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BackgroundPeople with serious mental illnesses (SMIs) have three-fold higher rates of comorbid insomnia than the general population, which has downstream effects on cognitive, mental, and physical health. Cognitive Behavioral Therapy for Insomnia (CBT-i) is a safe and effective first-line treatment for insomnia, though the therapy's effectiveness relies on completing nightly sleep diaries which can be challenging for some people with SMI and comorbid cognitive deficits. Supportive technologies such as mobile applications and sleep sensors may aid with completing sleep diaries. However, commercially available CBT-i apps are not designed for individuals with cognitive deficits. To aid with this challenge, we have developed an integrated mobile application, named "Sleep Catcher," that will automatically incorporate data from a wearable fitness tracker and a bed sensor to track nightly sleep duration, overnight awakenings, bed-times, and wake-times to generate nightly sleep diaries for CBT-i.MethodsThe application development process will be described-writing algorithms to generating useful data, creating a clinician web portal to oversee patients and the mobile application, and integrating sleep data from device platforms and user input.ResultsThe mobile and web applications were developed using Flutter, IBM Code Engine, and IBM Cloudant database. The mobile application was developed with a user-centered approach and incremental changes informed by a series of beta tests. Special user-interface features were considered to address the challenges of developing a simple and effective mobile application targeting people with SMI.ConclusionThere is strong potential for synergy between engineering and mental health expertise to develop technologies for specific clinical populations. Digital health technologies allow for the development of multi-disciplinary solutions to existing health disparities in vulnerable populations, particularly in people with SMI.

Hoarding disorder (HD) is marked by difficulty discarding possessions. Many refuse treatment or drop out, which may be due to treatment's incorporation of in-home decluttering, which is feared and avoided. Thus, strategies to prepare patients for decluttering/discarding are needed. Imaginal exposure (IE), or imagining one's worst fears about discarding, could be one such strategy. This pilot preliminarily tested a short-duration IE intervention compared with a control intervention. Over 3 days, adults diagnosed with HD (n = 32) were randomly assigned to either write about and imagine their worst fears about discarding (IE condition) or a neutral topic (control writing [CW] condition). The IE condition showed significant improvements in HD symptoms from preintervention to 1-week follow-up, with medium to large effects; however, the CW condition did as well. Comparing change scores between conditions, the IE condition's improvements were not significantly different than the CW condition's. Overall, IE was helpful in improving HD symptoms, but this pilot did not indicate that it was more helpful than CW. This raises important questions about possible demand characteristics, placebo effects, or regression to the mean, and it has implications for the design and methodology of other studies assessing IE's utility.

BACKGROUND: Limited English Proficiency (LEP) Latinxs experience a longer duration of untreated depression and anxiety. LEP Latinxs have difficulty accessing mental healthcare due to insufficient Spanish-speaking behavioral/mental health clinicians to meet demand. These under-resourced healthcare systems are less likely to be the site for the implementation of innovations. Digital interventions can provide an effective option for overcoming these barriers; yet, when digital evidence-based treatments are available, uptake and engagement is often low. This manuscript presents the protocol for the SUPERA (SUpport from PEeRs to expand Access) study which will evaluate the implementation of an evidence-based, Spanish language, digital cognitive-behavioral therapy (dCBT) intervention (i.e., SilverCloud) in safety-net primary care clinics for LEP Latinx patients with depression or anxiety. METHODS: We will conduct an effectiveness-implementation hybrid trial (Type 2) design comparing engagement and clinical outcomes in two modalities of dCBT delivery (peer-supported vs. unsupported). We will also compare provider-level outreach (using a clinic patient registry) versus inreach (traditional provider referral) to compare rates of initiation, completion, and cost. Participants will be 426 LEP Latinx adults ≥18 years of age, PHQ-9 ≥ 10 or GAD-7 ≥ 8, with access to the internet via smartphone, and not currently receiving individual psychotherapy. We will collect baseline, post-intervention (8 weeks), and follow up (3 months) data. CONCLUSION: The long-term goal of this research is to aid in the implementation of digital mental health interventions that can be sustainably implemented in low-resourced settings, while reducing the reliance on professionals, overcoming workforce deficits, and increasing relevance for diverse populations.

BACKGROUND: Substance Use Disorder (SUD) persists as a significant public health challenge worldwide, with an estimated prevalence of approximately 10-15% across the global populace. This condition is characterized by a notably high risk of lapses and relapses, even subsequent to treatment interventions. Mobile health interventions, owing to their widespread accessibility, emerge as a promising approach to diminish the risk of relapse post-treatment and to broaden the scope of care, especially in regions with a scarcity of trained medical professionals. METHOD: This study is designed to assess the effectiveness of mobile interventions in mitigating cravings and preventing lapses among individuals diagnosed with SUD. Employing a two-armed, randomized controlled trial framework, the study will evaluate a self-administered psychological intervention delivered through a mobile application, Nałogometr 2.0. Over a period of three months, participants will engage with intervention modules that primarily incorporate mindfulness techniques and Cognitive Behavioral Therapy (CBT) principles. Ecological Momentary Assessment (EMA) will be utilized to gather longitudinal data on a range of variables that are indicative of craving intensity and the risk of lapse. In addition to this, a monthly-administered battery of questionnaires will be employed to gauge the severity of substance dependence, as well as to measure levels of anxiety, depression, and overall life satisfaction. RESULTS: Results will be submitted for publication in peer-reviewed journals. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/, identifier [NCT05730504].

