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Gamified interventions are an emerging approach in mental health treatment and prevention. Their positive effects on managing various clinical conditions stem from enhancing social skills. However, cost-effective options like Table-top Role-Playing Games (TTRPGs), which offer similar benefits to other gamebased interventions, lack standardized methods for ensuring replicability. In this regard, the method outlined in this study endeavors, in a structured and guided manner drawing from the Consolidated Framework for Implementation Research (CFIR), to establish a six-step protocol for developing an intervention method utilizing TTRPGs. In all Steps, we aim to anchor ourselves in robust literature concerning social skills training (SST), cognitive behavioral therapy (CBT), and gamification comprehensively. Thus, the method presented encompasses the objectives of SST, the strategies of CBT, and the dynamics of gamification via TTRPGs. Furthermore, we demonstrate a possible application of the method to illustrate its feasibility. Ultimately, the final method is structured, evidence-based, easily applicable, cost-effective, and thus viable. Mental health professionals seeking a structured and instructional tool for protocol development will find support in the method proposed here. [ABSTRACT FROM AUTHOR]

Background: Working alliance is a prominent non-specific factor for treatment outcomes in face-to-face and internet-based interventions. The association between working alliance and therapy outcome appears to be time- and disorder-specific, but less is known about the change of working alliance during the intervention and the impact of working alliance in grief-specific interventions. The present study examines the association between the change of working alliance and treatment outcomes in an internet-based intervention for parents who experienced pregnancy loss. Methods: 228 participants received a grief intervention based on cognitive behavioral therapy with asynchronous text-based therapist feedback. Prolonged grief and related symptoms of traumatic stress, depression, anxiety, and general psychopathology were assessed with validated instruments before and after the intervention. The change of working alliance was assessed using the short version of the Working Alliance Inventory at mid-treatment (session 4) and the end of the treatment (session 10). Results: Data for N = 146 persons was analyzed. Working alliance in total and all subscales increased significantly from sessions 4 to 10. This change in working alliance correlated significantly with a reduction in prolonged grief. Changes in subscales of working alliance also correlated with symptoms of depression and general psychopathology. Regression analysis showed that a change in working alliance predicted a reduction in prolonged grief but did not predict improvements in other grief-related symptoms. Conclusion: The results examine the change of working alliance during an internet-based intervention and the association with treatment outcome. A small impact of change in working alliance on treatment outcome of prolonged grief was confirmed, but not on related symptoms. Further research is needed to assess moderators of the alliance-outcome association to improve internet-based interventions. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background Prolonged grief disorder (PGD) has serious impact on the quality of patients' work and life. Previous relevant studies have explored the intervention effect of cognitive behavioral therapy (CBT) on PGD, but their conclusions remain controversial due to differences in frequency, time and content of intervention. Objective To explore the intervention effects of CBT on the PGD through Meta-analysis, so as to provide references for clinical treatment. Methods On October 22, 2022, the database of VIP, China Biomedical Literature Database, Wanfang, CNKI, Embase, Cochrane Library, PubMed and Web of Science were searched systematically, and randomized controlled trials (RCTs) of CBT in treating PGD was collected. Outcome indicators include sadness, depression, anxiety and somatization symptoms. RevMan 5. 3 was used for Meta-analysis. Results A total of 7 articles were included with a total sample size of 528 cases. Meta-analysis results showed that the study group had lower scores than the control group for grief (SMD=-0. 78, 95% CI: -1. 27~-0. 29), depression (SMD=-0. 45, 95% CI: -0. 73~-0. 17) and anxiety symptom (SMD=-0. 38, 95% CI: -0. 59~-0. 18) with statistically significant differences. However, the difference of scores for somatization symptom between two groups was not significant (SMD=-0. 01, 95% CI: -0. 26~0. 25). Conclusion CBT may contribute to improving the symptoms of grief, depression and anxiety in PGD patients but unsatisfactory efficacy on somatization symptom. [ABSTRACT FROM AUTHOR]

Background The course of schizophrenia is prolonged, and patients have impaired social function and significantly reduced quality of life. Drug therapy combined with psychological therapy is particularly important for improving the quality of life of patients. Brief cognitive behavioral therapy (BCBT) has been widely applied in clinical practice, but current research on BCBT focuses more on improving patients' symptoms and lacks relevant reports on improving quality of life. Objective To evaluate the efficacy and influencing factors of BCBT combined with conventional treatment on improving the quality of life in patients with schizophrenia. Methods A total of 210 patients who met the diagnostic criteria for schizophrenia in the International Classification of Diseases (10th edition) (ICD-10) and were followed up at the outpatient department of Beijing Anding Hospital Capital Medical University from August 2011 to December 2016 were selected. Using a random number table method, patients were divided into study group and control group, with 105 cases in each group. Both groups received routine treatment, and the research group received a total of 8 BCBT sessions for 12 weeks on this basis. At the baseline period and 12 weeks of treatment, 26 weeks of follow-up and 52 weeks of follow-up, Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP) and World Health Organization Quality of Life Brief (WHOQOL-BREF) were used for evaluation. Results The results of repeated measures analysis of variance showed that the time point effect and interaction effect of PANSS total score were statistically significant (F=118. 783, 8. 083, P<0. 01). The time point effect, inter group effect and interaction effect of PSP total score were statistically significant (F=94. 358, 4. 048, 5. 490, P<0. 05 or 0. 01). The time point effect, inter group effect and interaction effect of the total score of WHOQOL-BREF were all statistically significant (F=12. 330, 4. 168, 4. 142, P<0. 05 or 0. 01) Binary Logistic regression analysis showed that the study group (OR=1. 861, 95% CI: 1. 004~3. 448) and young age (OR=1. 044, 95% CI: 1. 001~1. 088) were protective factors for improving quality of life of patients, while high PANSS baseline score (OR=0. 972, 95% CI: 0. 945~ 0. 999) was a risk factor for improving quality of life of patients. Conclusion The combination of BCBT and conventional treatment has an earlier onset of improvement in the quality of life of patients with schizophrenia, and long-term efficacy is superior to conventional treatment. [ABSTRACT FROM AUTHOR]

This study examined the effects of internet-based cognitive behavioral therapy on the nutritional status and scores from the Knowledge, Attitude, and Practice questionnaire in maintenance hemodialysis patients. Patients in the traditional therapy group received standard health education, whereas those in the experimental group participated in three months of this therapy. Clinical and nutritional indicators, including blood biomarkers and Knowledge, Attitude, and Practice questionnaire scores, were recorded for both groups before and after the treatment. Post-treatment, the group receiving internet-based cognitive behavioral therapy exhibited higher blood calcium levels, increased upper arm circumference, and reduced levels of potassium and phosphorus. They also showed comparatively lower scores in Nutritional Risk Screening 2000 and Malnutrition Inflammation, along with higher Visual Analog Scale scores (P < 0.05). The internet-based cognitive behavioral therapy group exhibited higher albumin and prealbumin levels, reduced transferrin, total cholesterol, creatinine, and urea levels, and modified quantitative subjective global assessment scores than the traditional therapy group (P < 0.05). They also scored higher on the Knowledge, Attitude, and Practice questionnaire (P < 0.05). These results indicate that internet-based cognitive behavioral therapy can improve the nutritional status, Knowledge, Attitude, and Practice questionnaire scores, and overall quality of life in maintenance hemodialysis patients, highlighting its potential benefit in patient outcomes. [ABSTRACT FROM AUTHOR]

