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Cognitive behavioural therapy (CBT) is recommended as the frontline treatment for depression and anxiety disorders and has been implemented in a wide range of mental health care contexts. In Danish mental health services, group CBT is the most common psychotherapeutic treatment format. Recently, a standardized, time-restricted treatment format has been implemented. No studies have investigated the patients' experiences of group CBT in such a format. Furthermore, few studies have investigated patients' experiences of group CBT for anxiety and depression. The current study set out to explore patients' experiences of group CBT for anxiety and depression and the role of a standardized, time-restricted treatment format, using a qualitative framework.We explored the experiences of 23 patients with a primary diagnosis of social anxiety, panic disorder/agoraphobia, or depression. Data were collected through semi-structured interviews. Data were analyzed using phenomenological narrative analysis. The results revealed a common narrative across the 23 interviews. The narrative was made up of six distinct themes, namely: How did I get here?; Being seen, heard and recognized; Shared responsibility of problems and solutions; Education and tools; Limitations of this group format; and Launchpad. The results indicated that the patients found group CBT helpful due to a range of factors, both common factors and treatment-specific factors. Patients expressed skepticism towards group CBT prior to beginning, because of a lack of information and previous failed treatment attempts. The patients highlighted the importance of the context of the mental health system by explaining how systemic factors impacted negatively on their psychotherapy experience. Many described feeling abandoned due to the sudden ending of a treatment course that was generally considered insufficient., Author(s): Anne Bryde Christensen [sup.1] [sup.2] , A. J. Pavlo [sup.3] , L. Davidson [sup.3] , S. Poulsen [sup.4] , N. Reinholt [sup.2] [sup.5] , M. Hvenegaard [sup.5] , E. [...]

The promotion of mental health and well-being for the working population is crucial. Several studies have examined the effects of group cognitive-behavioral therapy (CBT)-based interventions on promoting employees' mental health, but whether their work performance-related factors also improved has not been studied thoroughly. This systematic review was conducted to summarize and synthesize the effectiveness and characteristics of group CBT-based interventions on improving mental health and enhancing work performance-related factors from previous studies. A systematic search of studies published until November 2019 was performed using the Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and MEDLINE. Only ten studies investigated the impact of group CBT-based interventions on both mental health and work performance-related factors in a non-clinical working population using a randomized controlled trial study design. Studies on group CBT-based interventions such as psychosocial skills training and communication skills training were included. Eight studies showed that group CBT-based interventions improved aspects of mental health; ten studies demonstrated that group CBT-based interventions influenced some aspects of work performance-related factors. Overall, the reported effect sizes varied widely, from small to large. This review supports the idea that group CBT-based interventions in a non-clinical working population may partially influence mental health and work performance-related factors. All ten included articles were published after 2015. Additional research on this topic, such as through meta-analysis, is necessary to assess whether group CBT-based intervention is effective for supporting mental health and enhancing work performance-related factors in non-clinical working populations., Author(s): Yuko Ihara [sup.1] , Takumu Kurosawa [sup.1] , Tamami Matsumoto [sup.1] , Ryu Takizawa [sup.1] Author Affiliations: (1) grid.26999.3d, 0000 0001 2151 536X, The University of Tokyo, , 7-3-1 [...]

Purpose: To examine how cognitive speed of processing training affects driving mobility across a 3-year period among older drivers. Design and Methods: Older drivers with poor Useful Field of View (UFOV) test performance (indicating greater risk for subsequent at-fault crashes and mobility declines) were randomly assigned to either a speed of processing training or a social and computer contact control group. Driving mobility of these 2 groups was compared with a group of older adults who did not score poorly on the UFOV test (reference group) across a 3-year period. Results: Older drivers with poor UFOV test scores who did not receive training experienced greater mobility declines as evidenced by decreased driving exposure and space and increased driving difficulty at 3 years. Those at risk for mobility decline who received training did not differ across the 3-year period from older adults in the reference group with regard to driving exposure, space, and most aspects of driving difficulty. Implications: Cognitive speed of processing training can not only improve cognitive performance but also protect against mobility declines among older drivers. Scientifically proven cognitive training regimens have the potential to enhance the everyday lives of older adults. Key Words: Cognitive training, Cognitive interventions, Transfer of training, Prolonging driving, Older drivers

