therapists, priests and scientists, thereby inspiring creative work and improvement of the quality of everyday functioning of patients [ABSTRACT FROM AUTHOR]

The paper discusses behavioural addiction in the context of cognitive-behavioural model of therapy. Behavioural addiction can be diagnosed based on the six main criteria: (1) preoccupation with activity, (2) mood modification resulting from involvement in behaviour, (3) increased level of tolerance for the addictive activity, (4) withdrawal symptoms, (5) increased number of conflicts, and (6) relapses. According to research conducted in a representative sample of Polish population aged 15 years and older, the most popular behavioural addictions in our country include workaholism, shopaholism, internet addiction, social media addiction, smartphone addiction, and gambling. Cognitive-behavioural therapy is one of the most effective therapeutic strategies for behavioural addictions. This approach is based mostly on Beck's and Ellis's traditional models. The models of cognitive-behavioural therapy include identification of early maladaptive experiences resulting in negative core beliefs. They also refer to psychopathological factors that were developed later in lifetime. Furthermore, they incorporate description of negative automatic thoughts that trigger addictive behaviours, and allow to observe the vicious circle and entanglement in addictive activity, which initially perceived as a way for reducing the tension, used in excess contributes to increased individual's discomfort. Cognitive-behavioural therapy in behaviourally addicted patients usually includes an analysis of four phases: (1) antecedent phase, (2) triggering phase, (3) the phase of satisfying the needs connected to the addiction, and (4) the phase following the accomplishment of the addictive behaviour. Cognitive-behavioural therapy includes various methods of work based on the knowledge about cognitive processes. Interventions in this approach are structuralised and limited in time. There are three basic phases of cognitive-behavioural therapy: (1) behaviour modification, (2) cognitive restructuring, and (3) harm reduction. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The best evidence-based treatments for alcohol dependence are currently those developed within multidisciplinary programmes based on a cognitive-behavioural approach, which include psychological, sociological, and medical dimensions. However, recovery is not always achieved. The percentage of individuals who abandon these programs and relapse is high throughout the whole process and an adequate state of wellbeing is not always found. This paper outlines some of the complements or techniques that could be incorporated into the most common treatments to enhance behavioural change while also considering long-term outcomes. Thus, the text highlights the importance of considering recovery as the culmination of the process of change towards improved health, wellbeing, and a self-directed life purpose, rather than just abstinence. [ABSTRACT FROM AUTHOR]

Referring to the addition of burnout into the ICD-11, the authors review the literature and propose a combination of transactional analysis concepts with systemic-psychodynamic, cognitive-behavioural and logotherapy perspectives to generate a three-dimensional heptagon in which each summit represents a dimension of the burnout condition: cognitive, behavioural, motivational, emotional, somatic, relational and existential. They indicate how here-and-now symptoms are representations of there-and-then experiences and demonstrate how these elements may be represented within the script system developed by O’Reilly-Knapp and Erskine (2010). They go on to combine this with Freudenberger and North’s (1992) 12 steps model into a simplified five phase model of Honeymoon, Suppression, Denial, Dehumanisation and Burnout. Based on this material, they have developed a proxy-rated Burnout Assessment Chart (BAC) and a semi-structured Burnout Assessment Interview (BAI). A case study is then included of this material being applied with a 56-year-old male client in Switzerland. Whilst the limitations of this single case are recognised, the authors propose that the material can be used in developing a manual for working with burnout, with the different phases making it applicable to the various fields of TA application.

Chronic or recurrent pain in childhood is a common phenomenon, which psychologists encounter in their work within a multidisciplinary care team. In this article, we try to shed some light on the theoretical background and practical guidelines when dealing with chronic pain in children and adolescents. To understand chronic pain properly, biological/physiological, cognitive, emotional, behavioural and social factors need to be taken into consideration. In the first part of the article, we try to summarize the results of recent studies on the connection between these factors and the development of chronic pain. We highlight the theory of understanding and treating chronic pain in children and adolescents based on cognitive-behavioural theory. The second part of the article deals with the methods of cognitive-behavioural therapy for assessing and monitoring pain, psychoeducation, and specific cognitive and behavioural techniques in a systematic and practical fashion.