This study addresses the gap in understanding the varied effectiveness of group cognitive behavioral therapy (gCBT) delivered by different professionals. This study aims to address this gap by conducting a systematic review of randomized controlled trials (RCTs) that evaluate gCBT and compare it to inactive controls in adults with a clinical diagnosis of depression. A total of 33 RCTs were included for analysis. In the overall analysis, 'profession of gCBT deliverer' was not a significant moderator in the meta-regression model (p = 0.57). For people without comorbidity, the overall effect size estimate was −0.69 (95% CI, −1.01. to −0.37, p = 0.03). Among gCBT deliverers, psychologists and nurses/psychiatric nurses demonstrated significant effectiveness, with psychologists showing a large effect size of −0.78 (95% CI, −1.25 to −0.30, p < 0.01) and nurses/psychiatric nurses showing a medium effect size of −0.45 (95% CI, −0.85 to −0.05, p = 0.03). The certainty of evidence for both professionals was moderate. These results have significant implications for the delivery of mental healthcare, as nurses/psychiatric nurses may be more accessible and cost-effective than psychologists in some settings. However, further research is necessary to determine the effectiveness of gCBT delivered by a broader range of healthcare professionals for patients with depression and other comorbidities. [ABSTRACT FROM AUTHOR]

Purpose: Depressive disorders cause a major burden of disease worldwide and often lead to a loss of social functioning. Patients suffering from depressive disorders report a lower quality of life (QOL) than people without a history of mental health issues. Internet-based interventions (IBIs) based on cognitive behavioral therapy (CBT) are effective in reducing symptom severity but data on their impact on quality of life in clinically depressed patients so far is scarce. Methods: Selfapy is a CBT-based IBI for depressive disorders. 401 participants (332 female, mean age 37 (SD = 11) with a diagnosis of major depressive disorder (MDD) or dysthymia were enrolled in a randomized, parallel, three-arm trial comparing a therapist-guided Selfapy intervention with an unguided Selfapy intervention and a waiting list control. QOL was measured using the WHOQOL-BREF at baseline, post-treatment (12 weeks) and at 24-week follow-up. The effects of the interventions on QOL were calculated using linear mixed effects models. Results: At post-treatment (12 weeks) the guided and unguided intervention groups reported an increase in QOL on physical and psychological health domains compared to controls (significant group*time interaction). The gain in QOL was maintained over the follow-up period only for psychological health. QOL decreased in the social relationships and environment domains over the course of treatment and during the follow-up treatment for all participants. There were no differences between the guided and the unguided intervention. Conclusion: Selfapy proved to positively affect psychological and physical QOL in a sample of participants suffering from depressive disorders and can therefore be considered an effective and highly scalable therapeutic tool. The pattern of results might partly be attributable to effects of the COVID-19 pandemic and public health measures that coincided with the trial. Trial registration: German Clinical Trials Register (DRKS): DRKS00017191. Registered June 14th, 2019, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017191. [ABSTRACT FROM AUTHOR]

• Evaluated two versions of parent-led CBT for anxiety in autistic youth. • Compared low with standard therapist contact. • No differences were found in primary or secondary outcomes. • 69% of completers were responders at posttreatment. • Low-contact CBT saved an average of $1,222.64 per family. Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders, though to date it has been minimally tested. In this study, 87 autistic youth (7 to 13 years old) with anxiety disorders and their parents were randomized to two forms of parent-led CBT in which parents led their child through a guided CBT workbook across 12 weeks: one with low therapist contact (four 30-minute telehealth calls), and one with standard therapist contact (ten 60-minute telehealth calls). Anxiety, functional impairment, and autism features significantly declined across therapy, without differences between groups. High satisfaction was reported in both groups, though significantly higher satisfaction ratings were reported in standard-contact CBT. Responder rates were 69% of completers at posttreatment (70% in standard contact, 68% in low contact) and 86% at 3-month follow-up (86% in standard contact, 87% in low contact). Low-contact CBT was estimated to incur an average cost of $755.70 per family compared with $1,978.34 in standard-contact CBT. Parent-led CBT with minimal or standard therapist contact both appear to be effective CBT delivery formats for autistic youth with anxiety disorders, with significant cost savings for low-contact CBT. [ABSTRACT FROM AUTHOR]

Purpose: Using data from a randomized clinical trial evaluating cognitive behavioral therapy (CBT) for children with autism and co-occurring anxiety, this study examined the relationship between autism features and anxiety symptoms throughout CBT. Methods: Two multilevel mediation analyses were run which examined the mediating role of changes in anxiety for changes in two core features of autism, (a) repetitive and restrictive behaviors (RRBs) and (b) social communication/interaction impairments, between pre- and post-treatment. Results: Indirect effects between time and autism characteristics were significant for both models, indicating that as anxiety changes, so do RRBs and social communication/interaction as the outcomes respectively. Conclusion: Findings suggest a bidirectional relationship between anxiety and autism features. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Objective: Evidence on the optimal "dose" of cognitive behavioral therapy (CBT) for treating major depressive disorder is sparse. This analysis aimed to evaluate the dose–response curve in CBT using a nonlinear approach, whereby "dose" was defined as number of treatment sessions. The dose–response curve of CBT was compared to other psychotherapies and pharmacological treatments for depression. Method: A systematic review and metaregression analysis of randomized controlled trials (RCTs) examining the efficacy of CBT in adults with acute depression was conducted. Treatment arms examining other psychosocial or pharmacological interventions were also analyzed. Cubic spline metaregression techniques were used to model nonlinear dose–response curves. Results: Seventy-two studies and 7,377 participants were included. Modeling the dose–response curve between change of depression symptom severity and the number of CBT sessions resulted in a nonlinear curve characterized by a strong improvement in symptom severity from baseline within the first eight sessions. Symptom reduction continues in the further course of the treatment, but at a slower pace. A similar pattern of symptom development was found for other therapies as well, although the prominence of early improvement and overall effect sizes vary across treatment arms. Conclusion: Results imply a general tendency for the strongest alleviation of depressive symptom severity in early stages of CBT treatment, thus, if aiming at symptom alleviation, speak for short CBT interventions. However, these findings have to be discussed in the light of the limited data regarding the sustainability of treatment effects in short-term therapies and effects beyond symptomatic changes. What is the public health significance of this article?: The aim of the present study was to investigate whether there is an optimal dose of treating depression with cognitive behavioral therapy (CBT), that is, to identify the number of treatment sessions under which the most improvement of depression symptoms could be found. The finding that the rate of change of symptom severity was highest at early stages of CBT as well as other treatments brings the implication that early treatment response plays a major role across active treatments and that the mechanisms underlying its function need to be further investigated. This article can have an impact on the ramifications of evidence-based psychotherapeutic treatment length that need to be reconsidered according to the present results, whereby early response effects need to be discussed in light of the number of initially planned treatment sessions. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the long-term effectiveness of cognitive behavioral therapy (CBT) (≥ 2 years after the end of therapy) in the routine care of youth (mean 11.95 years; SD = 3.04 years) with primary anxiety disorder (AD). Methods: Two hundred and ten children with any AD as a primary diagnosis and with any comorbidity were included in the "Kids Beating Anxiety (KibA)" clinical trial and received evidence-based CBT. Diagnoses, severity of diagnoses, and further dimensional outcome variables of symptoms and functioning were assessed before (baseline), after the last treatment session (POST), and at two follow-up (FU) assessments in the child and caregiver report: 6 months (6MONTHS-FU) and >2 years (mean 4.31; SD = 1.07 years) after the last treatment session (long-term FU). Results: At POST, 61.38% showed total remission of all and any ADs. At long-term FU, the remission rate was 63.64%. Compared to baseline, ratings of severity, anxiety, impairment/burden, and life quality improved significantly after CBT in child and caregiver report. All pre-post/FU improvements and global success ratings were stable in child (Pre-Post: Hedges' g = 3.57; Pre-6MONTHS-FU: Hedges' g = 3.43; Pre-LT-FU: Hedges' g = 2.34) and caregiver report (Pre-Post: Hedges' g = 2.00; Pre-6MONTHS-FU: Hedges' g = 2.31; Pre-LT-FU: Hedges' g = 2.31) across all POST- and FU-assessment points. Some outcomes showed further significant improvement, and no deterioration was found over the course of time. Effect sizes calculated in the present study correspond to, or even exceed, effect sizes reported in previous meta-analysis. Conclusions: Stable long-term effects of "KibA" CBT for youth with ADs, comparable to those results from efficacy studies, were achieved in a routine practice setting by applying treatment manuals tested in randomized controlled trials. These findings are remarkable, as the patient group studied here consisted of an age group within the main risk phase of developing further mental disorders, and therefore an increase in new-onset anxiety and further mental disorders would be expected over the long time span studied here. [ABSTRACT FROM AUTHOR]