A randomized clinical trial evaluated the efficacy of multisystemic therapy (MST) versus usual community services (UCS) for 48 juvenile sexual offenders at high risk of committing additional serious crimes. Results from multiagent assessment batteries conducted before and after treatment showed that MST was more effective than UCS in improving key family, peer, and academic correlates of juvenile sexual offending and in ameliorating adjustment problems in individual family members. Moreover, results from an 8.9-year follow-up of rearrest and incarceration data (obtained when participants were on average 22.9 years of age) showed that MST participants had lower recidivism rates than did UCS participants for sexual (8% vs. 46%, respectively) and nonsexual (29% vs. 58%, respectively) crimes. In addition, MST participants had 70% fewer arrests for all crimes and spent 80% fewer days confined in detention facilities than did their counterparts who received UCS. The clinical and policy implications of these findings are discussed. Keywords: juvenile sexual offender, multisystemic therapy, MST, cognitive-behavioral therapy, randomized clinical trial

The purpose of this experiment was to conduct a dismantling study of cognitive processing therapy in which the full protocol was compared with its constituent components--cognitive therapy only (CPT-C) and written accounts (WA)--for the treatment of posttraumatic stress disorder (PTSD) and comorbid symptoms. The intent-to-treat (ITT) sample included 150 adult women with PTSD who were randomized into 1 of the 3 conditions. Each condition consisted of 2 hr of therapy per week for 6 weeks; blind assessments were conducted before treatment, 2 weeks following the last session, and 6 months following treatment. Measures of PTSD and depression were collected weekly to examine the course of recovery during treatment as well as before and after treatment. Secondary measures assessed anxiety, anger, shame, guilt, and dysfunctional cognitions. Independent ratings of adherence and competence were also conducted. Analyses with the ITT sample and with study completers indicate that patients in all 3 treatments improved substantially on PTSD and depression, the primary measures, and improved on other indices of adjustment. However, there were significant group differences in symptom reduction during the course of treatment whereby the CPT-C condition reported greater improvement in PTSD than the WA condition. Keywords: cognitive processing therapy, posttraumatic stress disorder, interpersonal violence, cognitive behavioral therapy

Practicing psychologists may question the relevance of cognitive--behavioral treatments for their ethnic minority clients. Many cognitive-behavioral treatments are listed as empirically supported treatments by the Task Force on the Promotion and Dissemination of Psychological Procedures i D. L. Chambless et al., 1998). However, the samples in these effectiveness studies are composed primarily of White European American individuals. There is a paucity of research examining the effectiveness of cognitive behavioral therapy (CBT) for ethnic minority clients. The author reviews the current literature on the use of CBT with ethnic minority clients living in the United States, specifically those of African, Asian, and Hispanic/Latino descent. Twelve studies are reviewed that examined the effectiveness of CBT for ethnic minority participants with a variety of psychological disorders. Recommendations for conducting and evaluating clinical outcome research that includes ethnic minority participants are provided. Keywords: ethnic, CBT. minority, effectiveness. EST

Mindfulness-based cognitive therapy (MBCT) is a recently developed class-based program designed to prevent relapse or recurrence of major depression (Z. V. Segal, J. M. G. Williams, & J. Teasdale, 2002). Although research in this area is in its infancy, MBCT is generally discussed as a promising therapy in terms of clinical effectiveness. The aim of this review was to outline the evidence that contributes to this current viewpoint and to evaluate the strengths and weaknesses of this evidence to inform future research. By systematically searching 6 electronic databases and the reference lists of retrieved articles, the authors identified 4 relevant studies: 2 randomized clinical trials, 1 study based on a subset of 1 of these trials, and 1 nonrandomized trial. The authors evaluated these trials and discussed methodological issues in the context of future research. The current evidence from the randomized trials suggests that, for patients with 3 or more previous depressive episodes, MBCT has an additive benefit to usual care. However, because of the nature of the control groups, these findings cannot be attributed to MBCT-specific effects. Further research is necessary to clarify whether MBCT does have any specific effects. Keywords: mindfulness, mindfulness-based cognitive therapy (MBCT), depression, treatment studies