Internet-Based Cognitive Behavioral Therapy (iCBT) is an innovative modality of cognitive-behavioral intervention that presents a promising therapeutic strategy for individuals diagnosed with binge spectrum eating disorders. This study employed a meta-analysis methodology to assess the clinical effectiveness and acceptability of iCBT. We conducted searches in databases such as PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO, collecting literature that met the inclusion criteria until August 5, 2023. A comprehensive analysis was conducted, encompassing a total of 11 randomized controlled studies that satisfied the predetermined criteria for inclusion. The summary results demonstrated that iCBT could significantly improve the pathological features related to eating in patients with binge spectrum eating disorders and also significantly reduce the frequency of binge episodes. Additionally, iCBT could ameliorate the depressive and anxious emotions of patients with binge spectrum eating disorders and boost their self-esteem. Furthermore, a notable disparity in dropout rates was seen in comparison to the control group. Heterogeneity across studies，limitations of self-assessment scales and potential publication bias. iCBT can effectively assist patients with binge spectrum eating disorders in improving clinical symptoms. However, it is important to use caution when interpreting the findings of this study, as there are limitations pertaining to the quantity and quality of the included studies. • Patients with binge spectrum eating disorders face challenges in accessing standardized treatment. • iCBT markedly ameliorated clinical symptoms associated with binge spectrum eating disorders. • Our meta-analysis illustrates the clinical efficacy and acceptability of iCBT for binge spectrum eating disorders. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other nonpharmacological approaches for decreasing pain interference. Methods: 79participantsengagedintheCCintervention fromtwoacademicmedical rehabilitation clinics with weekly assessments of pain intensity, interference, and medication use. Participant feedback on the intervention was gathered by interview with the care manager (CM) at the last treatment session and/or booster session. Provider feedback was gathered by a confidential survey post intervention. Results: Ninety percent of participants received at least 11 of the target 12 sessions with a care manager (CM), the majority occurring over the phone. Participants endorsed an average of 7 pain locations. All participants received pain education, skills in self-monitoring, goal setting/behavioral activation and relaxation training. Pain interference scores (impact on activity and enjoyment), tracked weekly by the CM, significantly decreased across sessions. 89% of participants received recommendations for CBT skills, 65% received referrals for additional treatments targeting pain interference, and 43% received care coordination. 75% of participants reported 6 or more medications/supplements at both the first and last session, with changes recommended primarily for headache treatment. Feedback from participants and providers was positive. Discussion: TBI Care, a novel patient-centered CC approach, was flexibly delivered, tailored to the needs of those living with TBI and chronic pain, with a high level of participant engagement, and satisfaction among participants and providers. This approach, prioritizing pain self-management strategies and other non-pharmacological approaches, along with optimizing pharmacological treatment, led to significant reductions in self-reported pain interference and intensity during the intervention. Using a CC model in TBI is feasible and successfully improved access to evidence-based treatments for chronic pain as well as outcomes for pain interference and intensity. [ABSTRACT FROM AUTHOR]

Background: The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW). Factors such as the culture of perfectionism, excessive workloads, and stigma against seeking help exacerbate this issue. This umbrella review synthesizes the existing literature on HCW suicide, exploring the prevalence, causes, and potential preventive strategies. Methods: This study conducted a search of the literature from PubMed/Medline, Scopus, Web of Science, Cochrane Library, PsycINFO, and Google Scholar until April 2, 2024. The non-exhaustive search terms used were "doctor suicide," "physician suicide," "medical professional suicide," "suicide in healthcare," "healthcare worker suicide prevention," and "causes of healthcare worker suicide." Hand-searches were also conducted. Of the 487 studies initially identified, a total of 10 systematic reviews/meta-analyses were included. Results: This umbrella review collates findings from 400 primary clinical studies conducted between the years 2004 and 2023. With a focus on mental health factors contributing to suicide in HCW, there are regional and specialty-specific variations in stress prevalence in the populace. Further, anesthesiologists and psychiatrics depicted higher rates of burnout compared to other HCW; causative factors such as seeking perfection and challenging work-life balance were key when assessing suicidal behaviors in these groups. Job demand level was found to correlate directly with suicidal thoughts, specifically among psychiatric ward HCW, where access to drugs and sharp instruments is readily available. In specific contexts, female HCWs showed a standardized mortality ratio (SMR), indicating that the rate of suicide was higher among them as compared to the general female population. Interventions such as cognitive behavioral therapy (CBT) and mindfulness were effective in decreasing depression, psychological distress, and anxiety in several included studies. This umbrella review also identified major obstacles to seeking help, including stigma and the fear of professional consequences. Conclusion: To reduce suicide rates among HCWs, it is the need of the hour to implement evidence-based interventions and create supportive work environments that encourage mutual care for each other's emotional health. Further research is necessary to determine the effectiveness of various measures in preventing suicide among HCW. [ABSTRACT FROM AUTHOR]

Background: An extended group program called Mind and Body (MB), based on body awareness exercises and cognitive behavioral therapy (CBT), was offered to a subgroup of patients who had completed their traditional outpatient multidisciplinary rehabilitation and were motivated for further treatment. Purpose: To explore how patients with multisite musculoskeletal pain experienced participation in the MB program with respect to usefulness, meaningfulness, behavioral changes, and transferability to daily life and work. Method: The study is rooted in the phenomenological tradition. Individual, semi-structured interviews were performed with eight patients aged 29–56 years. The data were analyzed using systematic text condensation. Results: Two main themes emerged: 1) New knowledge provided increased body awareness, new ways of thinking, and acceptance of one's own situation. This theme reflected how new knowledge and MB coping strategies were useful in the process of changing problematic thoughts, increasing body awareness, and facilitating acceptance; and 2) Implementing new habits and strategies in daily life revealed how demanding it was to alter behavior, a process that unfolded over time. Conclusion: A combination of body awareness exercises and cognitive coping strategies was described as helpful in further improving function and coping with pain and stress in daily life and work. [ABSTRACT FROM AUTHOR]

Les Thérapies cognitives et comportementales (TCC) explorent les schémas de pensée en lien avec les troubles psychiques, agissant sur le plan cognitif, comportemental et émotionnel, selon des protocoles structurés et validés. Les représentations culturelles du patient peuvent être questionnées dès l'étape initiale de l'Analyse fonctionnelle (AF), permettant ainsi l'adaptation des modèles TCC en situation transculturelle. L'AF interroge le trouble et son contexte. La Synchronie, selon le modèle SECCA (Cottraux), aborde les cognitions, les émotions et les croyances en lien avec la situation problématique. La Diachronie recueille les données structurales et d'anamnèse en lien avec le trouble. Une modélisation de l'AF peut être proposée en contexte transculturel, prenant en compte la construction sociale et culturelle du symptôme, de la maladie, du trouble, ou de la crise. L'AF, à travers l'adaptation du modèle SECCA et de la grille de lecture diachronique, s'adapte à la situation transculturelle et prend en compte les aspects relatifs à la culture, à l'exil, à la migration, au modèle étiologique, à l'itinéraire thérapeutique, au traitement traditionnel de la maladie, aux représentations du patient et à ses croyances. Elle questionne également la notion de famille et d'affiliations, de transmission, et ce qui relève chez certains patients du « monde invisible ». L'ajustement de l'AF en contexte transculturel interroge les représentations, le système de croyance et l'histoire individuelle et collective dans laquelle s'inscrit le patient. La sensibilisation des cliniciens à la question culturelle en TCC permet de mieux appréhender l'influence de celle-ci dans l'expression clinique des troubles psychiatriques, et leur conceptualisation par les patients, au-delà des stéréotypes et des représentations du thérapeute lui-même. Le modèle théorique de l'AF ainsi conceptualisé prend en compte la subjectivité du patient, mêlant l'approche transculturelle à la méthodologie cognitivo-comportementale et permet ainsi de s'adapter à nos patients du monde et à leurs singularités. Cognitive and Behavioral Therapies (CBT) explore thought patterns related to psychological disorders, acting on the cognitive, behavioral, and emotional levels, according to structured and validated protocols. The patient's cultural representations can be questioned as early as the initial stage of Functional Analysis (FA), enabling CBT models to be adapted to transcultural situations. FA examines the disorder and its context. Synchrony, based on Cottraux's SECCA model, addresses the cognitions, emotions and beliefs associated with the problematic situation. Diachrony collects structural and anamnestic data related to the disorder. A model of FA can be proposed in a transcultural context, taking into account the social and cultural construction of the symptom, illness, disorder or crisis. By adapting the SECCA model and the diachronic reading grid, FA is adjusted to the transcultural situation, considering aspects relating to culture, exile, migration, the etiological model, the therapeutic itinerary, the traditional treatment of the illness, and the patient's representations and beliefs. It also questions the notion of family and affiliations, transmission, and what, for some patients, is the "invisible world". The adjustment of FA in a transcultural context raises questions about representations, belief systems and the individual, and the collective history of the patient. Raising the clinicians' awareness of the cultural issue in CBT helps them to better understand its influence on the clinical expression of psychiatric disorders and their conceptualization by patients, over and above stereotypes and the therapist's own representations. The theoretical model of FA conceptualized in this way takes into account the subjectivity of the patient, combining the transcultural approach with cognitive-behavioral methodology; and thus making it possible to adapt to our global patients and their singularities. [ABSTRACT FROM AUTHOR]