The Washington State CBT+ Initiative offers a flexible training and consultation approach for community mental health providers in evidence-based practices for four child mental health targets: cognitive behavioral therapy for depression, anxiety, trauma, and behavioral difficulties. As part of consultation, clinicians used an online system to track delivery of treatment components and clinical outcomes using standardized symptom measures. The current study used these clinician-input data to examine symptom change for children using paired sample t-tests. Additionally, we explored if time elapsed or number of sessions between measurements related to symptom change using simple linear regression. Children had significant symptom reduction across all four targets. For most measures, children did not show greater improvements with increased length of time or increased number of sessions between assessment measures. Findings suggest that children treated by a CBT+ trained clinician may demonstrate symptom reduction for their primary clinical problem. Findings add to support for flexible training approaches for community mental health clinicians. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is a challenging process that affects the diagnosed people and their social environment psychologically, physiologically, socially, and economically. The main purpose of this study is to investigate the effectiveness of the Online Cognitive Behavioral Stress Management (CBSM) for Cancer program, which is structured for people diagnosed with cancer to develop coping methods that will enable them to cope with the stress they experience healthily and actively. The research question is whether attending the CBSM program is effective for the psychological well-being of breast cancer patients or not. Material and Method: The study was completed with a total of 35 people, 17 in the experimental group and 18 in the control group. The pretest-posttest results of the experimental and control groups were analyzed. The independent sample t-test was used in the comparison of the two groups of experimental and control groups. Paired sample t-test was used to compare the pretest-posttest scores of each group. Results: There was a significant difference observed between the experimental and control groups in the post-test measurements in terms of psychosocial adjustment to illness, assessment of coping attitudes, depression, hope, state, and trait anxiety (p<0.001). There was no significant difference in the pre-test and post-test scores of the experimental and control groups in terms of mental adjustment to cancer. Conclusion: The CBSM program for breast cancer patients is effective in coping with daily and illness-related stress by increasing psychological well-being: increased psychosocial adjustment; adaptation and decreased depression, and anxiety [ABSTRACT FROM AUTHOR]

Rumination and worry are common risk factors of depression and anxiety. Internet‐based transdiagnostic interventions targeting individuals with these specific risks may be an effective way to prevent depression and anxiety. This three‐arm randomized controlled trial compared the efficacy of Internet‐based rumination‐focused cognitive behavioral therapy (RFCBT), mindfulness‐based intervention (MBI), and psychoeducation (EDU) control among 256 at‐risk individuals. Participants' levels of rumination, worry, depressive, and anxiety symptoms were assessed at post‐intervention (6 weeks), 3‐month, and 9‐month follow‐ups. Linear mixed model analysis results showed similar levels of improvement in all outcomes across the three conditions. Changes in rumination differed comparing RFCBT and MBI, where a significant reduction in rumination was noted at a 3‐month follow‐up among participants in RFCBT, and no significant long‐term effect among participants in MBI was noted at a 9‐month follow‐up. All three conditions showed similar reductions in risks and symptoms, implying that the two active interventions were not superior to EDU control. The high attrition at follow‐ups suggested a need to exercise caution when interpreting the findings. Future studies should tease apart placebo effect and identify ways to improve adherence. [ABSTRACT FROM AUTHOR]

Introduction: Recently, acceptance- and commitment therapy (ACT) gained increasing interest. Studies show good efficacy in the treatment of patients presenting with several psychologic and somatic complaints. The present systematic review and meta-analysis addresses effectiveness of ACT-based interventions to reduce stress in children, adolescents, and young adults compared to control conditions. Methods: The meta-analysis was pre-registered at PROSPERO (CRD42019117440). Randomized controlled trials (RCTs) and quasi-randomized controlled trials (qRCT) in German or English language comparing the effects of ACT-based interventions to control conditions (e.g., treatment as usual, waitlist control) on stress-related outcome measures in youth were considered for inclusion. The target population was subjects 0–18 years of age. The databases PubMed, PsychInfo, Cochrane Database, CINAHL, and Web of Science were searched systematically up to July 2023. A random effect meta-analysis and a risk of bias assessment according to the procedure outlined in the Cochrane Handbook of Systematic Reviews were conducted. Results: The search resulted in 187 studies, of which eight studies with 976 participants were finally subjected to meta-analysis. Studies implemented ACT both in school-based group settings and in single settings and both as a universal and indicated prevention. Analyses yielded a significant main effect (Hedges' g = −0.20; 95% confidence interval [−0.36; −0.05]), indicating that interventions based on ACT resulted in greater reduction of stress compared to control conditions. Conclusion: ACT appears effective at reducing stress in youth. Further research is needed due to methodological shortcomings of existing studies. Small sample sizes, heterogenous studies, methodological shortcomings, and evidence of publication bias limit the conclusions that can be drawn from this meta-analysis. [ABSTRACT FROM AUTHOR]

• Low-frequency EA + CBT improves sleep, reduces severity, prevents daytime sleepiness. • Low-frequency EA improves sleep quality, reduces insomnia severity. • Low-frequency EA + CBT has better therapeutic effects, improves cognition in insomnia patients. To explore the therapeutic effects of low frequency electroacupuncture (EA) combined with cognitive behavioral therapy (CBT) for short-term insomnia. Patients with "short-term insomnia" were randomly divided into the treatment and control groups. Patients in the treatment group were treated with low-frequency EA combined with CBT, while those in the control group were only treated with low-frequency EA. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) scores in the two groups were compared before and after treatment within the same group, as well as between the two groups. After four weeks of treatment, the comprehensive therapeutic effects of both treatment modalities and the number of people who developed chronic insomnia were compared. The differences in PSQI score, PSQI sleep rate, ISI score, and DBAS score band after treatment, within the same group and between groups were statistically significant. There was significant difference in DBAS score between the two groups before and after treatment, and in the composition ratio of comprehensive therapeutic effects between the two groups. Low-frequency EA combined with CBT and low-frequency EA alone can significantly improve sleep cycles in patients with insomnia, reduce the sleep severity index, prevent daytime sleepiness symptoms in patients, and improve cognition in patients. Low-frequency EA combined with CBT had better therapeutic effects and improved cognition in patients, and hence can be recommended. [ABSTRACT FROM AUTHOR]