The article provides an overview of tic disorders and empirically supported cognitive-behavioural techniques for treating tics and helping children and adolescents to learn effective coping skills to manage the adverse psychosocial consequences the ticks may produce. The article first defines and describes tics and tic disorders, it presents the epidemiological data, the course of the disorder, its comorbid conditions and the psychosocial consequences of tics, assessment methods and indications for treatment. The second part of the article focuses on the description of cognitive-behavioural treatment methods compliant with the clinical guidelines for the treatment of tic disorders. Psychoeducation and two of the most studied and empirically supported behavioural techniques – habit reversal training and exposure with response prevention – targeting tics directly, are described in more detail. The results of empirical research corroborating the effectiveness of the behavioural treatments of tics are provided. Other cognitive-behavioural techniques aimed at managing adverse psychosocial consequences and co-occurring problems are also presented. Finally, the requirements for effective cognitive-behavioural therapy for children and adolescents with tics are discussed together with ideas for the dissemination of knowledge of specific therapeutic methods among cognitive-behavioural therapists in Slovenia.

The purpose of this paper is to present cognitive-behavioural strategies for dealing with adolescents with deliberate self-harm. The presented interventions can be useful for anyone who is faced with that kind of problem in the clinical setting. Deliberate self-harm is defined as self-injury and self-poisoning. It usually occurs between the ages of 11 and 15 years. During adolescence, the prevalence of this type of behaviour is between 12 and 23%. The frequency of such behaviour is even greater among the clinical population. The most powerful risk factor for deliberate self-harm is the presence of mental disorder. Adolescents often report of chronic feelings of emptiness, alienation and isolation, of hopelessness, helplessness, of being unloved, of low self-esteem and a low tolerance for stress. The increased risk of deliberate self-harm is mainly related to emotional dysregulation and poor problem solving skills. If adolescents with deliberate self-harm do not seek help, self-inflicted behaviour may increase in its severity. It also represents a strong predictor of suicide; therefore, therapeutic intervention is of utmost importance. When dealing with deliberate self-harm, cognitive-behavioural therapy has proven to be one of the effective methods of treatment. Within therapy, the emphasis is on emotion regulation, dealing with dysfunctional thoughts and beliefs, reinforcing behavioural skills (such as problem solving skills) and improving interpersonal relationships. Moreover, much attention is paid to a mindful attitude towards oneself and one’s own past. Research shows that after completed treatment, adolescents reported less frequent self-harm behaviour and suicidal thoughts. At the same time, symptoms of depression and anxiety were reduced and adolescents reported of more positive self-image, better emotion regulation and better problem solving skills.

Abstract Personalized cognitive-behavioural therapy for obesity (CBT-OB) is a new treatment that combines the traditional procedures of standard behavioural therapy for obesity (i.e., self-monitoring, goal setting, stimulus control, contingency management, behavioural substitution, skills for increasing social support, problem solving and relapse prevention) with a battery of specific cognitive strategies and procedures. These enable the treatment to be individualized, and to help patients to address the cognitive processes that previous research has found to be associated with treatment discontinuation, the amount of weight lost and long-term weight-loss maintenance. The treatment programme can be delivered at three levels of care, outpatient, day hospital and residential, and includes six modules, which are introduced according to the individual patient’s needs as part of a flexible, personalized approach. The primary goals of CBT-OB are to help patients to (i) achieve, accept and maintain healthy weight loss; (ii) adopt a lifestyle conducive to weight control; and (iii) develop a stable “weight-control mindset”. A randomized controlled trial has found that 88 patients suffering from morbid obesity treated with CBT-OB followed a period of residential treatment achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between 6 and 12 months. The treatment efficacy is also supported by data from a study assessing the effects of group CBT-OB delivered in a real-world clinical setting. In that study, 77 patients with morbid obesity who completed the treatment achieved 9.9% weight loss after 18 months. These promising results, if confirmed by future clinical studies, suggest that CBT-OB has the potential to be more effective than traditional weight-loss lifestyle-modification programmes.

Patients feel more vulnerable when accessing community mental health programs for the first time or after being discharged from psychiatric inpatient units. Long wait times for follow-up appointments, shortage of mental health professionals, lack of service integration, and scarcity of tailored support can weaken their connection to the health care system. As a result, patients can present low adherence, dissatisfaction with treatment, and recurrent hospitalizations. Finding solutions to avoid unnecessary high-cost services and providing tailored and cost-effective mental health interventions may reduce the health system burden and augment patient support. We propose implementing an add-on, supportive text messaging service (Text4Support), developed using cognitive–behavioural therapy (CBT) principles to augment mental health support for patients attending to or being discharged from psychiatric care in Nova Scotia, Canada. This randomized controlled trial aims to investigate the effectiveness of Text4Support in improving mental health outcomes and overall mental well-being compared with usual care. We also will examine the intervention’s impact on health services utilization and patient satisfaction. The results from this study will provide evidence on stepped and technology-based mental health care, which will contribute to generating new knowledge about mental health innovations in various clinical contexts, which is not only helpful for the local context but to other jurisdictions in Canada and abroad that are seeking to improve their health care.