Background: inability to adherence treatment is a general and special health problem in the treatment of elderly people with diabetes. therapies Studies have reported on the effect of cognitive behavioral therapy to improvement adherence to treatment, also, motivational interviewing by empowering effect on this behavior. However, compares the effect these in elderly people with diabetes has been overlooked. Aims: the aim of this study to compare the efficacy of cognitive behavioral therapy & motivational interviewing on adherence to treatment in elderly people with diabetes living in nursing homes and living at home. Methods: Research method was quasi-experimental with pre-test, post- test with control group. The statistical population consist of all elderly diabetics were living at home and living in nursing homes in Tehran in 1400. Sampling method was Convenience Sampling. 75 people were selected and replaced in 5 groups of 15 people (60 people in 4 experimental groups and 15 people in a control group). Research tools include; The Adherence to treatment questionnaire Seyed Fatemi (1970), cognitive behavioral therapy protocols (Younk et al., 2011) and motivational interview by Miller and Rolink (2019). The data were analyzed using the statistical test of Analysis of covariance with repeated measures and Benferroni test. Results: The results showed that the two intervention methods of cognitive behavioral therapy and motivational interview had a significant effect on adherence to treatment scores in the post-test. The effect of the group was different according to the measurement time levels. The experimental intervention led to changes in the experimental group, which was 0.47 of the total changes caused by the experimental procedure (p< 0.01). Considering that the average of the motivational interview group was higher than the cognitive behavioral therapy, then motivational interviewing was more effective in increasing the adherence to treatment of elderly people with diabetes living in nursing homes and living at home. Conclusion: Both cognitive behavioral therapy and motivational interviewing can improve adherence to treatment in nursing home and home-dwelling elderly with diabetes. The mentioned findings can help therapists to choose the type of treatment. [ABSTRACT FROM AUTHOR]

Negative cognitions play a key role in the development and maintenance of depression. To reduce depressive symptoms, most interventions either encourage adolescents to change negative cognitions, theorizing that the presence of negative cognitions underlies depression, or to acknowledge negative cognitions, theorizing that one's reaction to negative cognitions underlies depression. We compared these two therapeutic strategies in a multilevel meta-analysis of the effects of changing versus acknowledging cognitions on adolescent depression. We searched three databases in June 2022 and identified 104 randomized controlled trials (335 effect sizes). The sample comprised 27,978 adolescents (sample mean age 14−18 years) with all levels of depressive symptoms (M age = 15.6 years; 63% female; 65% ethnic majority). The overall effect of interventions on depression was small (d = 0.21, p <.001). We found no evidence that either strategy was superior to the other. Strategies to acknowledge (d = 0.23, p =.016) or change cognitions (d = 0.20, p <.001) both reduced adolescent depression. Our findings suggest, though based on self-reported outcomes, that both strategies are effective in reducing adolescent depression, which allows for flexibility for clinicians and patients. The next step to further understand these strategies is to scrutinize the relative effects of single versus combined approaches to change and acknowledge negative cognitions. [ABSTRACT FROM AUTHOR]

• We compare Meaning Centered Psychotherapy (MCP) to Cognitive Behavioral Therapy (CBT) • This is a randomized controlled trial in a natural setting with cancer survivors. • MCP was more effective than CBT in increasing meaning in life. • MCP and CBT were similarly effective in improving depression. • MCP and CBT were similarly effective in developing posttraumatic growth. Meaning-centered psychotherapy (MCP) has been found to be effective in improving meaning in life and increasing fulfillment in participants with cancer. However, to date, no previous studies have compared MCP with evidence-based treatments such as cognitive behavioral therapy (CBT). The aim of this study was to analyze the differential efficacy of MCP, compared to CBT, in participants with cancer. The study is a randomized controlled trial with 76 participants, n = 41 (MCP) and n = 35 (CBT). At posttreatment, the MCP intervention for cancer survivors was more effective than CBT in increasing the presence of meaning in life, purpose and meaning in life, and life goals. Moreover, our results showed that, at posttreatment and the 6-month follow-up, MCP and CBT were similarly effective in improving depression and developing posttraumatic growth. This study suggests that MCP could be more effective than CBT in improving meaning in life, purpose, and life goals, and equally effective as CBT in improving depression and posttraumatic growth, in cancer survivors. [ABSTRACT FROM AUTHOR]