Background: Dental behavior support (DBS) describes all techniques used by dental professionals to ensure that dental care is safe, effective, and acceptable. There is a need to standardize outcome measures across DBS techniques to reduce heterogeneity, limit selective reporting, promote consistency, and optimize outcomes across DBS research. A comprehensive review of existing measures is a prerequisite to understanding potential outcomes related to the area of interest. Aim: This review had three aims: first, to identify the outcome measures (OMs) reported in trials of dental behavior support; second, to categorize the component DBS techniques reported within interventions according to emerging agreed terminology; and, third, to map outcome measures to intervention type. Methods: A scoping review of trials evaluating DBS techniques was undertaken from 2012 to 2022. The review was prospectively registered. Studies were identified through Medline, Embase, and PsycINFO. Study abstracts were screened by two reviewers. Data were extracted by single selector. Outcome measures were sorted according to measurement domains (physiological, behavioral, psychological, and treatment). Responses were assimilated and summed to produce a refined list of distinguishable outcome measures. Intervention types were categorized according to accepted descriptors. Frequencies were presented; associations between outcome domain and DBS type were also reported (Chi‐square test of independence). Results: A total of 344 trials were included in the review from an initial 14,793 titles / title and abstracts screened. Most involved children (n = 215), most were from India (n = 104), involving basic dental care (n = 117). The median number of outcome measures per trial was four (range = 1–12); 1,317 individual outcomes were reported, categorized as: psychological (n = 501, 38.0%); physiological (n = 491, 37.3%), behavioral (n = 123, 9.3%) or, treatment‐related (n = 202, 15.3%). DBS interventions were split between 239 (45.7%) pharmacological and 283 (54.1%) non‐pharmacological; 96.6% of interventions mapped to accepted descriptors. A significant relationship was noted between the type of intervention and the outcome domain reported. Conclusion: The findings demonstrate massive variation in outcome measures of DBS interventions that likely lead to unnecessary heterogeneity, selective reporting, and questionable relevance in the literature. A large range of DBS interventions were mapped according to BeSiDe list. There is a need for consensus on a core outcome set across the spectrum of DBS techniques. [ABSTRACT FROM AUTHOR]

This study examined the feasibility and acceptability of two group-based interventions: group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family group (MFG-FS), to address HIV stigma among adolescents living with HIV (ALHIV) and their caregivers. A total of 147 adolescent -caregiver dyads from 9 health clinics situated within 7 political districts in Uganda were screened for eligibility. Of these, 89 dyads met the inclusion criteria and provided consent to participate in the study. Participants were randomized, at the clinic level, to one of three study conditions: Usual care, G-CBT or MFG-FS. The interventions were delivered over a 3-month period. While both adolescents and their caregivers attended the MFG-FS sessions, G-CBT sessions were only attended by adolescents. Data were collected at baseline, 3 and 6-months post intervention initiation. The retention rate was 94% over the study period. Across groups, intervention session attendance ranged between 85 and 92%, for all sessions. Fidelity of the intervention was between 85 and 100%, and both children and caregivers rated highly their satisfaction with the intervention sessions. ALHIV in Uganda, and most of sub–Saharan Africa, are still underrepresented in stigma reduction interventions. The Suubi4Stigma study was feasible and acceptable to adolescents and their caregivers –supporting testing the efficacy of the interventions in a larger trial. [ABSTRACT FROM AUTHOR]

Given the prevalence of depression, it is worthwhile to consider a variety of treatment approaches to reach as many sufferers as possible, including highly accessible formats such as self-help books. Books based in acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) propose to treat depression through distinct processes of change, though the degree to which these treatments are distinguishable in this format is unclear. Furthermore, it is possible that some individuals may respond better to therapeutic processes from one approach over the other based on personal preferences. We tested the effects of ACT and CBT self-help books on processes of change in a sample of 139 depressed college students in which some participants were given a choice of treatment and others were randomized. Cognitive fusion, which improved better in the ACT group, was the only process of change that distinguished the two treatments. Additionally, early improvements in cognitive fusion were associated with less depression-related stigma at posttreatment. Lastly, randomization, instead of choosing a treatment, led to greater improvements in almost all processes of change. We discuss how these findings inform personalized care, tangible differences between ACT and CBT, and effective practices for treating depression at large scale. [ABSTRACT FROM AUTHOR]

Background: Coping refers to conscious responses to negative circumstances, with the intention of ameliorating these situations. Few studies have compared the differences between psychotherapy and medication treatment for coping strategies for depression. In this study, we investigated the differences in coping strategies between cognitive behavioral therapy (CBT) combined with medication (CBT group) and medication alone (pharmacotherapy group) among outpatients with depression. Methods: A prospective observational study was conducted among 50 patients with major depression (24 and 26 in the CBT and pharmacotherapy groups, respectively). Stress coping strategies (Coping Inventory for Stressful Situations [CISS]) and depression severity (Beck Depression Inventory-Second Edition [BDIII]) were assessed at baseline and 16 weeks later. Changes in the CISS and BDI-II scores in both groups were tested using repeated analysis of variance. Inverse probability weighting with propensity score analysis was applied to address potential selection bias. Results: At 16 weeks, the CBT group exhibited increased CISS task-oriented coping, distraction, and social diversion scores, which differed from those of the pharmacotherapy group. The CBT group exhibited a significantly greater reduction in depressive symptoms than the pharmacotherapy group. Limitations: This study was not a randomized controlled trial and thus may have selection bias. Conclusion: Gaining adaptive coping skills, including task-oriented coping, distraction, and social diversion skills, by combining CBT with medication may lead to greater improvement in depression symptoms. These findings suggest that clinicians should evaluate coping strategies and facilitate the acquisition of adaptive coping strategies in patients with depression to reduce their symptoms. [ABSTRACT FROM AUTHOR]

AbstractThe Unified Protocol (UP) is a flexible, transdiagnostic form of cognitive behavioral therapy that effectively treats diverse psychiatric conditions in children, adolescents and adults. However, the UP has not been rigorously evaluated among children who have experienced severe trauma and may have limited caregiver involvement in their life. The present research project was a single arm, open trial examining the feasibility of utilizing the UP within a residential treatment facility in Calgary, Canada for children involved with child welfare authorities who often have limited caregiver involvement. Children (n = 19; age 9–13) and their caregivers (n = 18; age 32–60) participated in 15 weekly therapy sessions of the UP for Children with minor structural and content modifications. Trauma exposure was high among children, especially physical neglect and emotional abuse (89% exposed to each). Fidelity to the manualized intervention was high (88% for children; 89% for caregivers), indicating the intervention was feasible to deliver and that the adaptations did not interfere with fidelity. All children and caregivers completed the intervention, suggesting high acceptability for recipients. Improvements over time in maladaptive cognitions and behaviors (among children and caregivers) provide preliminary evidence for efficacy. The present study provides support for the notion that the UP for Children can be utilized for children who live in residential care and/or those who have experienced high levels of trauma. [ABSTRACT FROM AUTHOR]

AbstractObjective: Previous research indicates positive effects of feedback based on rational or empirical decision rules in psychotherapy. The implementation of these usually session-to-session-based feedback systems into clinical practice, however, remains challenging. This study aims to evaluate decision rules based on routine outcome monitoring with reduced assessment frequency. Method: Data routinely collected every 5–20 sessions of N = 3758 patients treated with CBT in an outpatient clinic (Msessions = 42.8, SD = 15.4) were used to develop feedback decision rules based on the expected treatment response and nearest neighbors approach, the reliable change index, and method of percental improvement. The detection of patients at risk of treatment failure served as primary endpoint. Results: Significantly lower reliable improvement, higher reliable deterioration rates, and smaller effect sizes were found for patients identified at risk of treatment failure by all rules. The nearest neighbors-based approach showed the highest sensitivity regarding the detection of reliably deteriorated cases. Conclusion: Consistent with previous research, the empirical models outperformed the rational rules. Still, the first-time used percental improvement-based rule also showed satisfactory results. Overall, the results point to the potential of basic feedback systems that might be easier to implement in practice than session-to-session based systems. [ABSTRACT FROM AUTHOR]