The purpose of the present paper is to explore the conceptual compatibility between cognitive behaviour therapy (CBT) and the common values of Chinese Culture. In order to address such a question, the distinctive processes attributed to CBT (e.g., teaching of skills, emphasis on homework, cognitive processes, present/future focus), as summarized in the metaanalysis by Blagys and Hilsenroth [(2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychology Review, 22, 671-706], and the core values of Chinese Culture, determined through an integration of The Hofstedc Project, [Hofstede, G.H. (1980). Culture's consequences: International differences in work related values. Beverly Hills: Sage]. The Chinese Value Survey [Chinese Culture Connection (1987). Chinese values and the search for culture-free dimensions of culture. Journal of Cross-Cultural Psychology, 18, 143-164]. The Schwartz Value Survey [Schwartz, S.H. (1994). Cultural dimensions of values: Towards an understanding of national differences. In Kim, U., Trandis, H.C., Katiticibasi, C., Choi, S.C., & Yoon, G. (eds.), Individualism and collectivism: Theory, method and application (pp. 85-119). Thousand Oaks, CA: Sage] were used. A strong degree of compatibility between the two was found and it is argued that rather than developing new indigenized therapies, with some structural changes to the processes of CBT, this therapy can be effective for Chinese clients. It is further proposed that Chinese clients may benefit from challenging their irrational cognitions that are bound up in their strict adherence to social norms. Future recommendations for increasing the compatibility of CBT to Chinese culture are discussed. Keywords: Cognitive behaviour therapy; Chinese; Culture; Values; CBT processes

A multiple baseline across subjects design was used to test the efficacy of cognitive therapy for obsessive-compulsive disorder (OCD). Six people with OCD received 10-18 sessions of weekly, outpatient cognitive therapy. Assessment included both structured interviews and diary data. For three to four of the six patients, stable baseline periods were followed by reductions of symptoms during intervention. Two clients met stringent criteria for Jacobson and Truax's (J. Consulting Clin. Psychol. 59 (1991) 12) recovered status at posttest according to the Yale-Brown Obsessive-Compulsive Scale (Arch. Gen. Psychiatry 46 (1989) 1006). For the group, large pretest-posttest effect sizes were found.

Controlled outcome studies investigating the efficacy of psychological treatments for obsessive-compulsive disorder (OCD) have employed different methods of determining the clinical significance of treatment effects. This makes it difficult to draw conclusions regarding the absolute and relative efficacy of psychological treatments for OCD. To address this issue, standardized Jacobson methodology for defining clinically significant change was applied to recent psychological outcome trials for OCD. The proportion of asymptomatic patients following treatment was also calculated. When recovery is defined by Jacobson methodology, exposure and response prevention (ERP) appears the most effective treatment currently available (50-60% recovered). However, when the asymptomatic criterion is used as the index of outcome, ERP and cognitive therapy have low and equivalent recovery rates (approximately 25%). Keywords: Obsessive-compulsive disorder; Clinical significance; Efficacy

The efficacy of contemporary cognitive therapy for obsessive-compulsive disorder (OCD) has only recently been investigated. The current study compares exposure and response prevention (ERP) and cognitive behavior therapy (CBT) delivered in an individual format. Participants were randomly assigned to the 12 consecutive-week CBT or ERP treatment. Based on 59 treatment completers, there was no significant difference in YBOCS scores between CBT and ERP at post-treatment or at 3-month follow-up. A higher percentage of CBT participants obtained recovered status at post-treatment (67%) and at follow-up (76%), compared to ERP participants (59% and 58%, respectively), but the difference was not significant. Effect sizes (ESs) were used to compare the results of the current study with a previous study conducted at our center that utilized group CBT and ERP treatments, as well as other controlled trials that have compared CBT and ERP. The significance of these results is discussed and a comparison is made with the existing literature. Keywords: Obsessive-compulsive disorder; Cognitive behavioral treatment; Exposure and response prevention

This study assessed whether men and women differed in using associative and dissociative cognitive strategies during athletic performance. Athletes (31 men, M age=23.2 yr., SD=3.9 and 29 women, M age=22.9 yr., SD=4.3) who practiced endurance activities (running, swimming, and cycling) were considered high-level performers because they participated in national or international competition. The athletes were interviewed, and Schomer's 1986 method of measurement was used to evaluate and quantify two cognitive strategies. Most specifically, categories of association concerned the way the athlete paid close attention to bodily signals, and categories of dissociation described how the athlete shunned sensory inputs. Analysis of variance and the t test showed that women tend to be more dissociative than men and men more associative than women. The results suggest that pain perception in these sports may be a function of sex.