Objective: The aim of the current meta-analysis was to examine potential differences in posttreatment effect size estimates for gambling frequency (i.e., the number of days gambled) and gambling expenditure (i.e., the amount of money gambled) when using the gambling timeline followback (G-TLFB) versus other self-report assessments. Method: Using an open-access meta-analysis database of studies on cognitive behavioral treatment for gambling disorder, 22 studies representing 2,824 participants were identified for inclusion. Hedges's g effect sizes representing posttreatment differences on gambling frequency and expenditure between cognitive behavioral treatment versus inactive and minimal treatment controls were calculated, and mixed-effect subgroup analyses examined the effect sizes for each outcome between studies using the G-TLFB versus other self-report assessments. Results: Mixed-effect subgroup analyses indicated that the effect size for gambling frequency was significantly lower for studies using the G-TLFB (g = −0.15) than studies using other self-report assessments (g = −0.71). When examining whether the use of the G-TLFB was associated with the posttreatment effect size for gambling frequency in a random-effect metaregression model that controlled for study grant funding status, the use of the G-TLFB was not significantly associated with effect size. The effect size for gambling expenditure was not significantly different between studies using the G-TLFB (g = −0.22) versus studies using other self-report assessments (g = −0.38). Conclusions: The G-TLFB yields more conservative and precise effect size estimates of posttreatment gambling frequency, but not gambling expenditure, than other self-report assessments. Public Health Significance Statement: The current meta-analysis indicated that the effect size estimates of gambling frequency are lower when using the gambling timeline followback assessment compared to other self-report assessments. Resource-intensive assessment methods are necessary to accurately understand the magnitude of differences in posttreatment outcomes between treatment and control. [ABSTRACT FROM AUTHOR]

Avoidant/Restrictive Food Intake Disorder (ARFID) and food neophobia present significant challenges in pediatric healthcare, particularly among children with food allergies (FAs). These eating disorders, characterized by the persistent avoidance or restriction of food, can lead to severe nutritional deficiencies and psychosocial impairments. The presence of FAs further complicates these eating behaviors, as the fear of allergic reactions exacerbates avoidance and restrictive patterns. This comprehensive review synthesizes current knowledge on ARFID and food neophobia, focusing on their definitions, characteristics, and the unique challenges they present in the context of FAs. The review explores the critical role of healthcare professionals, especially nurses, in integrating psychological and clinical care to improve outcomes for affected children. A multidisciplinary approach, including Cognitive Behavioral Therapy (CBT) and Family-Based Therapy (FBT), is emphasized as essential in addressing the complex needs of these patients. The review also highlights the need for standardized treatment protocols and further research on the long-term outcomes of these disorders, aiming to enhance therapeutic strategies and family support systems. Effective management of ARFID and food neophobia in the context of FAs requires a holistic and integrated approach to mitigate the profound impacts on a child's growth, development, and overall well-being. [ABSTRACT FROM AUTHOR]

Purpose of review: There are 4 million breast cancer survivors in the United States, making breast cancer one of the most common health issues affecting women. Given the significant psychosocial impact of breast cancer, the purpose of the present review is to recognize common psychological issues and evidenced based psychological treatments, while reviewing the impact of treatments on quality of life and cancer outcomes. Recent findings: Common psychological concerns include adjustment disorder, depression, and anxiety. and treatments such as cognitive behavioral therapy, mindfulness-based interventions, and meaning centered psychotherapy are effective. Summary: Psychological interventions have been found to decrease distress and improve quality of life among breast cancer patients, while additionally increasing length of disease-free survival and decreasing rates of recurrence and mortality. More research is needed on the impact of psychological interventions on breast cancer outcomes, as well as with diverse populations and telehealth interventions. [ABSTRACT FROM AUTHOR]

This paper compares formal accounts that laboratory members use to describe a digital psychiatry intervention with lab practices as they were observed ethnographically. The intervention uses correlations between wearable data and self-reports of mood to produce behavior change recommendations, which participants then implement with the help of a guide. In formal accounts, the trial is described as the accomplishment of the individual participant who is empowered by data-driven insights. Formal accounts from the lab present this participant as multi-layered. In observation, however, participants do not seem multiple. Instead, the contingencies of living and working environments come to the fore. Observations of open-ended interactions in guidance sessions, which are minimized in formal accounts, are particularly powerful in capturing these contingencies. The critique of representation from philosophical pragmatism shows how the multi-layered participant is similar to the multiple representational meanings entities take on according to theories common in twentieth-century psychiatry, and supports the ethnographic approach as a way out of these paradoxical formulations. The paper, thus, explains the role of otherwise underspecified human labor involved in the trial, while demonstrating ethnography's ability to account for interactions with participants, through which we gain insights into the contingent, emplaced process of implementing the trial. [ABSTRACT FROM AUTHOR]

Improving intimate partner violence interventions requires understanding pathways to change among couples participating in these interventions. This article presents qualitative data from 18 males and 16 females who participated in a combined behavioral economics (contingency management) and cognitive behavioral therapy alcohol and violence reduction intervention trial in Bengaluru, India. Results confirmed several theorized pathways of change, as well as identified further mechanisms through which the intervention supported the change. These included the emotional impacts of incentives, perceived and actual accountability via breathalyzers and family involvement, and enhanced support gained through counseling skills. Findings reveal critical insights into intervention design for future implementation. [ABSTRACT FROM AUTHOR]

Background/Objective: Pain is one of the most common chronic conditions in the US, estimated to affect 20.9% of the population (51.6 million people). We evaluated the Partners Aligned in Transformative Healing (PATH) program at University Medical Center's Comprehensive Pain Program clinic. Feasibility, initial clinical and financial results were assessed to inform payers' support for PATH, an integrative transdisciplinary program within a bundled payment format. Methods: Participants completed a multi-week program including integrative therapies, with empirically validated assessment surveys administered at the beginning and end of the program. Insurance claims data were analyzed 12 months pre- and post-program. Statistical significance of pre-post differences was assessed by paired T-tests with P < 0.05. Results: Between June 2019 and August 2022, 170 individuals enrolled in PATH, 151 (88.8%) completed the program, and 121 participants completed outcome surveys. Participants were predominately White, non-Hispanic (98%), female (76%), with an average age of 49.8. All participant-reported clinical outcomes (PROs) showed statistically significant improvement from baseline to final assessment, and some but not all were clinically significant. PEG subscale of average pain interference, enjoyment of life, and interference with general activity each decreased. The T-scores for the following domains of PROMIS-29 decreased: Pain interference; fatigue; sleep disturbance; anxiety, and depression. The PROMIS-29 domains of overall physical function and social roles and activities mean T-scores increased. Per Member Per Month (PMPM) total cost of care decreased by $462 (18%). Emergency room utilization for all diagnoses decreased by 457 visits/1000 patients (65%), and for pain-related diagnoses by 194 visits/1000 patients (67%) during the observation period. Conclusions: Results suggest that the PATH Program is a feasible and acceptable model that shows initial effectiveness relative to short-term patient-reported clinical outcomes and shows signs of durability in both utilization and financial outcomes at 1 year. The results support continued study including a multi-site RCT. [ABSTRACT FROM AUTHOR]