Objective: The clinical efficacy of cognitive behavioral therapy (CBT) after Total knee arthroplasty (TKA) is still controversial, and the purpose of this meta-analysis was to evaluate the effect of CBT on pain, knee function, and psychological status of patients after TKA. Methods: We systematically searched electronic databases such as CNKI, CBM, VIP, PubMed, Cochrane Library, and EMBASE for randomized controlled studies up to February 30, 2023. Screening against inclusion criteria to select valid studies and extract data. The quality of included studies was evaluated by the Cochrane Collaboration risk-of-bias 2 (RoB 2) tool for randomized trials. Statistical analysis of the data from this study was carried out using Stata 15.1 software. Results: Finally, our meta-analysis incorporated seven randomized controlled studies of high quality, including 608 patients. The findings of the meta-analysis demonstrated a noteworthy decrease in kinesiophobia levels during the early postoperative phase in the CBT group as compared to the usual care group (WMD = -6.35, 95% CI: -7.98 to -4.72, Z = 7.64, P < 0.001). However, no statistically significant difference between the CBT and usual care groups in terms of postoperative pain as well as knee function. Conclusion: CBT may effectively reduce the level of kinesiophobia in the short term after TKA, but did not significantly relieve knee pain or improve knee function. [ABSTRACT FROM AUTHOR]

While everyone experiences threats, some threats are culturally specific and not universally recognized or addressed by providers. A prominent example is threat-based worry and hypervigilance in Black Americans and other minoritized individuals, which is higher due to systemic racism and increases risk for psychopathology like clinically significant paranoia. To date, there have been no adaptations of cognitive-behavioral therapies for Black Americans with psychosis, despite the long-standing history of systemic racism in the United States, and its increasingly recognized contribution to psychotic experiences. Accordingly, we present the first step towards developing an adapted cognitive-behavioral intervention for Black and minoritized Americans with psychosis. This adaptation of an empirically supported worry-based treatment for persecutory delusions was accomplished by comprehensive conceptualization and integration of how systemic racism and minoritization drive the prevalence and perception of threats. This contrasts with conceptualizing racism-related hypervigilance and cognitions as worry or ignoring these critical experiences altogether, which is invalidating and neglects optimal identification and intervention on behavioral targets. Using a validating and normalizing approach, the individual was able to identify how frequent threats related to systemic racism resulted in increased worry, vigilance, and distress. By identifying and intervening on the perception of threat and associated worry, the individual engaged in more helpful responses to the threat, which in turn increased participation in more meaningful activities and reduced worry and clinical paranoia. This case illustrates how accurate conceptualization clarifies behavioral targets and increases patient engagement, which together enhance the effectiveness of the intervention for minoritized individuals. [ABSTRACT FROM AUTHOR]

This research paper explores the theories of Albert Ellis and Jeffrey Young in Cognitive Behavioral Therapy (CBT), a therapeutic approach aimed at modifying behavior and building resilience against psychological pressures and negative thoughts. The paper discusses the key principles and techniques used in CBT, including rational thinking, challenging irrational beliefs, and modifying maladaptive schemas. It also highlights the importance of the therapeutic relationship in both theories. While CBT has been effective in improving mental health, it has faced criticisms for its focus on cognitive aspects over emotional and affective aspects. Overall, CBT has proven to be effective in addressing psychological problems and improving well-being. [Extracted from the article]

Background: Inflammatory bowel diseases (IBDs) are chronic conditions that negatively affect the patient's quality of life. With the spread of the biopsychosocial model, the role of mental health in the activity and course of inflammatory bowel disease is becoming more and more recognized. Our study aimed to assess the prevalence of anxiety and depression in IBD patients in our tertiary referral center and determine the predictive factors of these mental conditions. Methods: A total of 117 patients were included consecutively between 1 December 2021 and 28 February 2022. We used a questionnaire to gather demographic information, disease course, and IBD-specific symptoms. We assessed anxiety symptoms using the GAD-7 and depressive complaints using the PHQ-9 questionnaire. We evaluated disease activity using CDAI and pMayo scores. Results: Of the 117 patients (male/female: 63/54), 88 suffered from Crohn's disease, and 29 were diagnosed with ulcerative colitis. Only 6 patients were taking medication for mood disorders, and 38 individuals sought mental support during their lifetime. A total of 15% of the population suffered from moderate–severe anxiety disorder, and 22% were affected by moderate–severe depression. The GAD-7 and PHQ9 values showed a significant correlation between the number of stools, bloody stools, abdominal pain, number of flare-ups, and CDAI scores. Conclusions: Our study confirmed that there is a high incidence of anxiety and depressive symptoms among IBD patients. Our results highlighted the symptoms that could be associated with mental disorders. It is important to assess the mental status of IBD patients to improve their quality of life. [ABSTRACT FROM AUTHOR]

Background: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. Method: Studies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system. Results: The meta-analysis included 22 studies of 2,602 bereaved adults (averaged study Mage = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention (K = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up (K = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms (K = 10, g = 0.74, 95% CI [0.49, 0.98]), depression (K = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance. Conclusion: This review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. What is the public health significance of this article?: This review suggests that grief-focused cognitive behavioral therapies are efficacious in reducing prolonged grief disorder symptoms in adulthood and to some extent also bereavement-related depression, anxiety, and posttraumatic stress symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases are among the most lethal physical diseases of the 21st century, posing a greater threat to human life than any other disease and problem. This research compared the effectiveness of mindfulness-based stress reduction and emotion-focused therapy on the cognitive flexibility of cardiovascular patients in Isfahan City. Methods: The research was conducted using a quasi-experimental design with a pre-test-post-test and a three-month follow-up with a control group. The statistical population included 380 male cardiovascular patients admitted to Shahid Chamran Cardiovascular Hospital in Isfahan in the winter of 2023. Forty-five patients were selected by purposive sampling and randomly assigned to two experimental groups and one control group. Patients in the first experimental group received eight 90-minute sessions of mindfulnessbased stress reduction, while those in the second experimental group received eight 90-minute sessions of emotion-focused therapy. The measurement tools were the Cognitive Flexibility Questionnaire (Dennis & Vanderwaal, 2010) and a short clinical interview. Research data were analyzed through mixed variance analysis using SPSS version 24 software. Results: The results showed that both intervention methods increased the average cognitive flexibility and its components, including alternatives, control, and alternatives for human behaviors of patients (P≥0.01). No significant difference was observed between the effectiveness of the two methods (P≤0.01). Conclusion: According to the research results, it is possible to use the intervention method of mindfulness-based stress reduction program and emotion-focused therapy to improve the cognitive flexibility of cardiovascular patients. [ABSTRACT FROM AUTHOR]

Objectives: Opioid abuse is one of the most critical problems today, and individuals struggling with this issue often experience stress, anxiety, and depression disorders. This study aimed to investigate the effects of software-based cognitive bias modification on stress, anxiety, and depression disorders among patients receiving methadone maintenance treatment. Methods: This double-blind clinical trial was conducted in 2022. Eighty-four participants were selected through convenience sampling from individuals undergoing methadone maintenance treatment for opioid abuse at an addiction treatment center in Isfahan city. They were then randomly assigned to either the intervention group (n=42) or the control group (n=42). The intervention involved a four-week program utilizing software-based cognitive bias modification through the dot-probe task, with two sessions per week. Participants in both groups completed DASS21 questionnaires before, immediately after, and two months following the intervention. Results: The repeated-measures ANOVA test revealed statistically significant differences in the mean scores of stress (P<0.001), anxiety (P<0.001), and depression (P<0.001) disorders in the intervention group before, immediately after, and two months post-intervention. Conclusion: The findings of this study suggest that software-based cognitive bias modification can lead to a reduction in stress, anxiety, and depression disorders among patients undergoing methadone maintenance treatment. Therefore, incorporating this program alongside other treatment methods for individuals in methadone maintenance treatment is recommended. [ABSTRACT FROM AUTHOR]