Female assault survivors (N = 171) with chronic posttraumatic stress disorder (PTSD) were randomly assigned to prolonged exposure (PE) alone, PE plus cognitive restructuring (PE/CR), or wait-list (WL). Treatment, which consisted of 9-12 sessions, was conducted at an academic treatment center or at a community clinic for rape survivors. Evaluations were conducted before and after therapy and at 3-, 6-, and 12-month follow-ups. Both treatments reduced PTSD and depression in intent-to-treat and completer samples compared with the WL condition; social functioning improved in the completer sample. The addition of CR did not enhance treatment outcome. No site differences were found: Treatment in the hands of counselors with minimal cognitive-behavioral therapy (CBT) experience was as efficacious as that of CBT experts. Treatment gains were maintained at follow-up, although a minority of patients received additional treatment. Keywords: exposure therapy, posttraumatic stress disorder, cognitive restructuring, rape

This study compared the effectiveness of cognitive processing therapy for sexual abuse survivors (CPT-SA) with that of the minimal attention (MA) given to a wait-listed control group. Seventy-one women were randomly assigned to 1 of the 2 groups. Participants were assessed at pretreatment and 3 times during posttreatment: immediately after treatment and at 3-month and 1-year follow-up, using the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (D. Blake et al., 1995), the Beck Depression Inventory (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), the Structured Clinical Interview for the DSM-IV (R. L. Spitzer, J. B. W. Williams, & M. Gibbon, 1995; M. B. First et al., 1995), the Dissociative Experiences Scale-II (E. M. Bernstein & F. W. Putnam, 1986), and the Modified PTSD Symptom Scale (S. A. Falsetti, H. S. Resnick, P. A. Resick, & D. G. Kilpatrick, 1993). Analyses suggested that CPT-SA is more effective for reducing trauma-related symptoms than is MA, and the results were maintained for at least 1 year. Keywords: PTSD, child sexual abuse, cognitive therapy, trauma, treatment

The efficacy of (cognitive) behavioral therapy ([C]BT) for generalized anxiety disorder was investigated and compared with the efficacy of pharmacological therapy using meta-analytic techniques. A total of 65 (C)BT studies and pharmacological studies were included. (C)BT was more effective than control conditions. The results of the comparison between (C)BT and pharmacotherapy varied according to the meta-analytic methods used. Conclusions about differences in efficacy between therapy approaches are limited when all available studies are included owing to a number of factors that influence effect sizes. When only those studies that directly compared both therapies were included in the analysis, there were no significant differences in efficacy. Attrition rates were lower for (C)BT, indicating that it is better tolerated by patients. Keywords: generalized anxiety disorder, cognitive--behavior therapy, drug therapy, meta-analysis

Recent methodological advancements for structural equation modeling were used to test a comprehensive version of the TCU Treatment Model, especially for addressing the hypothesized sequential relationships of early engagement components (participation and therapeutic relationship) and early recovery (psychosocial and behavioral changes) that contribute to retention and posttreatment recovery. Relationships among pretreatment patient motivation, treatment process elements, a cognitive-based treatment strategy, retention, and drug use outcomes were estimated using intake, during treatment, and 1-year followup data for 711 patients in outpatient methadone treatment. Hypothesized sequential elements representing treatment process and patient functioning were supported, and relationships between these components were estimated also as odds ratios as an aid for translating the findings and increasing their clinical usefulness to treatment settings. Keywords: Treatment process; Patient functioning; Engagement; Recovery stages; Motivation: Cognitive-based treatment

The present study sought to explore the relationship between negative cognitions and emotional problems after bereavement, with a group of 329 adults who had suffered the loss of a first degree relative. The following cognitions were assessed: global negative beliefs, cognitions about self-blame, negative cognitions about other people's responses after the loss, and negative cognitions about one's own grief reactions. Results showed that each of these cognitive variables was significantly related to the severity of symptoms of traumatic grief, depression and anxiety, even when background and loss-related variables that were initially found to influence symptom severity, were statistically controlled. When the shared variance between the cognitive variables was controlled, it was found that global negative beliefs about life, the world, and the future, and threatening interpretations of grief reactions each explained a unique proportion of variance in traumatic grief symptom severity. Global negative beliefs about life, the self and the future, and threatening interpretations of grief explained most variance in depression, while negative beliefs about the self and threatening interpretations of grief explained most variance in anxiety. Overall, the findings are in support of cognitive theories of grief, and suggest that effective treatment of problematic grief will need to address negative cognitions. Keywords: Traumatic grief; Negative cognitions; Bereavement', Grief; Cognitive therapy