Background: Chronic pain often clusters in families, where parents and their offspring both experience chronic pain conditions. Young children of parents with irritable bowel syndrome (IBS) represent an at-risk group for the development of abdominal pain, disability, and excess health care visits in later childhood. Parental solicitous responses to children's expressions of discomfort and maternal modeling of their own illness behavior contribute to a greater focus on somatic sensations, leading to illness behaviors in children. This randomized controlled trial will test the effectiveness of an early preventive web-based psychosocial intervention (REACH)[TM] vs. an educational web-based safety comparison condition delivered to parents with IBS to alter parental responses and lead to improved child health and decreased health care costs. Methods: Parents with IBS who have children ages 4–7 years are recruited via community-based approaches (e.g., social media advertisements, school electronic distribution, research networks) and health care providers. The target sample is 460 parents randomized to REACH, a web-based social learning and cognitive behavior therapy (SLCBT) intervention or an educational web-based safety comparison condition (EC). Participants will be assessed at baseline, 6-week (immediate post-intervention), 6-month, 12-month, and 18-month follow-up periods (months post-completion of intervention). The primary outcome is change in parental solicitous/protective behaviors. Secondary outcomes include parent risk and protective factors, child health and symptom outcomes, and health care utilization and cost savings. Discussion: This study adapts a validated, parent-delivered intervention to treat chronic pain in children to a web-based application designed to prevent the development of chronic pain in very young, high-risk children. If successful, this strategy can both prevent adverse sequelae of this condition from developing as well as be widely accessible. Furthermore, the availability of a prevention model for parent training could result in significant short- and long-term health benefits across a broad spectrum of conditions. Trial registration: ClinicalTrials.gov NCT05730491. Registered on February 15, 2023. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to present a novel cognitive-behavioral intervention protocol focused on treating social isolation through telematic interaction, thus overcoming common barriers characteristic of face-to-face interventions. Methods: We examined current literature about face-to-face and telematic psychotherapeutic interventions for the treatment of social isolation in early adulthood. Current evidence is mixed, suggesting the need to develop novel interventions focused on patients' cognitive functioning. Moreover, telematic interventions are promising candidates for overcoming common barriers intrinsic to the condition of social isolation. Results: The present 8-session model inspired by cognitive behavioral theoretical models and cognitive interventions currently present in the literature is thought to help socially isolated adult patients reduce clinical symptoms associated with the condition and lead to a reduction in the avoidance of social situations, leading to an improvement of the quality of life. Conclusion: We presented a telematic psychotherapeutic intervention aimed at helping adult patients suffering from social isolation who are unable to seek help from national health systems and face-to-face interventions, thus overcoming barriers intrinsic to social isolation. The present cognitive-behavioral treatment protocol has been developed in the context of a randomized clinical trial ongoing in Italy, aimed at implementing and testing the feasibility and effectiveness of multimodal digital interventions for treating social isolation. [ABSTRACT FROM AUTHOR]

During the war time dysregulation of negative emotions such as fear, anger, hatred, frustration, sadness, humiliation, and hopelessness can overrule normal societal values, culture, and endanger global peace and security, and mental health in affected societies. Therefore, it is understandable that the range and power of negative emotions may play important roles in consideration of human behavior in any armed conflict. The estimation and assessment of dominant negative emotions during war time are crucial but are challenged by the complexity of emotions' neuro-psycho-physiology. Currently available natural language processing (NLP) tools have comprehensive computational methods to analyze and understand the emotional content of related textual data in war-inflicted societies. Innovative AI-driven technologies incorporating machine learning, neuro-linguistic programming, cloud infrastructure, and novel digital therapeutic tools and applications present an immense potential to enhance mental health care worldwide. This advancement could make mental health services more cost-effective and readily accessible. Due to the inadequate number of psychiatrists and limited psychiatric resources in coping with mental health consequences of war and traumas, new digital therapeutic wearable devices supported by AI tools and means might be promising approach in psychiatry of future. Transformation of negative dominant emotional maps might be undertaken by the simultaneous combination of online cognitive behavioral therapy (CBT) on individual level, as well as usage of emotionally based strategic communications (EBSC) on a public level. The proposed positive emotional transformation by means of CBT and EBSC may provide important leverage in efforts to protect mental health of civil population in war-inflicted societies. AI-based tools that can be applied in design of EBSC stimuli, like Open AI Chat GPT or Google Gemini may have great potential to significantly enhance emotionally based strategic communications by more comprehensive understanding of semantic and linguistic analysis of available text datasets of war-traumatized society. Human in the loop enhanced by Chat GPT and Gemini can aid in design and development of emotionally annotated messages that resonate among targeted population, amplifying the impact of strategic communications in shaping human dominant emotional maps into a more positive by CBT and EBCS. [ABSTRACT FROM AUTHOR]

Background: Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT‐I) among Black and White cancer survivors. Methods: We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT‐I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co‐morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Results: Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT‐I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT‐I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (−3.0 points, 95% CI −5.4 to 0.4, p = 0.02). Conclusion: This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT‐I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT‐I adherence and confirming the effectiveness of acupuncture in Black cancer survivors. [ABSTRACT FROM AUTHOR]

Objective: It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta‐analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy. Methods: In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept‐only meta‐regression, and univariate meta‐regression (for moderator analysis). Results: Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294–0.483, p < 0.001. Additionally, age and delivery format can influence the efficacy of CBT in this patient population. Conclusions: CBT statistically improves the MH and QoL psychosocial parameters in cancer patients with greater efficacy in younger patients. Important clinical and intervention‐related factors, that is, age and delivery, should be considered when oncologists consider CBT as a psychotherapeutic intervention for individuals with cancer. [ABSTRACT FROM AUTHOR]