Cognitive behavioral therapy (CBT) appears to achieve its effects at least in part by fostering the development of CBT skills. In an effort to leverage CBT skill development, our group developed and tested a skill‐enhanced version of CBT (CBT‐SE) in a recent trial. In this paper, we describe our work with a client who participated in a 12‐week course of CBT‐SE as part of that trial. Although homework is a critical aspect of CBT, the greater emphasis on skill development in CBT‐SE means that homework is even more central. This client's course of treatment illustrates the potential benefits of a strong focus on skill development and the use of specific homework assignments to foster mastery and ongoing use of CBT skills. The client developed CBT skills at a rapid pace early in treatment and exhibited enduring symptom reductions. The experience of this client reinforces the value of a focus on CBT skills and highlights strategies for fostering skill development. Given the evidence in support of the therapeutic value of CBT skills and the well‐established benefits of homework assignment, we encourage use of skill enhancing procedures, including in‐session procedures and assignments that help clients develop and maintain ongoing skill use. [ABSTRACT FROM AUTHOR]

Objective: Cognitive‐behavioral therapy (CBT), which includes a decided emphasis on exposure and response/ritual prevention (ERP) and between‐session practice of treatment principles, has consistently demonstrated efficacy for the treatment of obsessive‐compulsive disorder (OCD) and is a gold standard, recommended first‐line treatment. CBT with ERP has been successfully adapted to fit the needs of autistic individuals with OCD. The present article provides a brief overview of CBT for OCD and outlines special considerations and adaptations needed when working with patients with OCD and comorbid autism, with an emphasis on the importance of between‐session homework. Method: A case vignette is presented. Results: This case study illustrates the role of homework in the exposure‐based treatment of an adult autistic individual with comorbid OCD. Conclusion: Implications of this case vignette are discussed, and recommendations are offered for clinicians working with autistic individuals with OCD, especially in regard to bolstering completion of between‐session ERP homework. [ABSTRACT FROM AUTHOR]

Cognitive Behavioral Therapy (CBT) is among the gold-standard psychotherapeutic interventions for the treatment of psychiatric disorders, including bipolar disorder (BD). While the clinical response of CBT in patients with BD has been widely investigated, its neural correlates remain poorly explored. Therefore, this scoping review aimed to discuss neuroimaging studies on CBT-based interventions in bipolar populations. Particular attention has been paid to similarities and differences between studies to inform future research. The literature search was conducted on PubMed, PsycINFO, and Web of Science databases in June 2023, identifying 307 de-duplicated records. Six studies fulfilled the inclusion criteria and were reviewed. All of them analyzed functional brain activity data. Four studies showed that the clinical response to CBT was associated with changes in the functional activity and/or connectivity of prefrontal and posterior cingulate cortices, temporal parietal junction, amygdala, precuneus, and insula. In two additional studies, a peculiar pattern of baseline activations in the prefrontal cortex, hippocampus, amygdala, and insula predicted post-treatment improvements in depressive symptoms, emotion dysregulation, and psychosocial functioning, although CBT-specific effects were not shown. These results suggest, at the very preliminary level, the potential of CBT-based interventions in modulating neural activity and connectivity of patients with BD, especially in regions ascribed to emotional processing. Nonetheless, the discrepancies between studies concerning aims, design, sample characteristics, and CBT and fMRI protocols do not allow conclusions to be drawn. Further research using multimodal imaging techniques, better-characterized BD samples, and standardized CBT-based interventions is needed. [ABSTRACT FROM AUTHOR]

Background: Systemic inflammation, particularly the elevation of interleukin-6 (IL-6), plays an important role in the maintenance and progression of knee osteoarthritis. Insomnia, being highly prevalent in knee osteoarthritis, is understood to be a risk factor for systemic inflammation. The present study examined if cognitive behavioral therapy for insomnia (CBT-I) would reduce circulating IL-6 levels to a larger extent than the active control condition via greater improvement in sleep maintenance disturbance at mid-treatment, among individuals with knee osteoarthritis and insomnia disorder. Methods: This is an ancillary study (N = 64) from a larger double-blind, randomized, active controlled clinical trial. Serum IL-6 was measured at baseline, post-treatment, and 3- and 6-month follow-ups. Sleep was measured by daily sleep diaries. Results: Overall, there was no significant IL-6 trajectory differences between CBT-I and the active control (p =.64). Compared to the active control, CBT-I demonstrated greater improvement in sleep maintenance disturbance at mid-treatment (p =.01), which, in turn, was significantly associated with lower levels of IL-6 at 3-month follow-up (p <.05). Sleep maintenance disturbance at mid-treatment did not significantly predict changes in IL-6 levels at post-treatment (p =.43) and 6-month follow-up (p =.90). Conclusions: Our study demonstrates that CBT-I can be efficacious in improving sleep maintenance disturbance among individuals with knee osteoarthritis and insomnia disorder. However, no convincing evidence was found that CBT-I can substantially reduce IL-6 levels via improvement in sleep. CBT-I alone may not be effective in reducing systematic inflammation in this clinical population. Trial Registration: NCT00592449. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the potential effectiveness of several mainstream therapies, including phototherapy, antidepressants, cognitive-behavioral therapy, and negative ion generators, in the treatment of Seasonal Affective Disorder (SAD). A systematic search of PubMed, Embase, Cochrane, and WOS databases was conducted from January 1975 to December 3, 2022. Randomized controlled trials meeting predefined selection criteria for the treatment of SAD using mainstream therapeutic approaches were identified. After reviewing abstracts, data were synthesized and categorized based on the type of intervention and the targeted disorder. A total of 21 randomized controlled trials, involving 1037 participants, were included. The standardized mean difference of depression scores and corresponding 95 % confidence intervals were calculated to assess the efficacy of phototherapy for Seasonal Affective Disorder. The meta-analysis revealed that phototherapy was significantly more effective than other intervention groups or control therapies, with an effect size of 4.64(2.38,7.03). Subgroup analysis demonstrated that no factors could explain the significant heterogeneity observed. Phototherapy exhibited statistically significant mild to moderate therapeutic effects in alleviating depressive symptoms and can be considered as a clinical therapy for treating Seasonal Affective Disorder. However, the quality of evidence remains low, and further well-designed, larger sample size, and high-quality studies are needed to confirm the efficacy of phototherapy in treating Seasonal Affective Disorder. In conclusion, our systematic review and meta-analysis indicate that bright light therapy is a promising first-line non-pharmacological treatment for Seasonal Affective Disorder (SAD), showing significant improvement in mood symptoms compared to placebo. The findings support the use of bright light therapy as an effective and well-tolerated intervention for SAD. However, further large-scale, multicenter randomized controlled trials with long-term follow-up are needed to assess the long-term efficacy and safety of different treatment approaches for SAD. • Light therapy showed mild to moderate effects in alleviating depressive symptoms and can be considered a clinical therapy for SAD. • Bright light therapy had superior effects compared to other interventions and placebo controls based on depression rating scale scores. [ABSTRACT FROM AUTHOR]