Cognitive behavior therapy can be effective in treating schoolchildren who have been exposed to violence, according to a study of 126 children. The therapy consisted of 10 weekly sessions of a program specifically designed for inner-city schoolchildren. Each session lasted for one class period and students were excused from their regular class in order to participate.

An increasing amount of literature has profiled the development of cognitive behavioural therapy (CBT) in treating psychotic disorders. In this qualitative study we review this evidence base and describe the [...]

Treating heart attack patients for their depression may be effective but it will not prolong their survival, according to a study of 2,481 patients. Some received usual care and others received cognitive behavior therapy and medication if necessary. This study was done because research has shown that heart attack patients who are depressed have a worse prognosis than other heart attack patients.

Cognitive behavioral therapy and exercise may improve symptoms in some Persian Gulf War veterans, according to a study of 1,092 veterans. Those who participated in cognitive behavioral therapy and exercise programs had high scores on the Veterans Short Form 36-Item Health Survey after one year of treatment. There are few effective treatments for Gulf War syndrome.

This article evaluates the long-term outcome of cognitive-behavioral therapy for bulimia nervosa. The authors, following up on patients after 3 years, maintain 85% of the patients did not have bulimia and 69% of the patients did not have an eating disorder.

Seventy-eight motor vehicle accident survivors with chronic (greater than 6 months) PTSD, or severe subsyndromal PTSD, completed a randomized controlled comparison of cognitive behavioral therapy (CBT), supportive psychotherapy (SUPPORT), or a Wait List control condition with two detailed assessments. Scores on the CAPS showed significantly greater improvement for those in CBT in comparison to the Wait List and to the SUPPORT conditions. The SUPPORT condition in turn was superior (p=0.012) to the Wait List. Categorical diagnostic data showed the same results. An analysis of CAPS scores including drop-outs (n=98) also showed CBT to be superior to Wait List and to SUPPORT with a trend for SUPPORT to be superior to Wait List. The CBT condition led to significantly greater reductions in co-morbid major depression and GAD than the other two conditions. Results held up well at a 3-month follow-up on the two active treatment conditions.

In order to evaluate the effect of frequency of counseling sessions, we studied retention, cocaine use and craving, and psychiatric symptoms of 68 cocaine-dependent outpatients randomly assigned to twice weekly, once weekly, or biweekly sessions in a 12-week treatment program that utilized manual-based, individual cognitive behavioral psychotherapy. All participants were tested and monitored twice a week. Retention was comparable among treatment groups, and improvement was found regardless of counseling frequency. Cocaine use (urine toxicology and self-report), cocaine craving (VAS), and total psychiatric symptoms (SCL-90) decreased by modest but statistically significant (p < 0.05) amounts in all treatment groups. Findings suggest that cognitive behavioral therapy is effective in reducing cocaine use even if a less intensive schedule is used. Keywords: Dose response; Cognitive behavioral therapy; Cocaine abuse; Manual driven psychotherapy

Recent cognitive accounts of psychotic symptoms have suggested that processes involved in the maintenance of emotional disorders may also be implicated in the maintenance of hallucinations and delusions, and particularly emphasise the appraisals of such symptoms as important. Imaginal appraisals have been identified in emotional disorders, and many studies have reported spontaneously occurring images in patients with anxiety disorders. Such images appear to be linked to affect, beliefs and memories. This study examined the occurrence of imagery, using a semi-structured interview, in 35 patients who were experiencing hallucinations and/or delusions and receiving cognitive therapy. The majority of patients (74.3%) reported images, and most of these were recurrent and associated with affect, beliefs and memories. Common themes included images about feared catastrophes associated with paranoia, traumatic memories, and images about the perceived source or content of voices. The theoretical and clinical implications of these findings are discussed and directions for further research considered. Keywords: Imagery; Psychosis; Cognitive therapy