Introduction: Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan. Methods: Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes. Results: At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved. Conclusion: Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions Cognitive Behavioral Therapy (CBT) for youth with Disorders of Gut‐Brain Interaction (DGBIs) is effective; however, there are calls in the field to strengthen the evidence base and identify specific mechanisms of treatment that yield the most benefit for this patient population. A unique, systematic treatment approach of CBT with initial evidence for success for pediatric patients with DGBIs was evaluated to further demonstrate its clinical utility in this population.This was a retrospective study of 42 pediatric patients aged 11–17 years with DGBIs, who were diagnosed and referred for CBT by pediatric gastroenterology providers. Providers also completed a survey rating acceptability and effectiveness of CBT. The systematic CBT approach included 10 sessions delivered by a psychologist at an integrated Pediatric GI Clinic.Review of 42 pediatric charts showed significant decreases in self‐reported functional disability, abdominal pain, as well as depression and anxiety symptoms pre‐ to post‐CBT completion. A moderation effect was observed where patients reporting higher levels of depressive symptoms and primary symptom of abdominal pain reported smaller reductions in functional impairment compared to those with lower levels of depression and primary symptom of nausea or vomiting. Pediatric Gastroenterology providers were satisfied with this psychological treatment approach.This study provides evidence for acceptability and effectiveness of implementation of a systematic CBT approach for pediatric DGBIs in an integrated GI clinic, as well as areas worthy of future research, including identifying the most important mechanisms of treatment and factors that influence treatment response. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine whether individuals with chronic tinnitus report more positive experiences following internet-based cognitive behavioral therapy (CBT). Methods: A mixed-methods design was used, nested in clinical trials evaluating internet interventions for tinnitus. Participants (n = 164) completed online questionnaires (both structured and open-ended) providing demographic information as well as health variables (e.g., tinnitus distress, anxiety, depression, insomnia). An open-ended question listing positive effects or outcomes related to having tinnitus was also included. Responses to the open-ended questions were analyzed using qualitative content analysis. Results: Of the 164 eligible participants, 32.3% (n = 53) provided at least 1 positive experience both at pre- and post-intervention, with 9.1% (n = 19) providing positive experiences only at pre-intervention, 49 (29.9%) providing positive experiences only at post-intervention, and 28.7% (n = 47) of the participants did not provide any positive experiences on either measurement occasion. Significantly more positive experiences were reported following the intervention in the overall sample (p < 0.0001, paired sample t-test). In addition, participants who reported positive experiences in both pre- and post-intervention also reported more positive experiences following intervention (p = 0.008, paired sample t-test). Conclusions: Internet-based CBT can help individuals with tinnitus to think more positively by changing unhelpful thought patterns. Open-ended questions can supplement structured questionnaires to measure treatment outcomes. [ABSTRACT FROM AUTHOR]

This study examined the preliminary feasibility, acceptability, and efficacy of an autism-adapted cognitive behavioral therapy for depression in autistic youth, CBT-DAY. Twenty-four autistic youth (11–17 years old) participated in the pilot non-randomized trial including 5 cisgender females, 14 cisgender males, and 5 non-binary youth. Youth participated in 12 weeks of, CBT-DAY and youth depressive symptoms (i.e., primary clinical outcome) and emotional reactivity and self-esteem (i.e., intervention mechanisms) were assessed through self-report and caregiver report at four timepoints: baseline (week 0), midpoint (week 6), post-treatment (week 12), and follow-up (week 24). Results suggested that CBT-DAY may be feasible (16.67% attrition) in an outpatient setting and acceptable to adolescents and their caregivers. Bayesian linear mixed-effects models showed that CBT-DAY may be efficacious in targeting emotional reactivity [βT1-T3 = −2.53, CrI95% (−4.62, −0.58), P d = 0.995, d = −0.35] and self-esteem [βT1-T3 = −3.57, CrI95% (−5.17, −2.00), P d > 0.999, d = −0.47], as well as youth depressive symptom severity [β = −2.72, CrI95% (−3.85, −1.63), P d > 0.999]. Treatment gains were maintained at follow-up. A cognitive behavioral group therapy designed for and with autistic people demonstrates promise in targeting emotional reactivity and self-esteem to improve depressive symptom severity in youth. Findings can be leveraged to implement larger, more controlled trials of CBT-DAY. The trial was registered at Clinicaltrials.gov (Identifier: NCT05430022; https://beta.clinicaltrials.gov/study/NCT05430022). Depression in youth is a significant public health problem worldwide, particularly for autistic youth who are over twice as likely to experience depression than their non-autistic peers. Although pathways to depression are complex, emotional reactivity and negative self-esteem are two risk factors for depression in autistic and non-autistic youth. Although autistic youth are more likely to experience depression than their non-autistic peers, psychotherapy options for autistic youth are very limited; community guidance in the development and testing of psychotherapy programs is a promising approach in autism. Therefore, in this study, we designed an autism-adapted CBT-DAY, in collaboration with autistic community members. Specifically, CBT-DAY combined neurodiversity-affirming and cognitive behavioral approaches to target emotional reactivity and self-esteem in youth to improve depressive symptom severity in a group setting across 12 weeks. We examined the preliminary feasibility, acceptability, and efficacy of CBT-DAY in a pilot non-randomized trial. In addition, we implemented a rigorous protocol for assessing, monitoring, and addressing potential harms in this intervention. Results from 24 autistic youth (11–17 years old) suggest that CBT-DAY may be feasible to use in an outpatient clinical setting and generally acceptable to youth and their caregivers. Participation in CBT-DAY may be associated with significant improvements in youth emotional reactivity and self-esteem, as well as depressive symptom severity per self-report only. Exploratory analyses showed that participation in CBT-DAY may also be associated with significant improvements in internalizing symptoms. Findings demonstrate the potential promise of neurodiversity-affirming and cognitive behavioral approaches to treating depressive symptoms in some autistic youth. [ABSTRACT FROM AUTHOR]

Relationship obsessive compulsive disorder (ROCD) is a disabling presentation of obsessive compulsive disorder (OCD) that has recently received increased research attention. ROCD refers to obsessive preoccupation, doubts, and compulsive behaviors focusing on one's relationship and relationship partner's qualities and attributes). In this paper, we present ROCD through a case study, describe its phenomenology and evaluate the impact of ROCD symptoms on sexual functioning. We then describe processes that may underlie dysfunctional sexual behavior in ROCD drawing on cognitive-behavioral models of ROCD and contemporary theories of sexual response. Conceptual links between ROCD and related constructs to various propensities of sexual behavior are discussed and treatment suggestions are outlined. This paper describes the phenomenon of relationship obsessive compulsive disorder (ROCD), via a case description that presents the reader with the possible effect of ROCD on sexual functioning. We them suggest possible cognitive-behavioral mechanisms that might explain the association between ROCD and sexual dysfunction, and finally, outline several treatment implications. [ABSTRACT FROM AUTHOR]