The meta-analysis aims to explore the effect of cognitive behavioral therapy for insomnia (CBT-I) in the perinatal period. Randomized controlled trials (RCTs) assessed the effects of CBT-I in perinatal women with insomnia, published in English, were eligible. Electronic searches were performed using PubMed, Embase (Elsevier), PsycINFO (Ebsco), and Web of Science (Clarivate Analytics). Insomnia Severity Index (ISI) as the primary outcome was used to estimate the pooled effects and durable efficacy of CBT-I. The secondary outcome measures were Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). Of 46 studies reviewed, seven studies met the inclusion criteria. The meta-analysis indicated significant improvement in insomnia as measured with the ISI (standardized mean difference (SMD) = − 0.62, 95% confidence intervals (CI) − 0.77, − 0.47, I2 = 28%). At the follow-up time point, the meta-analysis indicated the durable efficacy of CBT-I (SMD = − 0.47, 95% CI − 0.90, − 0.03, I2 = 73%). Definite improvement of CBT-I on EPDS (SMD = -0.31, 95% CI − 0.55, − 0.06, I2 = 33%) and PSQI (SMD = − 0.82, 95% CI − 1.27, − 0.38, I2 = 68%) score change post-intervention were found. In sub-analyses, CBT-I had similar effect sizes, independent of possible modifiers (study population, comparison group, delivery format, etc.). This meta-analysis demonstrates that CBT-I is effective in alleviating insomnia, depression, and sleep quality among perinatal women. It is equally important to find that CBT-I has a durable efficacy on insomnia in the perinatal period. However, it is necessary to include larger samples and conduct rigorous RCTs to further explore this issue. [ABSTRACT FROM AUTHOR]

Extramarital Infidelity (EMI) variants, such as sexual and emotional infidelities, are increasing in marriages. The literature indicates that spiritual and cognitive-behavioral techniques reduce marital conflicts, increase marital satisfaction and commitment, and improve couples’ compatibility and quality of life. To the best of our knowledge, little is known about which therapies can more effectively prevent and address this behavior. In addition, no therapeutic approach is effective for all clients. Given the limitations of each approach, various studies have shown that eclectic approaches can provide a better point of view for addressing patient-specific problems. This literature review discussed the effectiveness of spiritual counseling enhanced with cognitive-behavioral techniques in addressing EMI. The findings suggest that the spiritual realm, as an aid for coping with the desire for extramarital relationships reinforced with cognitive-behavioral techniques, maybe a suitable method to approach this complicated phenomenon. There is a need to address the direct and indirect ways in which spiritual health affects EMI in both personal and social life. [ABSTRACT FROM AUTHOR]

While cognitive behavioral therapy (CBT) is a first-line treatment for anxiety, it is not typically offered to those with intellectual disability (ID). In this article, we provide a historical perspective on the treatment of mental health concerns in adults with ID, describe an adapted CBT treatment for anxiety in adults with Williams syndrome (WS) and mild to moderate ID, and discuss general modifications to CBT for adults with ID. Strategies used to successfully adapt CBT for adults with WS that may generalize to adults with ID more broadly include (a) using child-based CBT manuals as a framework, (b) involving a caregiver as a therapy partner, (c) incorporating a high level of repetition, (d) simplifying language, (e) slowing the pace of instruction, and (f) incorporating specific examples and adaptations for WS. [ABSTRACT FROM AUTHOR]

There are few available culturally and linguistically adapted behavioral health interventions for substance use among Spanish-speaking adults. The authors describe the cultural adaptation of an innovative computer-based training for cognitive behavioral therapy program (CBT4CBT). Based in cognitive-behavioral skills training, CBT4CBT utilizes a telenovela to teach monolingual Spanish-speaking adults who have migrated to the United States to recognize triggers; avoid these situations; and cope more effectively with the consequences of substance use. Participants endorsed high levels of satisfaction with the program content and found the material to be easy to understand and relevant to their life experiences. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effectiveness of an online multicomponent intervention called FATIGUEWALK (FaW) compared to treatment as usual (TAU) in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Method: FaWincluded pain neuroscience education, therapeutic exercise, cognitive restructuring, and mindfulness training. A total of 428 patients with CFS/ME were randomized into two study arms: online FaW plus TAU versus TAU alone. A single-blinded randomized controlled trial was conducted. Validated patient-reported outcome measures of fatigue, pain, anxiety, depression, and physical function were collected at baseline and posttreatment, following the FaW intervention, which lasted 12 weeks. Results: Statistically significant improvements (with small-to-moderate effect sizes) were observed in online FaWversus TAU alone with respect to multidimensional aspects of fatigue (Cohen's d ranging from 0.25 to 0.73) and most secondary outcomes (pain and fatigue intensity, depressive and anxious symptomatology, functional impairment, kinesiophobia, physical functioning). The absolute risk reduction in FaWversus TAU was 19%, 95% confidence interval (CI) [12.19, 25.80] with number needed to treat= 6, 95% CI [3.9, 8.2]. Overall, similar clinical improvements were observed in sensitivity analyses including a subgroup of patients without comorbidity with fibromyalgia (n=70). Conclusions: This is the first study to assess the short-term effectiveness of an online multicomponent intervention added to TAU, compared to TAU alone, for the management of CFS/ME. Further trials, including active control groups with an equivalent treatment dose, and assessing the long-term effectiveness of the online FaW, are warranted. [ABSTRACT FROM AUTHOR]

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri 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: Cognitive behavioral stress management (CBSM) modifies individuals' maladaptive cognition and improves their ability in managing stress. The present study was to inquire about the utility of CBSM in mental health and quality of life in patients with cervical cancer. Methods: Totally, 172 postoperative cervical cancer patients were randomly classified into CBSM (N=86) and normal care group (N=86) to receive 8-week CBSM and normal care, correspondingly. Self-rating anxiety/depression scale (SAS/SDS), EuroQol-5 dimensions (EQ-5D), EuroQol-visual analogue scale (EQ-VAS), and quality of life questionnaire-core 30 (QLQ-C30) scores were evaluated at discharge (M0), 1st month (M1), M3, and M6 after discharge. Results: SAS scores at M6 (P=0.003), M1 (P=0.042), and M3 (P=0.010), and the proportion of patients with SAS-defined anxiety at M3 (P=0.040) and M6 (P=0.019) were reduced in CBSM group versus normal care group. SDS scores at M3 (P=0.020) and M6 (P=0.016), and the proportion of patients with SDS-defined depression at M6 (P=0.036) was descended in CBSM group versus normal care group. EQ-VAS score at M1 (P=0.044), M3 (P=0.014), and M6 (P=0.002) were increased, while EQ-5D score at M3 (P=0.030) was descended in CBSM group versus normal care group. Meanwhile, QLQ-C30 global health status score at M1 (P=0.046), M3 (P=0.037), and M6 (P=0.007), QLQ-C30 function score at M3 (P=0.033) and M6 (P=0.016) were ascended, but QLQ-C30 symptom score at M3 (P=0.042) was declined in CBSM group versus normal care group. Conclusion: CBSM is an effective intervention for decreasing anxiety and depression, and improving quality of life in patients with cervical cancer. [ABSTRACT FROM AUTHOR]

Adolescents with depression often experience negative automatic thoughts, which contribute to the development of suicidal ideation. Internet-based cognitive behavioral therapy has now become a treatment to address negative automatic thoughts to prevent suicide. This quasi-experimental study aimed to assess the effects of an Internet-based Cognitive Behavioral Therapy Program on the depression of Thai adolescents. The participants consisted of 60 adolescent students with a deviation from their usual mood who were enrolled in public high schools in a province adjacent to Bangkok. The participants were conveniently selected, paired based on gender and grade point average, and randomly assigned into two groups. The experimental group received the program, while the control group received usual care (n = 30 each). Data collection instruments included a personal data form and the Healthrelated Self-report Scale. One-way repeated measures ANCOVA was used to compare the mean depression scores between the two groups while controlling for baseline depression scores. The results indicate that the participants' depression scores decreased over time in both groups. However, a significant group effect suggests that being in the experimental group was associated with a greater decrease in depression scores both immediately after the intervention and at the two-week follow-up compared to the control group. These findings shed light on the potential benefits of implementing this Internet-based Cognitive Behavioral Therapy Program by school nurses, teachers, or primary care nurses to prevent extreme depression and suicidal ideation among adolescents. Further investigation with longer follow-up is recommended. [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.)

