Comparing the effectiveness of process-experiential with cognitive-behavioral psychotherapy in the treatment of depression.

This study compared process-experiential and cognitive-behavioral psychotherapy in the treatment of major depression in a researcher allegiance-balanced randomized clinical trial. Sixty-six clients participated in weekly sessions of psychotherapy for 16 weeks. Clients' level of depression, self-esteem, general symptom distress, and dysfunctional attitudes significantly improved in both therapy groups. Clients in both groups showed significantly lower levels of reactive and suppressive coping strategies and higher reflective coping at the end of treatment. Although outcomes were generally equivalent for the 2 treatments, there was a significantly greater decrease in clients' self-reports of their interpersonal problems in process-experiential than cognitive-behavioral therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cognitive-behavioral relationship record.

The Cognitive-Behavioral Relationship Record is a technique designed to help individual psychotherapy clients make sense of chronic relationship problems and to encourage them to experiment with new behavioral solutions. In this paper, the reader is given step-by-step instructions on how to use the Relationship Record accompanied by case illustrations. By conceptualizing relationships in terms of the interplay between two individuals’ cognitions and behaviors, the Relationship Record gives therapists a new tool to address the circular causality in relationship systems. In addition to its usefulness as a therapeutic technique, it may be seen as a step toward the integration of family systems into cognitive–behavioral therapy, or, more specifically, the assimilation of strategic therapy techniques and concepts into Aaron T. Beck’s school of cognitive therapy. The Relationship Record joins a movement in psychotherapy integration to enhance individual-based therapies by assimilating interpersonal approaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled trial of cognitive-behavioral therapy, light therapy, and their combination for seasonal affective disorder.

This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive-behavioral therapy (CBT), light therapy (LT), and their combination to a concurrent wait-list control. Adults (N = 61) with major depression, recurrent with seasonal pattern, were randomized to one of four 6-week conditions: CBT (1.5-hr twice-weekly group therapy), LT (10,000-lux for 90-min/day with administration time individually adjusted), combined CBT + LT, or a minimal contact/delayed LT control (MCDT; LT following 6 weeks of monitoring). CBT, LT, and CBT + LT significantly and comparably improved depression severity relative to MCDT in intent-to-treat and completer samples. CBT + LT (73%) had a significantly higher remission rate than MCDT (20%). Using prospectively measured summer mood status to estimate the "functional" population, CBT + LT also had a significantly larger proportion of participants with clinically significant change over treatment compared with MCDT. The LT condition outcomes virtually replicated results from prior trials. CBT, alone or combined with LT, holds promise as an efficacious SAD treatment and warrants further study. If replicated, CBT + LT's remission rate would represent a clinically meaningful improvement over the 53% observed across LT studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial.

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater reductions in depressive symptoms than did supportive-expressive, bibliotherapy, and assessment-only participants at posttest, though only the difference compared with assessment controls was significant at 6-month follow-up. CB participants showed significantly greater improvements in social adjustment and reductions in substance use at posttest and 6-month follow-up than did participants in all 3 other conditions. Supportive-expressive and bibliotherapy participants showed greater reductions in depressive symptoms than did assessment-only controls at certain follow-up assessments but produced no effects for social adjustment and substance use. CB, supportive-expressive, and bibliotherapy participants showed a significantly lower risk for major depression onset over the 6-month follow-up than did assessment-only controls. The evidence that this brief CB intervention reduced risk for future depression onset and outperformed alternative interventions for certain ecologically important outcomes suggests that this intervention may have clinical utility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

认知行为综合干预对慢阻肺患者负性情绪的影响

目的探讨认知行为综合干预对慢性阻塞性肺疾病患者负性情绪的影响效果。方法对2008年1～8月在本院治疗的84例COPD患者,根据就诊时间编号,分观察组和对照组,2组患者均按医嘱予以治疗,并给予一般的COPD知识宣教。对观察组选择治疗时与患者及家属进行有效沟通,并采取认知行为综合干预。结果1年后,病人各观察项目经统计学处理,研究组各观察因子明显优于对照组,其中病人生活质量、症状自评量表各因子、药物治疗依从性等因数,除生理功能外,皆有显著意义(P<0.05)。2组患者戒烟情况,研究组为90.5%,对照组为36.4%。结论认知行为综合干预有效控制COPD病人病情进展,减少患者负性情绪,提高COPD患者治疗依从性和生活质量。     

An evolved cognitive–behavioral view of the case of David.

A cognitive–behavioral conceptualization of depression is presented, identifying distorted perceptions, ineffective actions, and/or an unresponsive environment as possible causative factors. Acknowledging that information about a patient’s early history can inform the cognitive–behavior therapist about possible areas of vulnerability that are triggered by current life events, a transtheoretical case formulation model is presented and illustrated for the case of David. The case formulation highlights the intrapersonal and interpersonal issues that should be the focus of the therapeutic intervention, and an integrated cognitive–behavioral intervention that follows from this formulation is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of generalized anxiety disorder in older adults.

Older adults with generalized anxiety disorder (GAD; N=75; M age=67.1 years) were randomly assigned to cognitive-behavioral therapy (CBT), a discussion group (DG) organized around worry provoking topics, or a waiting period. Participants in both active conditions improved relative to the waiting list. Although CBT participants improved on more measures than DG participants, the authors found only 1 significant difference immediately after treatment and no differences at 6-month follow-up. Effect sizes were smaller than in younger samples, but CBT showed large effects and DG showed medium-sized effects. Overall, results indicate that brief treatment of late-life GAD is beneficial, but they provide only limited support for the superiority of CBT to a credible comparison intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Generalized anxiety disorder: From science to practice.

Reviews the book, Generalized anxiety disorder: From science to practice by Michel J. Dugas and Melisa Robichaud (2006). The reviewers commend the authors for providing a comprehensive overview of GAD. Chapters include information on diagnosis, assessment techniques and treatment modules. Dugas and Robichaud refer to their treatment as primarily cognitive and emphasize the difference between their approach and other cognitive and cognitive-behavioural treatments for GAD. The treatment presented does not employ relaxation training or other strategies to reduce physical tension and overarousal. Rather, this treatment makes use of specific cognitive interventions with the understanding that physical and affective symptoms will decrease with corresponding reductions in excessive worry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Process and treatment adherence factors in group cognitive-behavioral therapy for partner violent men.

This study used multilevel modeling to examine process and treatment adherence factors as predictors of collateral partner reports of abuse following participation in a cognitive-behavioral group treatment program for partner violent men (N = 107). Therapist working alliance ratings predicted lower levels of physical and psychological abuse at the 6-month follow-up and were the strongest predictors of outcome. Homework compliance partially mediated associations between early alliance ratings and psychological abuse at follow-up. Greater group cohesion during treatment, assessed by client report, also predicted lower physical and psychological abuse at follow-up. The findings support the promotion of a collaborative therapeutic environment to induce change among partner violent men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)