Graduate students frequently experience anxiety, depression, and psychological distress. Counseling centers struggle to meet this need. Brief, skills-based treatments to mitigate burgeoning or mild mental health problems could alleviate this problem. Participants were 51 graduate students in years one through seven of their respective programs. We examined a single-session virtual cognitive behavioral workshop and outcomes up to 6-months later. The program was feasible, acceptable, and beneficial for mood, anxiety, and emotion regulation, even during the COVID-19 pandemic. A majority of participants reported ongoing skills use at follow-up. Primary barriers to more frequent use were forgetting, time constraints, and difficulty when experiencing strong emotions. Few participants endorsed expecting that skills would not be helpful or forgetting how to use skills. This intervention may provide scalable, much needed aid to graduate schools. Moreover, results highlight opportunities for further enhancing brief interventions. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of cognitive behavioral therapy and acceptance and commitment therapy in the posttraumatic growth has always attracted researchers' attention and considering the importance of using these two methods in the context of Iran, it is important to identify a more efficient treatment to reduce posttraumatic growth. Aims: This study was conducted to compare the effectiveness of cognitive-behavioral therapy using Mowlana's parables and anecdotes and acceptance and commitment therapy in distress tolerance and posttraumatic growth in mothers of children with cerebral palsy. Methods: This applied study was conducted using a quasi-experimental method with a pretestposttest design and a control group. The statistical society included all mothers having children with cerebral palsy visiting the Rehabilitation Center of Nourafshar Cerebral Palsy Hospital and the Rehabilitation Center of Workers in Zafaranieh, Tehran, in 2022. Participants were 48 mothers who were selected using convenience sampling considering inclusion and exclusion criteria and were allocated to two intervention groups and a control group using random replacement. The participants filled the Posttraumatic Growth Inventory (developed by Tedeschi & Calhoun, 1996) in the pretestposttest and follow-up phases. Data were analyzed using the the repeated measures ANOVA in SPSS 23. Results: Results suggested that the cognitive-behavioral therapy using Mowlana's parables and anecdotes as well as the acceptance and commitment therapy proved effective in improving posttraumatic growth and its subscales in participants in the post-test and follow-up phases (p< 0.01). On the other hand, the cognitive-behavioral therapy using Mowlana's parables and anecdotes was more effective compared to the acceptance and commitment therapy in increasing posttraumatic growth(p< 0.05). Conclusion: Results suggest that the content of cognitive behavioral therapy based on Mowlana's works is more effective in promoting posttraumatic growth due to its proximity to the psychological status of mothers of children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Investigate whether aiding sleep by online cognitive behavioral therapy for insomnia (CBT-I) can improve glycemic and metabolic control, mood, quality of life (QoL) and insomnia symptoms in people with type 2 diabetes and assess the mediating role of lifestyle factors. Adults with type 2 diabetes and insomnia symptoms were randomly assigned to CBT-I or care as usual. At baseline, three and six months we assessed HbA1c as primary outcome and glycemic control, metabolic outcomes, sleep, mood and QoL as secondary outcomes. Mixed models were used to determine within-person and between-persons differences in outcomes and mediation analysis for lifestyle factors. We randomized 29 participants to CBT-I and 28 to care as usual. Intention-to-treat analysis showed no significant differences in glycemic control, metabolic outcomes, anger, distress or QoL, but showed a significantly larger decrease in insomnia (−1.37(2.65: 0.09)) and depressive symptoms (−0.92(-1.77: 0.06)) and increase in BMI (0.29 kg/m2(0.00:0.57)) in the intervention compared to the control group. Only half of the intervention participants completed the CBT-I. Per protocol analysis showed a not statistically significant decrease in HbA1c (−2.10 mmol/l(-4.83:0.63)) and glucose (−0.39 mmol/l(-1.19:0.42)), metabolic outcomes and increase in QoL. Furthermore, the intervention group showed a significant decrease in insomnia (−2.22(-3.65: 0.78)) and depressive symptoms (−1.18(-2.17: 0.19)) compared to the control group. Lifestyle factors partially mediated the effect of the intervention. CBT-I might improve insomnia symptoms and mood, and perhaps improves glycemic control, albeit not significant, in people with type 2 diabetes and insomnia symptoms, compared to care as usual. • Insomnia symptoms are highly prevalent in people with type 2 diabetes. • Can we improve glycemic status by improving sleep through CBT-I? • CBT-I improves insomnia symptoms and mood, and might improve glycemic control and QoL. • Lifestyle factors partially mediated the effect of CBT-I. [ABSTRACT FROM AUTHOR]

Aims: Altered brain functional connectivity has been proposed as the neurobiological underpinnings of attention‐deficit/hyperactivity disorder (ADHD), and the default mode interference hypothesis is one of the most popular neuropsychological models. Here, we explored whether this hypothesis is supported in adults with ADHD and the association with high‐risk genetic variants and treatment outcomes. Methods: Voxel‐based whole‐brain connectome analysis was conducted on resting‐state functional MRI data from 84 adults with ADHD and 89 healthy controls to identify functional connectivity substrates corresponding to ADHD‐related alterations. The candidate genetic variants and 12‐week cognitive behavioral therapy data were leveraged from the same population to assess these associations. Results: We detected breakdowns of functional connectivity in the precuneus and left middle temporal gyrus in adults with ADHD, with exact contributions from decreased connectivity within the default mode, dorsal and ventral attention networks, as well as increased connectivity among them with the middle temporal gyrus serving as a crucial 'bridge'. Additionally, significant associations between the altered functional connectivity and genetic variants in both MAOA and MAOB were detected. Treatment restored brain function, with the amelioration of connectivity of the middle temporal gyrus, accompanied by improvements in ADHD core symptoms. Conclusions: These findings support the interference of default mode on attention in adults with ADHD and its association with genetic risk variants and clinical management, providing insights into the underlying pathogenesis of ADHD and potential biomarkers for treatment evaluation. [ABSTRACT FROM AUTHOR]

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• Cognitive Behavioral Therapy (CBT) can address concerns of caregivers of children with cancer. • Manualized treatments for caregivers have used cognitive and behavioral techniques. • CBT with caregivers requires flexibility. • Identifying where CBT can help is a task of the therapist. Caregivers of children with cancer face a myriad of stressors related to caring for their child that can place them at risk for mental health concerns above and beyond that of the average adult. Additionally, they grapple with the existential distress caused by the possibility that they may outlive their child. Caregiver distress is not only problematic for their own emotional, spiritual, social, and physical well-being, but also affects the family unit and can interfere with aspects of the child's treatment. Clinicians trained in cognitive behavioral therapy (CBT) are well suited to support caregivers. Moreover, there is a strong evidence base for using interventions that incorporate cognitive and behavioral approaches with caregivers of children with cancer. We describe CBT's application to this population through several case examples and also highlight important special considerations. [ABSTRACT FROM AUTHOR]

• Youth with Type 1 Diabetes are at greater risk of psychological comorbidity. • Fear of hypoglycemia impacts diabetes self-management. • Cognitive behavioral therapy improves psychosocial functioning. • A course of modular cognitive behavioral therapy is demonstrated. Youth diagnosed with Type 1 Diabetes are at higher risk for psychological comorbidities such as anxiety and depression than the general population. Disease-related psychological distress including fear of hypoglycemia contributes to poor adherence to youths' medical regimes and glycemic control. Poorly managed Type 1 Diabetes often leads to adverse health outcomes such as ketoacidosis, vision impairment, and sometimes death. Cognitive-behavioral therapy is a promising method to improve health outcomes and psychological functioning in youth with Type 1 Diabetes. Accordingly, this article offers a brief overview of Type 1 Diabetes as well as examining the role of fear of hypoglycemia and disease-related anxieties in pediatric patients. Additionally, various obstacles to medical adherence and the impact of family conflict are discussed. The clinical sequelae of Type 1 Diabetes in diverse populations and the research supporting cognitive behavioral therapy are delineated. Next, the case description illustrates the challenges for youth with Type 1 Diabetes and their families. This bench-to-bedside translation presents evidence of clinically meaningful improvements from implementing CBT with a Latino male child. Psychoeducation, relaxation training, cognitive restructuring, and behavioral experiments were deployed. Last, additional considerations for treatment were presented. [ABSTRACT FROM AUTHOR]