Aim: The COVID‐19 pandemic has introduced many mental health professionals to therapy via videoconferencing. Mostly individual teletherapy has been offered and studied, although group therapy is often offered in clinics. In fact, little is known regarding group therapy's acceptability, feasibility, and potential impact when offered via videoconferencing. Methods: This pilot study offered group cognitive‐behavioural therapy for psychosis via videoconferencing to 14 individuals with early psychosis either living in remote areas or confined during the pandemic. Results: The rate of consenting to the study (79%) and actual participation rates were acceptable (18.5 sessions out of 24). Although some technological obstacles were encountered, solutions offered allowed the videoconferencing group to be considered feasible for most participants and therapists. Prepost results on symptoms and self‐esteem were comparable to those of other studies using the same group treatment but in‐person. Alliance scores seemed similar as well. Conclusions: More studies are warranted on the efficacy of group therapy via videoconferencing. This pilot study does offer promising results, suggesting that a wider range of people with early psychosis can be reached and benefit from the advantages of receiving an evidence‐based group intervention. [ABSTRACT FROM AUTHOR]

Objective: Internet‐based guided self‐help (GSH) programs increase accessibility and utilization of evidence‐based treatments in binge‐eating disorder (BED). We evaluated acceptance and short as well as long‐term efficacy of our 8‐session internet‐based GSH program in a randomized clinical trial with an immediate treatment group, and two waitlist control groups, which differed with respect to whether patients received positive expectation induction during waiting or not. Method: Sixty‐three patients (87% female, mean age 37.2 years) followed the eight‐session guided cognitive‐behavioural internet‐based program and three booster sessions in a randomized clinical trial design including an immediate treatment and two waitlist control conditions. Outcomes were treatment acceptance, number of weekly binge‐eating episodes, eating disorder pathology, depressiveness, and level of psychosocial functioning. Results: Treatment satisfaction was high, even though 27% of all patients dropped out during the active treatment and 9.5% during the follow‐up period of 6 months. The treatment, in contrast to the waiting conditions, led to a significant reduction of weekly binge‐eating episodes from 3.4 to 1.7 with no apparent rebound effect during follow‐up. All other outcomes improved as well during active treatment. Email‐based positive expectation induction during waiting period prior to the treatment did not have an additional beneficial effect on the temporal course and thus treatment success, of binge episodes in this study. Conclusion: This short internet‐based program was clearly accepted and highly effective regarding core features of BED. Dropout rates were higher in the active and lower in the follow‐up period. Positive expectations did not have an impact on treatment effects. Highlights: The present internet‐based guided self‐help program adds to the existing research regarding online treatment of binge‐eating disorder and is currently one of the two existing validated programs available in German language. It is based on an established cognitive‐behavioural treatment approach, shows high acceptance by patients and high efficacy after eight guided online sessions, thereby representing the shortest duration of currently evaluated treatmentsDuring the internet‐based therapy, the number of weekly binge‐eating episodes, depressive symptoms, eating disorder pathology as well as impairments in psychosocial functioning all significantly decreased. These positive effects were maintained during follow‐up (6 months). Abstainer rate (no binge‐eating during last month) continued to increase during follow‐up with booster sessionsAn email‐based pre‐treatment positive expectation induction did not alter the temporal course and thus treatment success, of binge episodes [ABSTRACT FROM AUTHOR]

Copyright of Revista de Psicoterapia is the property of Revista de Psiquiatria y Psicologia Humanista, S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Parents are key to helping their adolescent child access psychological therapy for mental health problems such as depression. However, little is known about how parents experience their child's psychological therapy. We aimed to explore parents' experiences of their adolescent child's cognitive behaviour therapy for depression. Method: We applied Thematic Analysis (TA) to qualitative data from in-depth interviews with parents (N = 16) whose adolescent child was randomly allocated to CBT in a large multisite RCT for adolescent depression (the IMPACT trial). Interviews were conducted at the end of treatment. Results: We generated two main themes: parents' perceptions of the adolescent's journey through therapy, and parents' perceptions of the therapeutic setting and process. Each included four sub-themes. Parents talked about key factors that impacted on their child's progress through treatment, including the adolescent's readiness for therapy and the adolescent-therapist relationship. Conclusion: Parents' insights confirm the foundations of what is considered good clinical practice of CBT for adolescent depression, including tailoring therapy to the adolescent, and establishing a strong adolescent-therapist relationship. Parents recognised that, for CBT to be helpful, their child had to be willing to engage in therapy and able to develop a trusting relationship with their therapist. [ABSTRACT FROM AUTHOR]