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: The aim of the present study was to determine the effectiveness of cognitive-behavioral therapy on psychological hardiness and the quality of marital relationships in couples with marital conflicts. Methods and Materials: The research method was a quasi-experimental design with a pre-test and post-test with a control group. The statistical population of this study consisted of couples with marital conflicts in Tehran in 2023. Then, 32 couples with marital conflicts were selected through convenience sampling and randomly assigned to the experimental group (16 people) and the control group (16 people). The data collection tools were questionnaires on psychological hardiness and the quality of marital relationships. Subsequently, cognitive-behavioral therapy training was conducted on the experimental group over 8 sessions of 90 minutes each. After the training sessions, post-tests were administered to both the experimental and control groups. Findings: The findings indicated that the post-test scores of the experimental group in psychological hardiness and the quality of marital relationships were significantly better than those of the control group. Conclusion: Therefore, cognitive-behavioral therapy has an effect on psychological hardiness and the quality of marital relationships in couples with marital conflicts. [ABSTRACT FROM AUTHOR]

Objective: Distress tolerance and self-compassion play a significant role in mitigating the harm caused by the experience of infidelity. This study compares the effectiveness of cognitive behavioral therapy (CBT) and compassion-focused therapy (CFT) in improving distress tolerance and self-compassion among women who have experienced marital infidelity. Materials and Methods: This quasi-experimental study employed a pre-test, post-test, follow-up design with a control group. The study population included women who had experienced infidelity by their spouse and sought counseling and psychotherapy services in Tehran in the year 2021. From this population, using purposive sampling, 45 women were selected based on the study's criteria and randomly assigned to two experimental groups and one control group (15 per group). The first experimental group received cognitive behavioral therapy, and the second received compassion-focused therapy. The control group did not receive any intervention. Data were collected using the Distress Tolerance Scale (Simons & Gaher, 2005) and the Self-Compassion Scale (Neff, 2003). Data were analyzed using repeated measures analysis of variance and SPSS software version 22. Findings: The results showed that both distress tolerance and self-compassion scores in the cognitive-behavioral and compassion-focused therapy groups were higher in the post-test compared to the pre-test (p<0.01). Furthermore, a comparison of the two experimental groups revealed no significant difference in scores of distress tolerance and self-compassion between the groups. Conclusion: It can be concluded that both cognitive-behavioral therapy and compassion-focused therapy were equally effective in improving distress tolerance and self-compassion among women. [ABSTRACT FROM AUTHOR]

Introduction: Chronic back pain is a widespread medical condition associated with high socioeconomic costs and increasing prevalence. Despite the advanced implementation of multidisciplinary approaches, providing a satisfactory treatment offer for those affected is often not possible. Exposure therapy (EXP) promises to be an effective and economical form of treatment and in a previous pilot study showed to be superior to cognitive behavioral therapy (CBT) in reducing perceived limitations of movement. The current study aims to further compare the efficacy of both treatment methods and identify those patient groups that particularly benefit from EXP. Methods: The general objective of this randomized multicenter clinical trial (targeted N = 380) is to improve and expand the range of treatments available to patients with chronic back pain. As the primary objective of the study, two different psychological treatments (EXP and CBT) will be compared. The primary outcome measure is a clinically significant improvement in pain-related impairment, measured by the QPBDS, from baseline to 6-month follow-up. Secondary outcome measures are absolute changes and clinically significant improvements in variables coping, psychological flexibility, depressiveness, catastrophizing, exercise avoidance and fear of exercise, and intensity of pain. Participants are recruited in five psychological and medical centers in Germany and receive ten sessions of manualized therapy by trained licensed CBT therapists or clinical psychologists, who are currently in their post-gradual CBT training. Potential predictors of each treatment's efficacy will be explored with a focus on avoidance and coping behavior. Conclusion: This study will be the first RCT to compare CBT and EXP in chronic back pain in a large sample, including patients from different care structures due to psychological and medical recruitment centers. By identifying and exploring potential predictors of symptom improvement in each treatment group, this study will contribute to enable a more individualized assignment to treatment modalities and thus improves the care situation for chronic back pain and helps to create a customized treatment program for subgroups of pain patients. If our findings confirm EXP to be an efficacious and efficient treatment concept, it should gain more attention and be further disseminated. Trial registration: ClinicalTrials.gov NCT05294081. Registered on 02 March 2022. [ABSTRACT FROM AUTHOR]

To evaluate the effects of cognitive behavioral therapy on anxiety and depressive symptoms in patients with advanced cancer. A systematical search was conducted on Embase, PubMed, Web of Science, Cochrane Library, PsycINFO, Chinese Biomedical Database, CNKI, VIP Database, and Wanfang database, and the search time was from the inception to May 26, 2023. Randomized controlled trials focusing on the effects of cognitive behavioral therapy on anxiety and depressive symptoms in patients with advanced cancer were collected using relevant terms such as advanced stage, cancer, anxiety, depression, and cognitive behavioral therapy. The quality of included studies was evaluated using the Cochrane risk of bias (ROB 2.0) tool, and meta-analysis was performed using RevMan5.4 software. 15 articles, including 1,597 patients, were included. Twelve of the studies reported the effect of CBT on anxiety symptoms in 1,485 advanced cancer patients; Fifteen studies reported the effect of CBT on depressive symptoms in 1,861 advanced cancer patients. The results of meta-analysis showed that CBT was effective in decreasing anxiety [SMD = -0.55, 95% CI (−0.82, −0.27), P < 0.001, I2 = 84%] and depressive symptoms [SMD = -0.38, 95% CI (−0.58, −0.17), P < 0.001, I2 = 78%] in patients with advanced cancer compared to controls, especially the interventions that were delivered lasted for 2–8 weeks. Cognitive behavioral therapy lasting for 2–8 weeks is effective for anxiety and depressive symptoms in advanced cancer patients to a moderate degree, but more rigorous research is needed to guide the choice between online and face-to-face delivery mode and the priority of self-guided versus therapist-guided interventions still needs to be studied. [ABSTRACT FROM AUTHOR]

This case report discusses the psychotherapy and supervision process of a 28-year-old female client with a dog phobia using the framework of cognitive behavioral therapy. The first section delves into the client’s life history, the reason for seeking therapy, the primary issues, and the progression of these issues. We describe the cognitive-behavioral therapy process and the clinical follow-up. We mentioned the topics covered in the sessions and detailed the techniques used. The therapy resulted in a decrease or even the disappearance of the client’s dog phobia. The therapist administered the Specific Phobia Scale in the first and last sessions, scoring 34 in the first session and 0 in the last session. We anticipate that the results of this study will shed light on the suitability of cognitive behavioral therapy for specific phobias and the impact of online therapy. [ABSTRACT FROM AUTHOR]