• Culturally adapted CBT has been shown to have favorable outcomes. • Cultural factors influence clinical factors as well as management. • The case of a young female from Pakistan is discussed with cultural challenges. • Factors relating to ethnicity, class, religion and gender are addressed. • Cognitive restructuring, Socratic questioning, mentalisation were adapted culturally. Cognitive Behavioral Therapy (CBT) is used widely throughout the world in diverse populations for successful treatment of a wide range of psychiatric and comorbid conditions. Over the years clinicians have been making efforts to culturally adapt CBT to various groups. This paper discusses the assessment and treatment of a young female from Pakistan with depression and anxiety with comorbid headache. After ruling out all organic causes, the treatment continued over 20 sessions with the initial phase consisting of introduction to CBT, risk assessment, and identification of treatment goals. Following this, the patient was helped in identifying automatic thoughts, feelings, and behaviors. Finally, tools such as thought substitutions, reappraisals, and positive diversions were used effectively to decrease automatic negative thoughts. A focus on the patient's religio-cultural identity was maintained throughout. Understanding of contextual factors like religio-cultural values and family dynamics helped to bring about favorable therapy outcomes. A case conceptualization that cohesively addressed factors relating to ethnicity, class, and gender yielded a positive result in our case. Involvement of the family and psychoeducation regarding neurobiological causes also proved to be helpful. Such an approach can facilitate a culturally responsive application of CBT in Pakistani youth experiencing comorbid medical and psychiatric disorders. [ABSTRACT FROM AUTHOR]

• Access to mental health providers alone does not sufficiently address the mental health crisis. • Standardized practices for hiring and training therapists are key. • Consistent application of effective mental health treatments contributes to better outcomes. • Financial viability in a fee for service integrated behavioral health model is possible. Integrated behavioral health (IBH) in primary care is growing as an approach to decrease barriers and provide earlier intervention for youth experiencing behavioral and mental health symptoms. However, increasing access to mental health providers alone without ensuring evidence-based treatment (EBT) is provided will not sufficiently address the current mental health crisis. To spread to scale, IBH needs to be implemented and tested in community-based practices with integrity to EBT. This paper provides a model for implementing cognitive behavioral therapy (CBT) in community pediatric primary care via master's prepared therapists through an academic-community partnership. This paper describes the hiring practices, training in CBT, ongoing supervision and consultation, and use of data to inform the evolution of the model. Using a retrospective review of the rate of emergency department (ED) admissions per 1,000 patients with a diagnosis of depression, we compared practices enrolled in our academic-community partnership IBH model to practices who implemented their own IBH and practices with no IBH. Across a four-year period, we found that practices enrolled in the academic-community partnership IBH model had a lower number of patients per 1,000 patients with a diagnosis of depression admitted to the ED with behavioral health concerns compared to practices that did not incorporate an IBH therapist. There was no difference in ED admission rates per 1,000 between practices that hired their own IBH and those without IBH. Analysis of costs of the program against generated revenue from billed services demonstrated that the academic-community partnership model shows promise of sustainability. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Therapy on relational obsessive-compulsive disorder and fear of intimacy in female students. Methods and Materials: This research was an applied study and utilized a quasiexperimental design with pre-test and post-test assessments, including two experimental groups and one control group, with a follow-up period of two months. The statistical population comprised all female students who visited a private counseling center in Tehran in 2023. Using convenience sampling, 30 participants were selected and randomly assigned to two experimental groups and one control group. Data collection tools included the Fear of Intimacy Scale (Descutner & Thelen, 1991) and the Relationship Obsessive-Compulsive Disorder Questionnaire (Doron et al., 2012). For statistical analysis, SPSS-26 software was employed, utilizing repeated measures ANOVA and Bonferroni post-hoc test. Findings: The findings indicated a significant difference between pre-test and posttest scores for both approaches in reducing fear of intimacy and relational obsessivecompulsive disorder (p < .01), demonstrating the significant effectiveness of these two therapeutic methods. Furthermore, no significant difference was observed between post-test and follow-up scores (p > .05). Analysis using the Bonferroni test revealed that there was no significant difference in the effectiveness between the two therapies on problem-solving components (p > .05). Conclusion: Based on the current findings, it can be concluded that both Cognitive Behavioral Therapy and Mindfulness-Based Therapy can be utilized to reduce fear of intimacy and relational obsessive-compulsive disorder in female students, with no significant difference in their effectiveness. [ABSTRACT FROM AUTHOR]

Background: Cognitive behavioural therapy for insomnia (CBT-I) is recommended as the first-line treatment for insomnia yet remains underutilised in general practice. Understanding patient motivations and barriers to engaging in psychological interventions for insomnia is critical. Theoretical frameworks, such as the theory of planned behaviour, are needed to identify variables related to intentions and behaviour change. Aim: To explore key influences that motivate individuals' intention to engage with psychological interventions for insomnia. Design and setting: Qualitative study consisting of an online survey and interviews with 20 community-dwelling participants with insomnia aged 26–75 years residing in Victoria, Australia. Method: Guided by the theory of planned behaviour, reflexive thematic analysis was used to identify factors influencing participants' intention to engage with psychological interventions for insomnia. Results: Participants reported positive attitudes towards psychological interventions for insomnia, stemming from negative beliefs about pharmacological sleep aids and the perceived benefits of a structured and evidence-based intervention. Important others positively influenced participants' intention to engage; however, the GP influence was less consistent and often indirect. Participants believed in the efficacy of psychological interventions, but several barriers hampered their ability to benefit from them. Accessibility was identified as a key facilitator, whereas lack of knowledge and clear referral pathways were the main barriers having an impact on uptake. Conclusion: This study highlights key factors influencing patients' intention to engage in psychological interventions for insomnia as well as opportunities for GPs to support uptake and engagement. Routine conversations about sleep health are essential to reduce the burden of untreated insomnia in the community, and the active promotion of evidence-based psychological interventions is needed. [ABSTRACT FROM AUTHOR]